As COVID-19 vaccines arrive, so does reckoning with racism in health care; herd immunity hinges on Black trust

Nurse Jessica Bell administers sedative medication for a man with COVID-19 and on a ventilator in the Intensive Care Unit at Roseland Community Hospital on the Far South Side, Tuesday afternoon, Dec. 8, 2020. | Ashlee Rezin Garcia/Sun-Times file photo

As the first COVID-19 vaccines arrive at hospitals Monday, America faces a reckoning with racism in health care — a history that could derail an end to the worst pandemic in a century.

How do you persuade Black Americans to participate in the largest vaccination campaign in U.S. history when the elders remember the Tuskegee experiment and younger have grown up in health care deserts, acutely aware they receive lower quality health care than whites?

That was the question tackled by Illinois officials and Black community leaders at a roundtable on ways to overcome this distrust that could hinder the nation’s goal of immunizing three out of four Americans, to achieve herd immunity.

“We understand very clearly the African American community’s mistrust and apprehension. We know where this comes from,” U.S. Rep. Bobby Rush (D-Ill.) said at the virtual gathering Friday, called by U.S. Sen. Tammy Duckworth (D-Ill.).

“It began before Tuskegee, but Tuskegee brought it to the forefront, created a condition where there had to be an admission by a medical professional that these tests at Tuskegee were implemented, and apology made. But there was no real solution to those problems, nothing that remediated ongoing mistrust,” Rush said.

“Now we’re at a point where we’ve got to have this participation by citizens from every demographic root, and we’re having to deal with this problem in terms of creating trust.”

U.S. Rep. Bobby Rush, (D-Ill.), says, “We understand very clearly the African-American community’s mistrust and apprehension” surrounding the new coronavirus vaccine. “We know where this comes from.”

Delivery of the Pfizer-BioNTech vaccine began Sunday — 3 million shots believed more than 90 percent effective against a disease that’s killed over 300,000 Americans.

It will be given first to health care workers and nursing home residents, then essential workers, older adults and those at high risk, before the general population, by spring. With 75 percent immunized, experts say the U.S. could reach herd immunity by summer’s end.

“Our local surveying has suggested, similar to what has been seen nationally, that Black Chicagoans and Black health care workers are less likely, right off the bat, to want to accept vaccines,” said Chicago Department of Public Health Commissioner Dr. Allison Arwady. “So it’s absolutely critical to talk about.”

In plans for marketing and rollout of the coronavirus vaccine, “We are absolutely focused on Black Chicago, based on prior data,” said Chicago Department of Public Health Commissioner Dr. Allison Arwady.

That distrust by Blacks, dying from coronavirus at twice the rate of whites, manifests in historically low Black participation in medical studies. So promoting the critical nature of the new vaccine to Black communities will mean relying on such “trusted messengers” as Black doctors, community groups and churches.

“As health care workers are the first to get the shot, they should help make the case,” said Rainbow PUSH Founder/ President the Rev. Jesse Jackson. “If we have Black and Latino doctors on television, taking the shot, saying why they trust it, we remove some of these reasonable doubts fairly soon.”

“We cannot use the Tuskegee experiment as a crutch in this situation,” Jackson said. We’re beyond that now. There are 62 Blacks in Congress. We have an obligation to tell that story.”

Rainbow PUSH Founder/President the Rev. Jesse Jackson said despite a history of racism in America’s health care system, all must be done to help Blacks trust the coronavirus vaccine. “We cannot use the Tuskegee experiment as a crutch in this situation,” he said.

Leaders like Jackson taking the shot would have similar effect, Duckworth said. CDPH and the Illinois Department of Public Health also plan to use social media influencers to spread the message to that community.

“Our group of Black electeds from across the state of Illinois, we’ve talked about all of us doing it together, so everyone can see,” said U.S. Rep. Robin Kelly (D-Ill.).

“But sometimes we can be in a weird situation. Some people will say, ‘Oh look, they got it first.’ On the other hand, some people will say, ‘Oh look, they’re telling us to take it, but they’re not taking it.’ ”

U.S. Rep. Robin Kelly (D-Ill.)

Marketing to the Black community must also be conducted in a culturally sensitive manner.

“We have to get this right. Time is of the essence, but we can’t force people. As with any kind of change, there are early adopters, late adopters, people in the middle, and people who never adopt. We have to respect that,” lDPH Director Dr. Ngozi Ezike said.

“We’re going to be working with the people who have some willingness to take this on, and they will need the appropriate education and support.”

In the grip of the pandemic’s more deadly second wave, Illinois now accounts for nearly 5% of all coronavirus deaths in the U.S. Rates of infection and death in communities of color speak to a need for massive new dollars for vaccine marketing, officials said.

Acknowledging Black distrust of the coronavirus vaccine linked to a history of racism in the health care system, Illinois Department of Public Health Director Dr. Ngozi Ezike says marketing to that community must be culturally sensitive. “We have to get this right. Time is of the essence, but we can’t force people,” she said.

There’s hope, however.

“UIC’s Moderna trial here had 75 percent non-white participants. That’s very unusual, and good news for Chicago,” Arwady said. “We’re doing some message testing right now, with a focus on Black and Latinx communities, thinking about how we acknowledge some of this past history, but then be very forthright, talk about the science of this vaccine.”

That messaging will also address potential for criminal elements to prey on the vulnerable.

“Everybody needs to know that anybody soliciting any kind of money, even if it’s an administration fee, anything like that, it’s not legit. The vaccine is free,” Ezike said. “You don’t have to bring something to prove you’re a citizen, or resident of Illinois. We are vaccinating everybody who presents. People need to know that right at the beginning.”