This week, I received the Pfizer Covid-19 vaccine. As a frontline health care worker, I was one of the fortunate few in the first wave of eligibility.
I was so excited -- it was as if Christmas had come early. Right before I got the shot, I had a very sick patient come in to the emergency department severely dehydrated and with confusion caused by the virus. The day before, I put another patient with Covid-19 on a ventilator as she gasped for breath. When the pandemic started, I faced it with nervous trepidation. Now, I view it with unfortunate familiarity.
I lost count of how many patients I have seen with the disease. But one thing I recall is that most of them have been Black.
There has been a lot of discussion within my own African American community about the vaccine. Relatives, colleagues and friends have all weighed in with different opinions. Some say they will never get it. Others want to wait, and have texted me asking for my thoughts and reactions to the initial dose. A few more have received it through their own work in the medical field.
The mixed response is understandable. It is not only fueled by our current political environment, but also rooted in a dark past.Communities of color have repeatedly been the subject of experimental treatments -- either unwillingly or to their own detriment. The birth control pill was first tested in poor women in a housing project in Puerto Rico. The most famous example is the Tuskegee Syphilis Experiment, in which the US Public Health Service studied the natural history of syphilis in 399 Black men infected with the disease over a 40 year period, where they suffered complications and deaths, and infected their wives and children.
In the general public, there is also a great deal of mistrust. President Donald Trump declared the existence of a "Medical Deep State" after Pfizer released early vaccine results shortly after the election. Long before the Covid-19 pandemic, the anti-vaccine movement promoted an unsubstantiated link between vaccines and autism.
These examples are all based on incredibly bad science. The foundation of the anti-vaccine argument was a study with only 12 patients. It was so poorly done that the findings were later retracted by the medical journal which published them, and the author subsequently lost his medical license. The Tuskegee syphilis experiment unethically withheld information about and treatment for a curable disease, causing unjust harm.The result is that there are now extensive safeguards in place to prevent similar atrocities. The Pfizer and Moderna vaccines are different. Phase 3 trials for these drugs had over 43,000 and 30,000 participants, respectively, and included individuals from diverse sociodemographic backgrounds, all of whom volunteered and underwent a careful informed consent process.
This does not mean that the medical community is off the hook. There continues to be numerous examples of discrimination in health care, ranging from racial disparities in the receipt of pain medications to therapies for cardiovascular care.
However, we should not view the Covid vaccine as an attempt to add to this discrimination. Instead, it can be our opportunity to level the playing field. We have been hit hard by Covid, and we must use every tool in our power to end this terrible pandemic.
In a Pew poll released earlier this month, only 42% percent of Black Americans said that they would get the vaccine. The mistrust from communities of color at times seems insurmountable. However, I do not believe this is the case. Culturally competent messaging is key.
It was no coincidence that the first person immunized against Covid in this country was a Black woman, or that former President Barack Obama has volunteered to get his vaccine in public. However, it is as important to see public figures get the vaccine, as it is to see individuals you know personally get it -- cousins, neighbors, your family doctor. We also must make sure that there is equitable access to the vaccine for vulnerable populations. Increasing outreach for the vaccine is useless if it cannot be obtained once available.I posted a photo documenting the receipt of my vaccine on Facebook. That post received some of the most likes and comments I have had since joining the social media platform many years ago. However, the comment that touched me the most was that of a classmate from my elementary school, which is located on the Southside of Chicago, an area with some of the worst health outcomes of the city. Even though I have not seen my classmate in over 40 years, she remarked that because she trusted me, she too was planning to get the vaccine.
We may not be able to reverse community mistrust in the vaccine overnight, but we can spread the word to one person at a time. And for me, that is a great start. When you get your vaccine, please be sure to tell a friend.
