Trust Is The Vaccine Infrastructure We Need

By | August 1, 2020

Co-authored by Avery Ofoje and Erika Lynn-Green, MSc

As state and national leaders continue to fumble the pandemic response, the promise of a vaccine is the failsafe for millions of Americans nostalgic for normalcy. Theoretically, a vaccine will allow our safe return to school, work, and recreation. But an effective vaccine response requires cooperation and trust from every corner of the country, especially from Black Americans. Black people share an outsized proportion of coronavirus cases and have died of Covid-19 at much higher rates than any other minority group in the U.S. However, those figures alone will not inspire uptake of a vaccine for all Black people. Therefore, to maximize protection against Covid-19, we must build an infrastructure of trust in Black communities.  

Unfortunately, the same systemic structures and policies that caused Black Americans to disproportionately suffer from the pandemic have also destroyed Black America’s trust in healthcare. In a recent Pew research study, 44% of Black adults said they would refuse a coronavirus vaccine if it were available today. To increase the number of Black Americans willing to accept a Covid-19 vaccine, we must earn trust in these communities through education, outreach and communication about its importance and its safety – starting now. 

And the messenger matters. While conducting outreach in an underserved community, I was approached by a man who believed many in the Black community would refuse the vaccine because it is perceived as “Trump’s vaccine” and thus harmful to Black people. When asked what it would take to convince him to accept a vaccine, he said, “I would if I could see other Black people working on it.” How should we respond to his concern? If Black Americans see Black people participating in the scientific process, that’s a step toward building trust. Thus, senior researchers, health system and state and local government leaders must ensure Black scientists, researchers and trial participants are highlighted and positioned as trusted messengers. This can also be accomplished by identifying, supporting, and if needed, hiring Black outreach workers, clinicians, and known community leaders.

Recommended For You

But many Black Americans are not likely to shift their opinions overnight. Even before the pandemic, as a result of ongoing structural racism rooted in history, Black people were skeptical of routine vaccination. Thus, scaling vaccine uptake in Black communities requires a new approach with trust as its foundation and empathy as its calling card.

Community-centric approaches like these have been tested and are effective. For example, public health teams in Boston achieved great success in contact contracting efforts by deploying teams well-known and trusted in the community and by integrating social support, like access to food and housing, into the process. Their efforts were successful because the response was led by people perceived as neighbors, friends who were part of a community. The support was received openly as one of caring and concern rather than punitive, judgmental and being imposed by disconnected and rarely seen health officials popping in for a situational emergency. For a Covid-19 vaccine to reach our most vulnerable neighbors, we must leverage pre-existing and trusted relationships like these in Black communities across the country.

Further, to address health disparities inflamed by the pandemic, public health policymakers should identify and eliminate barriers to vaccine access in Black communities. State and local governments should make the vaccine available to everyone regardless of ability to pay. The federal government should increase the federal match rate for state Medicaid programs to support programs vaccine access. In the long-term, at every level, trust-building initiatives to increase vaccine uptake should be supported and prioritized as an imperative.

It is not too late to get this done. As vaccine candidates progress through clinical trials, state and local governments have ample time to craft and support education and outreach strategies that are responsive to Black communities, specifically with an eye towards the messenger. With consistent messaging and tailored education we can gain people’s support and increase willingness to take the vaccine. Without this attention to implementation of proven strategies to build and sustain trust, vaccination against COVID-19 will fail to protect Black Americans, and we will all bear the consequences.

Avery Ofoje is a 2020 graduate of Boston University and a prospective medical student.

Erika Lynn-Green, MSc, attends Harvard Medical School. She was a 2018 Marshall Scholar.

Forbes – Healthcare

Read More:  Unraveling the Mysteries of mRNA Vaccine Shedding