NOTE: For National Minority Health Month, NIMHD Insights Blog is sharing this timely op-ed that was printed with permission from the Houston Chronicle from former and founding Director of NIH’s National Institute of Biomedical Imaging and Bioengineering, Dr. Roderic I. Pettigrew.
By Roderic I. Pettigrew, Ph.D., M.D.
CEO of Engineering Health
Executive Dean of Engineering Medicine
Texas A&M University and Houston Methodist Hospital
Former and Founding Director, National Institute of Biomedical Imaging and Bioengineering
When it was first announced that a COVID-19 vaccine was authorized for emergency use by the Federal Drug Administration in the United States, the scientific community was finally able to exhale. As a Black physician and member of the scientific community, I was particularly encouraged because of the disproportionately higher rates of hospitalizations and deaths from COVID-19 among the Hispanic, Black, and Indigenous American populations.
My relief, however, was short-lived. We continue to see troubling inequities with new reports showing that many people from the minority community are among the lowest currently receiving the new vaccines, and the highest to be hesitant about its safety and effectiveness. According to Pew Research Center1, just 42 percent of Black adults are inclined to get vaccinated, compared to 63 percent of white adults and 83 percent of adult Asian Americans.
The hesitation to get vaccinated is certainly understandable. Minorities have for centuries experienced egregious experimentation without consent.2 From J. Marion Sims, who used enslaved Black women as test subjects, to the federally sponsored and secretive Tuskegee study where treatment for syphilis was intentionally withheld, and the more recent unconsented use of tissue and cells taken from Henrietta Lacks while a cancer patient, Black America’s relationship to science and research has been in multiple instances exploitative and inhumane.
But this vaccine is not another Tuskegee. Looking at the preliminary data on who is getting vaccinated tells us that. News reports3 to date indicate that those who are majority persons and wealthy, including some from outside of the U.S., are quite active in pursuing vaccinations in America. National results show that Black people were inoculated at levels far below their share of the population. At the end of January, composite data4 shows that less than 5 percent of the vaccinations had been administered to Black people.
There is no doubt that the lack of equity in access is also playing a role in such low vaccination numbers. Currently, Black residents are significantly more likely than whites to live more than a mile from the closest vaccination facility5. Online portals and phone applications have been popular tools deployed across states to schedule vaccinations. But this leaves those who fall into “digital divides” and “app gaps” behind.
However, these challenges should not be compounded with fear. Some say that they want to wait and see if anything adverse happens to others who were vaccinated. This is a reasonable initial thought, but it should be weighed against the science, the demonstrated use and the clear risks. The science, conducted in tens of thousands of people of multiple ethnicities in multiple countries, shows a strong safety profile. Moreover, unlike the Tuskegee experiments, those advocating, conducting, and overseeing the vaccination studies are among the first in line to take the COVID-19 vaccine themselves. In Tuskegee, known curative treatment was withheld from Black patients. Now the effort is to deliver preventative vaccines. White Americans are getting these at disproportionate rates while underrepresented people are disproportionately bearing the brunt of the COVID-19 illnesses.
I chose to get the vaccine because I know and trust this science. At the same time, I recognize the logical concerns about the safety of the vaccine in a process that was indeed accelerated. While this vaccine was created unusually fast, the speed is the result of technological innovations that have actually been in development for two decades, supported by the National Institutes of Health and the Defense Advanced Research Projects Agency. In addition, there has been new federal economic support for more COVID-19 focused development and manufacturing processes in parallel. Now, as the country passes more than half a million dead, we have a means to stop this death toll.
Indeed, people of color have the most to lose in the fight against this virus, and therefore, the most to gain by getting vaccinated. Now we can take advantage of the very best that modern medical science has to offer. The weight of the evidence is overwhelmingly clear for all people. Everyone eligible should get the vaccine when it is available for you to do so.
To improve equity in access to the vaccine, leaders in government and all sectors of industry must work to reach our most vulnerable groups where they are located. This is working now in the extremes of Alaska, which leads the nation in vaccination rates6 despite much of the Native population being in remote and isolated communities. For underserved populations nationally, this means direct communication, not phone apps. It means purposeful targeting and collaborations with community churches, barber shops, Federally Qualified Health Centers, and community health centers. It means vaccination hubs and providers placed in the underserved areas of Houston. It means equipping the most trusted figures in minority communities with the best information to counter the myths. And it means closely monitoring vaccination assignment and delivery to ensure equitable inclusion. For minorities, this is indeed urgent.
- Funk, C., Tyson, A. (2020). Intent to Get a COVID-19 Vaccine Rises to 60% as Confidence in Research and Development Process Increases. Pew Research Center Science and Society. Retrieved from https://www.pewresearch.org/science/2020/12/03/intent-to-get-a-covid-19-vaccine-rises-to-60-as-confidence-in-research-and-development-process-increases/
- Simmons, M., Gaston, D. (2021). Why so many Black patients’ distrust Covid-19 vaccines (and 3 ways to rebuild their trust). Advisory Board. Retrieved from https://www.advisory.com/blog/2021/02/vaccine-distrust?utm_source=blog&utm_medium=email&utm_campaign=2021Feb05&utm_content=PN_x_x_x_x_x_x&elq_cid=1597138&x_id=003C000001jqUdfIAE
- Siemaszko, C. (2021). Vaccine tourism on the rise as wealthy international tourists eye an opportunity in the U.S.(2021, January 25) Retrieved from https://www.nbcnews.com/news/us-news/vaccine-tourism-rise-wealthy-international-tourists-eye-opportunity-u-s-n1255531
- Painter E., et al., Painter E., et al. Demographic Characteristics of Persons Vaccinated During the First Month of the COVID-19 Vaccination Program – United States, December 14, 2020-January 14, 2021. Morb Mortal Wkly Rep. 2021 Feb 5.
- Where Black Americans Will Travel Father Than Whites for COVID-19 Vaccination. (2021, February 4) Retrieved from https://publichealth.pitt.edu/news/details/articleid/8741/where-black-americans-will-travel-farther-than-whites-for-covid-19-vaccination.
- The Rural Alaskan Towns Leading the Country in Vaccine Distribution. (2021, February 21). Retrieved from https://www.newyorker.com/news/dispatch/the-rural-alaskan-towns-leading-the-country-in-vaccine-distribution