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Adelabu has countless reasons to be wary of a potential vaccine, and most of them hinge on the federal government’s “groping” response to the pandemic, which has killed more than 170,000 Americans in less than six months. But for a black man like him, the specter of racist medical experimentation is also significant, he said.
Black Americans die from COVID-19 at nearly two and a half times the rate of whites nationwide, according to the COVID Tracking Project, and although they make up about 13% of the population, they accounted for 22% of deaths of coronavirus in cases in which race and ethnicity are known. And yet, a sign of a deep and well-deserved distrust of the American medical establishment, surveys have consistently shown that black Americans are less willing than other racial and ethnic groups to agree to a coronavirus vaccine.
A national poll released earlier this month by researchers at Harvard, Rutgers, Northeastern and Northwestern universities found that 52% of black respondents are likely to take a COVID-19 vaccine, compared to 67% of whites, 71% of Latinos and 77 percent of Asian Americans.
The Pew Research Center, which reported similar results in June, found that black Americans are generally more wary of medical researchers and doctors, in addition to being more skeptical of experimental treatments. Fifty-three percent of black adults polled by Pew had overwhelmingly positive views of medical research scientists, compared to 68% of whites and 67% of Hispanics. An even smaller proportion of black adults, 35%, expressed “great confidence in medical scientists to act in the best interest of the public.”
Black mistrust of health care and research stems from a long history of medical exploitation and misconduct. 19th-century physician J. Marion Sims, supposedly father of modern gynecology, for example, developed his revolutionary surgical tools and techniques by operating on enslaved black women without anesthesia. In 1932, the US Public Health Service initiated the famous Tuskegee Study, a four-decade secret experiment in which hundreds of black men in rural Alabama, without their informed consent, were not treated for syphilis, so researchers can study the deadly disease. progression.
“The African American community has very, very significant and historical reasons, including racism, segregation and experimentation, to be very suspicious,” said Dr. Joseph Betancourt, vice president and director of the equity and inclusion at Massachusetts General Hospital. “This is compounded by the fact that African Americans are grossly under-represented among doctors and researchers, so these communities do not have trusted messengers.”
This distrust extends to the current treatment of black patients, who continue to face prejudices and inequalities in medical care and access. Numerous studies show that black Americans regularly receive worse care than their white counterparts, besides being subjected to the prejudices of their medical providers and insidious stereotypes, including the false belief that blacks feel less pain.
“It’s really about looking at the inequalities within our system and seeing who has and who doesn’t, which hospitals are of the highest quality and how some people are receiving more care. faster than others? ” said Dr Bisola Ojikutu, infectious disease specialist at Mass Hospitals. General and Brigham and Women’s. “These are structural inequalities in our system.”
“If you don’t feel like all things are equal,” she added, “why would you necessarily believe that new therapies and interventions will necessarily be as effective or necessarily equally available to you?”
Among public health scholars, the survey data on black patient skepticism about a potential COVID-19 vaccine is not surprising. Black adults consistently lag behind whites when it comes to vaccination rates for other illnesses, such as the flu, said Sandra Quinn, professor and chair of the University of Maryland’s family science department, said. who studies racial disparities in vaccine acceptance. In her research, Quinn found that black people who believe they have been treated fairly in health care settings are more likely to trust the flu shot.
“I think it’s important to recognize that people can be well-disposed, and one of the things we really need to be aware of is what health departments, government and health care providers are doing to help. be trustworthy, ”Quinn said.
But the federal government’s response to the pandemic has done little to build confidence among communities of color that have been devastated by the virus, Quinn noted. Even the name of President Trump’s initiative to develop and distribute millions of doses of a COVID-19 vaccine by early 2021, Operation Warp Speed, has contributed to the public perception that security will be compromised in the rush to administer a vaccine, she said.
So what can health care providers do to mend the relationship with black Americans, embittered by centuries of medical abuse and mistreatment?
Michael Curry, deputy managing director and general counsel for the League of Massachusetts Community Health Centers, said it was imperative that “voices of confidence” in communities of color lead public education campaigns about the potential vaccine. .
“We need to make sure that African Americans and other people disparately affected by COVID-19 know that people have been their advocates to ensure that medical efficacy and safety is ensured in all the laboratories that distribute these vaccines and regardless of the vaccines approved by the government. forward, ”he said.
Ojikutu, who has worked closely with researchers to enroll black and Latino participants in COVID-19 vaccine clinical trials through the Harvard University Center for AIDS Research, stressed the importance of acknowledging the sordid story the medical community, the justified mistrust of black Americans, and the persistent problem of structural racism in health care.
“We need to think about ways to become more transparent in our behaviors and activities so that patients and communities are aware of what is going on,” she added, especially when recruiting black patients and browns for clinical trials, another long-standing struggle for medical researchers.
Last year, black patients made up only 9% of participants in new drug trials, according to the Food and Drug Administration, while 72% of participants were white.
“Be very clear about the research being done, what are the pros and cons, why they should or shouldn’t be doing it,” Ojikutu said. “And even in our conversations with patients, understanding what we know and what we don’t know.”
Reverend Dr Ray Hammond, pastor of Bethel AME Church in Jamaica Plain, said he had already started to “prepare the ground” for discussions on the importance of taking the COVID-19 vaccine with his predominantly black congregation . A former emergency doctor, Hammond said he had previously spoken with worshipers about the need for diverse participation in clinical trials and had hosted mobile vaccination clinics in his church between services.
“What I found is that there is both mistrust, but there is also confusion over what vaccines can and cannot do, and what the process looks like,” did he declare. “One part is deep and lasting. I think other things are specific to this situation, but I think both can be dealt with with patience.
During a recent webinar with other doctors on COVID-19 vaccine research, Ojikutu recalled that a community member asked him, “Why should we trust you?” For the panelists, it was a moment of reflection.
“I think everyone stopped and said, ‘Hmm. This is a difficult question. She said. “I’m not saying that anyone should immediately trust anyone.. It is very clear that a certain level of mistrust is quite normal and quite expected. It is a normal response to an unfavorable environment. But if someone says, ‘OK, let’s talk about this,’ we have to open the door to these discussions at some point. “
Deanna Pan can be contacted at [email protected]. Follow her on Twitter @DDpan.
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