COVID-19 Vaccination in the African American Community: Let’s Talk

There are a lot of people right now discussing COVID-19 “vaccine hesitancy” among Black people. I have a problem with framing it this way, as I’ll explore in this post.

I understand how important it is for Black people to get the vaccine. We’re being disproportionately affected by this pandemic on every level.

We’re more likely to work at jobs that put us at risk of exposure. More likely to lose our jobs because of the pandemic. Less likely to have access to affordable health care. And we’re dying at higher rates than any other population.

Yet we’re also getting vaccinated at much lower rates than white Americans — both because it’s harder for us to even get the vaccine, and because we’re less willing to trust it.

I met with Independence Medical Director, Dr. Salina Graves, to talk about the deep-seated mistrust that so many of us feel — and what it’s going to take to get Black people on board with getting the vaccine.

A Legacy of Institutional Untrustworthiness

Danielle: Instead of talking about “vaccine hesitancy,” let’s discuss institutional trustworthiness. Black people’s mistrust of the American medical establishment runs deep — and for good reason.

The Tuskegee syphilis study, which started in 1932 and continued until 1972 — during my lifetime! — was just one of many unethical medical experiments conducted on Black people. We also tend to have far worse health outcomes than our white counterparts. Is it any wonder we have questions about the COVID-19 vaccine?

Dr. Graves: I can understand where the mistrust is coming from. There’s been a lot of false information out there, so it can be hard to know who to believe. And the vaccine was developed in such a short time, and then there was such a big thrust that everyone should take it…what I’m hearing from a lot of my friends is, it’s too much, too soon.

African-American representation in the vaccine clinical trials was pretty low as well. So, there is this concern that “these vaccines weren’t made for us.” However, in the words of Dr. Onyema Ogbuagu, who ran the Pfizer/BioNTech clinical trial at Yale University: “The trial represented both white, Black, and brown communities, and the studies found equal efficacy and no difference in safety signals by race or ethnic lines.”

Danielle: Some of the community members I’ve spoken with don’t know how to communicate their feelings about the vaccine. When you probe to ask why they aren’t planning to get it, they just say “I don’t want to, I heard that we shouldn’t…I don’t want to get injected with anything.”

But it’s rooted in a historical perspective that’s been passed down from generation to generation. I had this same conversation with my grandma about her not wanting to get the flu shot. She simply doesn’t trust it.

It’s crucial to acknowledge that historical perspective, and the unconscious biases that led to the real-life experiences we’re still having now. It’s important to have honest conversations.

Leading By Example

Dr. Graves: Speaking from my own personal experience, I have to admit that I initially had some instinctive fear of the vaccine too — and I’m a doctor!

But when I saw Kamala Harris actually getting the vaccine on camera, that’s when I started to get a more positive feeling. As I’ve seen more and more people on television getting vaccinated, I think that has had a really powerful effect.

As we see our friends, colleagues, and neighbors get the vaccine — that they’re walking around, smiling, doing well, and going about their business — more and more people are going to feel confident about getting their own vaccinations.

Danielle: My phone rings every day: “Are you getting the vaccine? What are your thoughts about it?” As we see more people in our community getting vaccinated, we see that maybe they get a low-grade fever or a little nausea, but then the next day they’re fine. That helps build our confidence. I think at this point everyone is communicating that there are more likely to be side effects with the second shot. And in fact, it’s a sign that the vaccine is working, because it proves that your immune system is responding.

For me it was very important to get the vaccine. Since last March I’ve lost fourteen people that I knew to COVID-19. I feel very fortunate that I was eligible to receive both of my shots already.

Dr. Graves: I recently had a conversation with my neighbors, a couple in their 70s. They asked me, “Are you planning on getting the COVID-19 vaccine?” I said “Absolutely. I think this is the answer to the problems we have right now.” And they replied, “You are? Do you think it’s safe?”

My response was, “As a physician and a scientist, I’ve reviewed the clinical trial results. I read up on everything, and I’m ready to get it myself and make sure all my loved ones get it.

Our most crucial doctors and surgeons are jumping in line to take it. These are smart people. They’ve read the literature…and they want to get it immediately.”

All medicines have potential side effects, including Tylenol and aspirin, which people take every day. And all vaccines have potential side effects. This one’s side effects are no worse than those of any other vaccines you might get.

And the benefit of getting it, the risk of not getting it, outweighs any concerns we might have about those side effects.

I said all this to my neighbors, who I have a relationship with. And they told me I was doing a pretty good job of convincing them to get vaccinated.

Danielle: My 28-year old son has signed up to get the vaccine too when it’s his turn. If I can convince him, I can convince anyone!

This Pandemic Isn’t Just Going To Go Away

Dr. Graves: I think a lot of people assumed that COVID-19 was just going to blow over. It’s a new year, and everyone wants everything to open up again and go back to normal…but COVID-19 is not going to magically disappear.

The only way to get back to some semblance of normal is through this vaccine. A lot of people are starting to realize that this is the way to go; this is the only solution.

Danielle: Yes, people were so happy 2020 was going to end! They landed on January 1st thinking the world was going to open right up. But people recognize now that we have to do our part to really make a difference with this.

Everybody’s like, “Just wear a mask and social distance,” and that’s great — but people aren’t always doing it. They may be wearing masks and distancing when they go to the store, but they’re not doing it around people they’re comfortable with. You see your aunt, your sister, your cousin… and you take your mask off to eat or have a drink.

It speaks volumes about how badly we need to be around our communities; it’s so important to us. But if you want to get back in those spaces safely, getting as many people in our community vaccinated as possible is our best option.

For the most part, people are ready to hear about something that’s going to allow them out of the house and back to normal.

And let’s face it…there’s no way we’re all going to get to the herd immunity we need unless we get the Black community participating as well.

Dr. Graves: Unfortunately, even Black people who are ready, willing, and able to get vaccinated may not have the same access to vaccination as their white counterparts. They may not be plugged into all the same information channels, or may not have any vaccination sites in their neighborhoods. And right now, we don’t seem have enough doses for all the people who are eligible and willing to get vaccinated.

Danielle: But we do have options, and we have to do what it takes to get the vaccinations that we deserve.

When it’s your turn to get vaccinated, you can contact your primary care doctor, your local health department, your employer, nearby drug stores, or non-profits like the Black Doctors’ COVID-19 Consortium to get an appointment. And seniors are eligible to get the vaccine right now. So are people with some high-risk health conditions, including obesity and smoking.

So, don’t give up!

 

---

Co-authored by Salina D. Graves, M.D.

Dr. Graves is a Family Medicine Physician who is a born and bred Philadelphian, having received her degree and residency training at Temple University. She has a background in community health for over eighteen years having worked for the US Public Health Service Corp as a commissioned officer, providing primary care in medically underserved communities. Dr. Graves later joined Independence Blue Cross in 2005 as a medical director in utilization management, case management, and quality improvement. In 2019 , she became Senior Medical Director, creating and executing policies, quality improvement initiatives, and overseeing the day-to-day operations of the medical directors in utilization management.