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Too Many Americans Still Mistrust the COVID-19 Vaccines. Here’s Why

Here’s What’s Behind Americans’ Uneasy Relationship With Vaccines
BY JEFFREY KLUGER  JANUARY 5, 2021 9:36 AM EST
Source: Time

If you’re feeling impatient waiting your turn for a COVID-19 vaccine, here’s a little good news: Angela Padgett will gladly give you her place in line—at least for now. Padgett, president of a day spa in Raleigh, N.C., is under no illusions about the mortal danger the pandemic poses to herself, her family and the world writ large—indeed, she had COVID-19 back in July. But as for the vaccine that is supposed to put an end to all of the suffering at last? Not today.

“I am a little bit hesitant,” she says. “I can appreciate President Trump trying to get this moving fast and I’ve taken pretty much every vaccine [for other diseases]. But I think it was rushed through very early, very quickly. So I would like a little more data.”

Padgett is not alone. According to a December survey undertaken by the Pew Research Center, nearly 40% of Americans say they will definitely not or probably not get the COVID-19 vaccine when it becomes available to them. Gallup polls put the number at 37%. That’s bad news not just for the vaccine refusers themselves but for the public as a whole. Experts including Dr. Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases, had previously concluded that achieving herd immunity—the point at which a population is sufficiently vaccinated that a spreading virus can’t find enough new hosts—would require anywhere from 60% to 70% of Americans to take the vaccines. But lately, he and others have been inching that number upward, now estimating that herd immunity could require as much as 85% vaccine coverage.

The holdouts have multiple reasons for their reluctance. There are, of course, the dead-enders in the anti-vax community, for whom no vaccine is safe or acceptable. There is, too, a faction peddling conspiracy theories about the COVID-19 vaccines in particular. As one falsely goes, the disease is caused by 5G cell towers, so a vaccine would be useless against it. (The rumor has been repeatedly debunked on Snopes.com and other sites.) Another spuriously claims the vaccines are a plot by the Bill and Melinda Gates Foundation—or, alternately, Elon Musk—to inject microchips into Americans. That last one—debunked herehere and elsewhere—has gained enough traction in the fever-swamp corners of the Internet that it prompted a rare acknowledgment from Bill Gates himself. “It doesn’t help that there are false conspiracy theories about vaccines, including some that involve Melinda and me,” he wrote in a foundation letter he released on Dec. 22.

But most people in the COVID-19 vaccine hesitancy camp are more rational, more measured—informed enough not to believe the crazy talk, but worried enough not to want to be at the head of the line for a new vaccine. “For first responders and for older people with underlying conditions it’s a godsend,” says Padgett. “But I do believe this was rushed. I’m reasonably healthy. Six months to a year just to get more data on it is what I’d need to be vaccinated.”


For all the urgency to get as many vaccines into as many arms as possible, the reluctance of such a large swath of the population to be among the early adopters is not completely without merit.

“I think it’s reasonable to be skeptical about anything you put into your body, including vaccines,” says Dr. Paul Offit, professor of pediatrics at the Children’s Hospital of Philadelphia and director of its Vaccine Education Center. Coming from Offit, a vocal proponent of universal vaccination and a particular boogeyman of the anti-vax camp, that carries particular weight. He goes further still, acknowledging that the speed with which the COVID-19 vaccines were developed can cause people special concern. “The average length of time it takes to make a vaccine is 15 to 20 years,” he says. “This vaccine was made in a year.”

Then too there is a question of effectiveness. Both of the vaccines that have been authorized for emergency use in the U.S., one from Pfizer-BioNTech and one from Moderna, have what Offit calls “ridiculously high efficacy rates—in the 95% range for all [COVID-19] disease and for Moderna’s product 100% for severe disease.” But in the haste to get the vaccine to market, test subjects have been followed up for only two to three months, so it’s impossible to say with any authority how effective the vaccines will remain at six or nine or 12 months.

Finally there are the side effects. Anaphylaxis—or a severe allergic reaction—is possible with any vaccine, though medical protocols call for people who have received the shot to wait 15 minutes before they leave so that they can be treated if they do have a reaction. More troubling are spotty reports of Bell’s palsy—partial facial paralysis—following COVID-19 vaccinations. But those numbers are exceedingly small. One false Facebook posting purported to be from a nurse in Nashville who got the vaccine and suffered Bell’s palsy, but that too has been debunked, as repeated searches have turned up no nurse in the Tennessee health system under that name. All the same, it sparked outsized fear of a real but minimal risk.

“There were four cases of Bell’s palsy within a month or month and a half in the Pfizer trial out of 22,000 recipients,” Offit says. “So that works out to roughly eight per 10,000 per year.” Such a case count may be low, but it does exceed the average background rate of Bell’s palsy in the general population, which is 1.2 per 10,000 per year, Offit says. Other sources put the incidence as a somewhat higher 2.3 per 10,000.

Armed with numbers like that, however, humans are not always terribly good at calculating risk. On the one hand even an eight in 10,000 chance of contracting facial paralysis does sound scary; on the other hand, about one out every 1,000 American was killed by COVID-19 this past year. The mortal arithmetic here is easy to do—and argues strongly in favor of getting the shots.

So too does the way the vaccines were developed—which is actually not as rushed as the calendar would make it seem. The Pfizer-BioNTech and Moderna vaccines both use mRNA—or messenger RNA—to prompt the body to produce a coronavirus spike protein, which then triggers an immune response. That is a novel method for making a vaccine, but the basic research was by no means conducted within the last year.

“The technology for the vaccine has actually been in development for more than a decade,” says Dr. Richard Pan, a pediatrician and a state senator in California. Pan has pushed hard over the years for laws mandating vaccines for children to attend school and, like Offit, has earned the animus of the anti-vax community for his efforts. He is just as big a booster of the COVID-19 vaccine—though he would not propose mandates until there are enough doses for everyone to get a shot—and tries to reassure doubters that no matter how soon they get the vaccine, there are a lot of people who went before them.

“I point out to people that when you get the vaccine you’re definitely not the first,” he says, “because there are tens of thousands of people who have been involved with clinical trials.” Health care workers who are already being vaccinated increase that number dramatically—some 2 million have gotten the shot in the U.S. as of this writing.


Offit’s and Pan’s reassurances will surely not assuage everyone, and here demographics play a role. As with so much else in the U.S., vaccines have become a political issue. The Gallup organization has been tracking vaccine attitudes by party since July and has found Democrats consistently more likely to get vaccinated than Independents or Republicans. In a poll taken at the end of November, 75% of Democrats said they would be willing to take the COVID-19 vaccine, compared to 61% for Independents and 50% for Republicans. Age plays a role too, with willingness to be vaccinated generally tracking susceptibility to the disease. In the December Pew Research Center poll, for example, 75% of adults over 65 reported that they intended to be vaccinated, compared to just 55% under 30.

But nowhere is the difference starker than among racial and ethnic groups, with 83% of Asian-Americans surveyed expressing an intent to be vaccinated, compared to 63% in the Latinx community and 61% among Whites. In Black American respondents, the numbers fall off the table, with just 42% intending to be vaccinated.

This is of a piece with a long history of medical disenfranchisement and much worse. Some of the mistrust goes back as far as the infamous gynecological experiments J. Marion Sims conducted on enslaved women—without anesthetic—in the 19th century; as well the Tuskegee experiment that began in the 1930s and involved decades of studying the progress of syphilis in Black men without informing them that they had the disease or offering them the antibiotics needed to treat it. But the structural inequality and bias continues today.

According to the U.S. Centers for Disease Control and Prevention (CDC) the death rate from COVID-19 is 2.8 times higher for blacks than it is for whites and the hospitalization rate is 3.7 times higher. Dr. Ala Stanford, a Philadelphia-based pediatric surgeon and founder of the Black Doctors COVID Consortium sees a lot of reasons for that disparity, not least being that in the neighborhoods in which she works, Blacks and other minorities were being tested for COVID-19 at only one-sixth the rate of white communities, which tended to be higher-income, according to data from Drexel University. “[The tests] had to be scheduled from nine-to-five, when most people were at work,” Stanford says. “There were no evening or weekend hours [and] they weren’t accepting children.”

What’s more, Black Americans are disproportionately likely to be front-line or essential workers like home-health aides and are less likely to have the kinds of other jobs that would let them work from home. Less social distancing plus less testing means more sickness and death, which plays into the lived reality for many people that Black lives are valued less than white lives in the U.S. That, in turn, breeds more suspicions of the system as a whole—including of vaccines.

“The main fear I hear [about vaccines] is that someone is injecting coronavirus into my body,” says Stanford. “And I answer in as detailed a way as I can about the mRNA and the protein and how it looks like coronavirus but it’s not.” That kind of clarity, she says, can help a lot.

Offit hears even starker—and more poignant—fears from Blacks. “One particular man did not want to get the vaccine and I asked him why,” Offit says. “He said, ‘because for my race they make a different vaccine.’”

One way Stanford sought to push back against such suspicions was to offer up herself as a living example, getting vaccinated on camera through the Philadelphia Department of Public Health. The local media sent a pool camera and the footage was shown on the evening news. Dr. Brittani James, a professor at the University of Illinois Hospital and executive director of the Institute of Anti-Racism in Medicine, did something similar, streaming her vaccination online.

“I talk until I’m blue in the face,” she says, “but there’s something I think for people to see me or see other Black people getting it that can really do a lot to soothe their fear. Like hey, guess what? If I’m wrong, I’m going down with you.”

Whether that kind of role-modeling and example-setting will work to reduce resistance is impossible to know at the moment, simply because vaccines are still unavailable to the overwhelming share of the population. If you can’t get the shot in the first place, it doesn’t matter how hesitant or receptive you are to it. Offit, who is white, does believe that efforts like James’s, to appeal to members of her own community, can be truly valuable.

“I think if someone like me says something, people are just going to see it as ‘Of course he’d say that,’” Offit says. He cites by way of example the effectiveness of TV ads by the National Medical Association, a professional organization of Black American physicians, showing one Black nurse inoculating another with the COVID-19 vaccine. “It’s subtle,” Offit says, “but they’re trying to create those images.”

Stanford believes Black churches can play a role too. During one of the testing drives she helped organize, church parking lots were used as sites to administer the tests—which helped increase turnout. “We know that in the African-American community, [the church] is a trusted institution,” she says. “Even if you don’t go to church, you know that’s a safe space.”Dr. Ala Stanford receiving her COVID-19 vaccine. Stanford's vaccination was televised in order to promote the safety and efficacy of the shot.Dr. Ala Stanford receiving her COVID-19 vaccine. Stanford’s vaccination was televised in order to promote the safety and efficacy of the shot. Emma Lee
Source: Time
Shidonna Raven Garden and Cook

In all communities, it helps too if doctors and other authorities listen respectfully to public misgivings about vaccines, explaining and re-explaining the science as frequently and patiently as possible. But there is a burden on the vaccine doubters themselves to be open to the medical truth. “Questions are fine as long as you listen to the answers,” Pan says. “So talk to your doctor, go to sources like the CDC and our incredible mainstream medical organizations. Those are the ones you should be getting information from.”

Adds Stanford: “My belief is that you don’t coerce or convince, you listen to concerns and you understand the fears and are empathetic with people. Then you educate and allow one to make their own choice.”

Pan also sees a role for social media companies, which must better control misinformation on their platforms. Journalists too must step up, avoiding false equivalency or both-sides-ism; there is no need to give equal time to rumor mongers or conspiracy theorists simply to appear balanced.

Ultimately, no vaccine is perfect, and the COVID-19 vaccines do have more questions associated with them than others, because there hasn’t been that much follow-up time since the study volunteers got their shots. But those questions are less about safety than about just how long the shots will prove protective. The truth is that they work.

Another truth, of course, is that for now, in the early stages of the vaccine rollout, masking and social distancing remain the best methods for protecting ourselves and others—and they will be part of our lives for at least many months to come. But slowly, over time, the vaccines will eliminate that need. What’s required now is trust in the power of the shots or, as Stanford puts it, in “faith and facts over fear.” Pandemics eventually stop raging. It’s vaccines that hasten that end game—and save millions of lives in the process.

WRITE TO JEFFREY KLUGER AT JEFFREY.KLUGER@TIME.COM.

As the article states the average time to actually develop a vaccine or new drug is 15 – 20 years. This vaccine has be developed in under a year. Why do you think people are hesitant around the world to take the COVID 19 vaccine? How often have pharmaceutical companies been fined for the drugs they develop and why? How effective or ineffective has the FDA been in protecting the public at large from predatory drugs and drug epidemics? Why? Why not?

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‘I’m not an anti-vaxxer, but…’ US health workers’ vaccine hesitancy raises alarm

Coronavirus

With up to 40% of frontline workers in LA county refusing Covid-19 inoculation experts warn that understanding and persuasion are needed

Amanda Holpuch

Amanda Holpuch in New York @holpuch
Sun 10 Jan 2021 03.00 EST
Last modified on Sun 10 Jan 2021 10.07 EST
Source: The Guardian

Registered nurse Valerie Massaro administers the second dose of the Pfizer/BioNTech vaccine to health care workers at the Hartford HealthCare at the Hartford Convention Center in Hartford, Connecticut on January 4, 2021.
 Registered nurse Valerie Massaro administers the second dose of the Pfizer/BioNTech vaccine to health care workers at the Hartford Convention Center in Hartford, Connecticut, this week. Photograph: Joseph Prezioso/AFP/Getty Images
Shidonna Raven Garden and Cook

Susan, a critical care nurse based in Alaska, has been exposed to Covid-19 multiple times and has watched scores of people die from the illness. But she did not want to get the vaccination when she learned it would soon be available.

“I am not an anti-vaxxer, I have every vaccine known to man, my flu shot, I always sign up right there, October 1, jab me,” said Susan, who didn’t want to give her last name for fear of retaliation. “But for this one, why do I have to be a guinea pig?”

The two authorized vaccines, made by Moderna and Pfizer-BioNTech, are safe according to leading expertsand clinical trials – for one thing they contain no live virus and so cannot give a person Covid – and with tens of thousands of patients, they have had about 95% efficacy. But across the country, health workers with the first access to the vaccine are turning it down.

Misinformation ‘superspreaders’: Covid vaccine falsehoods still thriving on Facebook and Instagram

The rates of refusal – up to 40% of frontline workers in Los Angeles county, 60% of care home workers in Ohio – have prompted concern and in some cases, shaming. But the ultimate failure could be dismissing these numbers at a critical moment in the US vaccination campaign.

Dr Whitney Robinson, an epidemiologist at the University of North Carolina, told the Guardian if these early figures coming from healthcare workers are not addressed: “It could mean after all this work, after all this sacrifice, we could still be seeing outbreaks for years, not just 2021, maybe 2022, maybe 2023.”

Vaccine hesitancy is common – 29% of healthcare workers said they were vaccine-hesitant, according to a survey by the Kaiser Family Foundation published last month. And it’s not exclusive to the US – up to 40% of care workers in the UK might refuse to have the vaccine, the National Care Association said in mid-December.

The numbers coming from hospital and care homes are unique in that they give a more specific picture of who is refusing the vaccine and why. Once vaccines are available to the general public, patterns will be more difficult to identify because the US does not have a centralized system to track vaccinations.

“If we don’t understand the patterns of who is not vaccinated, it will be hard to predict where outbreaks might spring from and how far they might spread,” Robinson said.

It will also leave underfunded public health agencies scrambling to identify and respond to hesitancy in the community.

“We can’t just write off somebody’s decisions and say, well that’s their personal decision,” Robinson said. “Because it’s not just their personal decision, it’s an infectious disease. As long as we have pockets of coronavirus anywhere in the world, until we have mass global vaccination, it’s a threat.”

Some employers and unions are seeing the numbers for what they are: an alarm in need of a response.

In New York City, the firefighters union found last month that 55% of 2,000 firefighter members surveyed said they would not get the vaccine.

But Covid cases are climbing at the FDNY. Twelve members have died and more than 600 were on medical leave in late December.

So, the Uniformed Firefighters Association (UFA) president, Andrew Ansbro, collected questions from some of the roughly 8,200 firefighters his union represents. A virologist friend had been helping Ansbro shape the union’s response to Covid-19 and answered their questions in a recorded video. The 50-minute video has now been viewed about 2,000 times.

“I actually received a couple dozen phone calls and messages from members that said it changed their mind,” said Ansbro, who was vaccinated on 29 December. “I think the vaccination numbers are definitely going to be higher than 45%.”Advertisement

He said people were concerned about how new the vaccine was, had read misinformation online and were worried about long-term effects. In other workplace surveys, people have shared concerns about how it could affect fertility or pregnant women. Some healthcare workers infected with Covid don’t think it’s necessary while they still have antibodies.

Each of these questions can be answered. And national surveys have shown that in general, vaccine hesitancy is decreasing.

But these surveys also suggest action is still needed to address populations more likely to be distrustful because of the country’s history of medical abuse.

Recent surveys show that Black people are the most vaccine-hesitant. In mid-November, 83% of Asian Americans said they would get the vaccine if it was made available to them that day. That sentiment was shared by 63% of Hispanic people, 61% of white people but just 42% of Black people, according to a Pew Research report.

Dr Nikhila Juvvadi, the chief clinical officer at Loretto hospital in Chicago, told NPR that conversations with vaccine-hesitant staff revealed mistrust was an issue among African American and Latino workers.

She said people specifically mentioned the Tuskegee Study, when federal health officials allowed hundreds of Black men with sexually transmitted diseases to go untreated to study disease progression. The study lasted from 1932 to 1972.

“I’ve heard Tuskegee more times than I can count in the past month – and, you know, it’s a valid, valid concern,” Juvvadi said.

Juvvadi, who administered vaccines at the hospital, said one-on-one conversations validating these concerns and answering questions had helped people be more comfortable with the vaccine.

Vaccine hesitancy in healthcare workers has also put pressure on health systems intent on getting doses to as many people as possible, as quickly as possible.

Georgia’s public health commissioner, Kathleen Toomey, announced last week that the state would expand vaccine access to adults 65 and older and first responders because healthcare workers were declining to take it.

Dr Toomey said that while hundreds of healthcare workers were on waiting lists to get the vaccine in the state’s urban center, Atlanta, in rural areas the vaccine was “literally sitting in freezers” because healthcare workers there did not want to take it.

At one of the Texas hospitals hardest hit by the virus, Doctors Hospital at Renaissance in the Rio GrandeValley, workers contacted local EMTs, paramedics and medical workers from outside the hospital to distribute their remaining vaccines because of their limited shelf-life.

Susan, the nurse in Alaska, said her preference would be for her parents to get the vaccine first because they are more vulnerable.

She has made peace with the vaccine and plans to get it the next time it is offered. She said she was ultimately convinced to get it after speaking to other health professionals who did not dismiss her concerns and listened to her questions.

Now, however, there is another hurdle. Susan has declined the vaccine twice because of logistics. She is currently on a temporary crisis assignment in rural Texas and the travel meant both times she was offered the vaccine, she would be in a different state when it was time to take the second dose. Susan said: “I feel terrible I’ve said no.”

Why do you think medical professionals are hesitant to take the vaccine? Shouldn’t one lead by example? If they are unwilling to do it, why should you be willing? Will you take the COVID 19 vaccine?

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COVID-19 vaccine stirs rare hesitation in nearly virus-free Singapore

By Chen LinAradhana Aravindan
Source: Reuters

SINGAPORE (Reuters) – As Singapore prepares to roll out COVID-19 vaccinations its striking success in controlling the virus is making some question whether they should take the jabs.FILE PHOTO: The first shipment of coronavirus disease (COVID-19) vaccine arrives in Singapore December 21, 2020. Betty Chua/Ministry of Communications and Informations via REUTERS

In a city-state where compliance with the authorities is generally high, some Singaporeans fear potential side effects – even if minimal – are not worth the risk when daily cases are almost zero and fatalities are among the world’s lowest.

“Singapore is doing pretty well,” said Aishwarya Kris, who is in her 40s and does not want a shot.

“I doubt the vaccine will help at all.”

A poll by local newspaper The Straits Times in early December found that 48% of respondents said they will get a vaccine when it is available and 34% will wait six to 12 months.

But the government is keen to open more of the economy with the help of the vaccine in a country dependent on travel and trade and preparing to host the World Economic Forum’s annual gathering next year.

“Singapore is a victim of its own success,” said Leong Hoe Nam, an infectious diseases expert at the city’s Mount Elizabeth Hospital.

To show the vaccine is safe, Prime Minister Lee Hsien Loong, 68, said he and his colleagues would be among the early recipients of the shots. They will be free, voluntary and given first to healthcare workers and the elderly.

The first shipment of the Pfizer-BioNTech vaccine arrived this week and Singapore expects to have enough vaccines for all 5.7 million people by the third quarter of 2021.

The first vaccines will be given to priority groups such as health workers in the next month or two, but it will be some time before its offered to the broader population, said Lawrence Wong, a minister who co-heads Singapore’s virus taskforce.

“The roll-out to the Singapore population will also take place over several months, depending on factors such as the supply and delivery schedules of the vaccines,” he said.

“RESPONSIBLE THING TO DO”

Many Singaporeans said they are ready to take the shots — not just to ward off infection but in hopes they can travel again. For others, it’s a civic duty.

“I am the one in the family that goes out daily to work, so it’s the responsible thing to do,” said Jeff Tan, a 39-year-old photographer.

Singapore acted swiftly after the first cases of the virus were reported and although it was blindsided by tens of thousands of cases in migrant workers dormitories, it has brought infections right down again.

Singaporeans are generally accepting of vaccines, with a near 90% uptake of major childhood jabs, said Hsu Li Yang at Saw Swee Hock School of Public Health at National University of Singapore.

But there is concern about a new vaccine that uses novel technology and has had a rapid development and approval. Typically, vaccine acceptance takes time, he said.

Even three nurses told Reuters under the condition of anonymity that they would prefer not to take the vaccine.

Singapore’s drug regulator said it granted approval after data submitted by Pfizer-BioNTech was assessed to demonstrate the vaccine meets the required safety, efficacy and quality standards, and that the benefits outweigh the known risks.

Pfizer’s vaccine has been linked with a few cases of severe allergic reactions as it has been rolled out in the UK and the United States. But it has not turned up any serious long-term side effects in clinical trials.

John Han, a sales manager, said he wanted to wait for 80% of the population to take the vaccine without side effects.

“If there is a choice given, I might not take it. I don’t mind to put on the mask, be safe, avoid crowded places,” said Han, 40.

Reporting by Chen Lin and Aradhana Aravindan in Singapore; Editing by Michael Perry

Why do you think people across the world are hesitant to take the COVID vaccination? Have you taken the vaccine? Why? Why not?

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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47% of Americans Still Hesitant to Get COVID-19 Vaccine, New Poll Says

Published: Jan 22, 2021 By Gail Dutton
Source: Biospace

Vaccine Hesitancy
Source: Biospace
Shidonna Raven Garden and Cook

Americans are still hesitant to be vaccinated against COVID-19, according to just-released research from Invisibly.

The online survey of 5,537 Americans conducted between December 4 and 14, 2020 shows Americans nearly equally divided on their willingness to receive COVID-19 vaccines. Only 53% said they were willing to get the vaccine.

“That’s a shockingly low number, but it corresponds well with what JAMA has reported,” Don Vaughn, Ph.D., a neuroscientist and VP Data & Insights at Invisibly, which conducted the survey, told BioSpace.

The Invisibly poll found that willingness to be vaccinated is tightly linked to trustworthiness. Of those who trust the vaccines to be safe and effective, 81% said they are willing to be vaccinated. Of those who considered the vaccine very untrustworthy, 80% said they were very unlikely to be vaccinated.

Notably, trust in the vaccine and willingness to be vaccinated correlated to race and age, with Caucasian people and those age 55 and older saying they are most likely to take the vaccine. The survey found no other significant correlations among income, education, gender or other demographics.

Those age 55 and older are the group most willing to take the vaccine (67%) but even among this group, 33% said they were unwilling to get the COVID-19 vaccine. The second most likely group to be vaccinated is aged 18-24 (58%), followed by those 45-54 (50%). Only 47% of respondents between ages 25 and 44 said they are likely to receive the COVID-19 vaccine.

“We’re seeing numbers now from California, reported in the Los Angeles Times, that 50% of front line healthcare workers (in Riverside County)  and 20-40% of Los Angeles County’s frontline workers refused to take the vaccine,” Vaughn said. “We presume they’re more medically educated, so…” hesitation among those outside of healthcare is less surprising.

Perhaps not surprisingly, people of color are most distrustful of the vaccine and thus the least likely to be vaccinated despite a higher incidence of COVID-19 in their communities. Of those not willing to be vaccinated:

  • 53% are Black
  • 50% are Latinx
  • 48% are of other ethnicities
  • 38% are White

Lisa Cooper, M.D., director of the Johns Hopkins Center for Health Equity and a former MacArthur “genius” fellow for her work in health disparities, explained the concern on NPR.

“In the Black community, there is skepticism that relates to historical experiences, and mistrust based on the discrimination that Black Americans face in the health care system and in the rest of society. It’s really well-founded,” Cooper said.

The overwhelming reason for this reluctance appears to be distrust of these vaccines (44%). Reports indicate that people are confused by medical terms and don’t understand how a safe vaccine was developed without cutting corners.

Vaughn has an additional explanation.

“A lot of people want to wait a bit,” Vaughn said.

An ABC poll confirmed it, with 44% of those respondents preferring to wait to see how those receiving the initial vaccines fared before rolling up their own sleeves.

In the Invisibly poll, most respondents said they will return to pre-pandemic activities only when officials say it is safe, while 23% said they would resume normal activities after most people are vaccinated. Until then, 75% said they plan to continue wearing a mask and social distancing. Notably, 25% said there are unlikely to wear a mask after vaccination.

Also, 47% of respondents think children should be required to be vaccinated against COVID-19 before returning to in-person learning. Given the low incidence of COVID-19 among children, 30% said vaccination should not be required for children and 23% were unsure.

According to the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report for January 13“Reported incidence and positive test results among children aged 0–10 years were consistently lower than those in older age groups.” Of the nearly 2.9 million laboratory-confirmed cases of COVID-19 in people younger than age 24 since the outbreak began, about 16% occurred in children aged 14-17; nearly 8% in those 11-13 years old; 11% in those 5-10 years old; and slightly more than 7% in those age 4 or younger.

Larry Corey, professor of medicine, Johns Hopkins Medical School, showed Kaplan-Meier curves concurrent with vaccine roll out that showed differences in the infection rate between vaccinated and unvaccinated individuals for both the Pfizer and Moderna vaccines.

The key to increasing vaccination rates begins with clear communication that translates the medical jargon into everyday language, followed by strategies that deliver ample quantities to vaccine where they are needed and clear guidance as to who is eligible to received the vaccines at given points in time.

For example, Washington state just entered Phase Ib of its vaccination plan and launched an online questionnaire  (http://www.FindYourPhaseWA.org) to help people know when and how to get vaccinated.

There’s still some confusion, though. One of the Phase Ib criteria includes people age 50 and older who live in multigenerational households. The definition of “multigenerational” in this context raises questions. The Washington State Department of Health defines it as two or more generations living together, although it’s often defined as three or more generations living together or grandparents caring for grandchildren. By way for example, the Washington State Department of Health says, “Think of a person over 50 who cannot live independently and receives long-term care from a caregiver, lives with someone who works outside the home, or lives with and cares for a grandchild.” Additional guidance is expected.

Regardless, throughout all 50 states and U.S. territories, people are queuing for vaccinations. Now that nearly 17 million doses of the vaccine have been administered, Vaughn said Invisibly plans to conduct another poll “in about a month,” to see whether attitudes have changed.

Indeed many healthcare workers are hesitant mainly siting the politicization of COVID 19. While other like a Jamaican doctor who died of COVID 19 complications sited poor health care treatment. Will you take the vaccine? Why? Why not? Why do you think people remain hesitant?

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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It’s essential to understand why some health care workers are putting off vaccination

Early data on why health care workers are delaying the Covid-19 vaccine could help us end the pandemic sooner.
By Katherine Harmon Courage  
Jan 11, 2021, 5:40pm EST
Source: Vox

Physician heal thyself comes from the Bible. Specifically, it can be found in Luke 4:23 where Jesus quotes a common Jewish phrase of the time, saying, “Ye will surely say unto me this proverb, ‘Physician, heal thyself’.” (KJV).

an environmental services provider cleans the room of an ICU Covid-19 patient
A housekeeper cleans and sanitizes the room of a COVID-19 patient in ICU at Providence St. Mary Medical Center amid a surge in Covid-19 patients in Southern California on December 23, 2020 in Apple Valley, California. So far, about 53 percent of health care workers have gotten the vaccine when it was offered to them, according to a December survey.
Source: Vox
Shidonna Raven Garden and Cook

Some hospitals around the country are reporting that 40 percent or more of their health care workers who could be getting a Covid-19 vaccine are not immediately signing up for it. Other health facilities have had so many extra doses from employees who declined the vaccine that people outside the first priority group — including a sheriff’s deputy and a Disney employee — have ended up getting shots.

It’s a troubling development, especially since health care workers are at higher risk of contracting the virus and are essential in our efforts to treat record numbers of Covid-19 patients. Some public health experts also hoped this group would be relatively easy to vaccinate— and could help pave the way for broader vaccine acceptance.

“I am definitely concerned that health care workers are electing to wait to get vaccinated,” Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the US Centers for Disease Control and Prevention, said in a briefing last week. “We want them not only to protect themselves, but we also want them to be educating their patients so that everyone across the United States understands that these vaccines are available, that they have a good safety profile, that they are working.”

December survey by the Kaiser Family Foundation found health care workers overall were about as likely to be hesitant about getting the vaccine as the general population (29 percent and 27 percent, respectively), with these respondents saying they would probably not or definitely not get the vaccine.

Another December survey of workers in the Yale Medicine and Yale New Haven Health systems described in a commentary in NEJM Catalyst found that of the 3,500-plus respondents, 85 percent said they would be “extremely likely” or “somewhat likely” to get a Covid-19 vaccine. But so far, about 53 percent of their workers have gotten the vaccine when it was offered to them.

Understanding what’s holding this group back could help us improve vaccine uptake in the wider population later. What’s clear is that we will need the vast majority of people in the US to get vaccinated against Covid-19 in order to stop the pandemic.

But we also have to be careful. Using the wrong language or approachto encourage vaccination could backfire, increasing hesitancy overall, says Alison Buttenheim, a faculty member at Penn Nursing and the Perelman School of Medicine, and scientific director for the Center for Health Incentives and Behavioral Economics. “If we go about it in the wrong way, we could miss the window and blow it,” she says.

Here’s what we know about vaccine hesitancy among health care workers — and what we can learn from it.

3 big reasons health care workers are putting off the vaccines

In addition to preventing infections, serious illness, and even death, vaccinating health care workers first provides an opportunity to gather a wealth of information we won’t get later fromthe general public. That’s because health care providers have the data not only on how many people were offered and got the vaccine, but also on their demographics.

It’s a diverse group: People working in health systems include not just nurses and doctors, but also those who move patients, work in food service, serve in administrative roles, and keep facilities clean and operational. And the people in these many roles span ages, races and ethnicities, educational attainment, income levels, and many other categories.

“In the United States, it’s our best shot at really understanding vaccine hesitancy and the populations we need to be considering for getting the most vaccine coverage,” says Whitney Robinson, an epidemiologist at the Gillings School of Public Health at the University of North Carolina.

From very early trends, some key lessons about why some health care workers are putting off the vaccine are already emerging.

1) Covid-19 vaccine hesitancy may not be the same as other vaccine hesitancy

The experts we spoke with noted that most of the health care workers who are reluctant to get the Covid-19 vaccine immediately are not necessarily refusing it indefinitely. Many nurses, Buttenheim says, “are in a wait-and-see mode: ‘I wouldn’t mind if a few more million people got it before I did.’” Despite robust safety and efficacy data, they want to see more real-world proof first.

That’s a very different stance from people who refuse — or refuse for their children — vaccines that have been around and proven safe for decades. This means “you can’t necessarily just apply what we know about vaccine hesitancy for childhood vaccines and other vaccines,” Robinson says.

Why the Covid-19 vaccines may feel different from other routine shots

As the Yale study found, among those 15 percent of workers who said they were less likely to get a Covid-19 vaccine now, many wanted a year — or at least six months — of follow-up data on recipients. About 11 percent of these reluctant people said that nothing would make them comfortable getting it; and fewer than 1 percent said they were “anti-vaccine” overall. Still, as Vice reports in a new feature, health care workers are vulnerable to both believing and disseminating the Covid-19 vaccine misinformation circulating via social media.

“Accounts with names like The Holistic Nurse are proclaiming that they won’t get vaccinated, and strongly implying their followers should do the same,” Vice’s Shayla Love and Anna Merlan write. “It’s a uniquely risky situation, where people claiming medical expertise are working to undermine trust in a vaccine, just as it becomes clear that a majority of the population worldwide will need to get it in order to keep us all safe.”

2) Covid-19 hesitancy among health care workers likely is linked to education

Of the 15 percent of adults in the Kaiser survey who said they would “definitely not” get a Covid-19 vaccine, more than half of those (53 percent) had not received education beyond high school. On the flip side, those who reported they would get the vaccine “as soon as possible” were most likely to have at least a college degree.

These patterns track with reports from health systems so far. For example, groups getting the vaccine at higher rates also are those most likely to have among the highest education.Brita Roy, of the Yale School of Medicine, where she is also director of population health and co-author of the Yale NEJM Catalyst study, notes that about 90 percent of medical residents have chosen to get the vaccine right away, compared with about 20 to 25 percent so far for those working in environmental services, food service, and transportation (who are likely to have lower overall education attainment).

Other striking demographic patterns have emerged in general population surveys, including that 35 percent of rural residents and Black respondents are hesitant about getting the Covid-19 vaccine. Tracking similar patterns in health care workers could help figure out how to bestaddress concerns about getting vaccinated.

3) There are historical reasons for health care workers of color to be skeptical about getting an early health intervention

About 40 percent of health care workers in the US are people of color. A deep history of institutionalized medical racism means that people of color have frequently been subjects of unethical experiments in the US, often sowing justified mistrust in the medical establishment. Unfortunately, due also to centuries of systemic racism, many of these groups have also been among those hardest hit by the pandemic.

Covid-19’s stunningly unequal death toll in America, in one chart

“I want these populations that have been burdened so badly with Covid-19 to be prioritized” for the vaccine, Robinson says. But, she acknowledges that even that ethos could make people suspect. “That’s so unusual with how health care usually operates in the United States, people might have pause,” she says.

And while some workers who haven’t gotten a vaccine yet might be prompted to sign up through simple reminders or other behavioral nudges, overcoming mistrust due to systemic racism, “this is not a nudgeable problem,” Buttenheim says. “That set of concerns and history isn’t going to be solved by a ‘mythbusters’ fact sheet or another study. It’s about really frank conversations about what you need to feel comfortable about this vaccine.”

Another step in addressing this, she says, would also be for health and medical institutions to clearly communicate and own up to past wrongdoings and indicate their goals for equitable medical treatment now and in the future.

Now is the time to address vaccine hesitancy

The rate at which health care workers are declining or delayingCovid-19 vaccines is, to many experts, unfortunately not a surprise. “I’m on record banging my head against the wall for several months that we need to be prepared for this, to have a vaccine acceptance strategy,” says Saad Omer, an infectious disease professor at the Yale School of Medicine and director of the Yale Institute for Global Health.

Although some were optimistic that health care workers would have a particularly high uptake of the vaccine, Robinson was also skeptical. “Everybody saw this coming who works in this field,” she says. “This is one of my frustrations: We know things that we haven’t been acting on.”

And there is a vast amount of research on the best ways to help people feel more comfortable getting a vaccine in general, which we can borrow from to some extent for the new Covid-19 vaccines.

For starters, we know what not to do when approaching people who are reluctant to get a vaccine. “‘You’re wrong’ — that doesn’t tend to work,” Robinson notes. “It’s a delicate thing.” She has found that among the most effective techniques is understanding where people are coming from and what their hesitations are. Acknowledging the vaccines’ newness will likely be important in addressing people’s concerns — both in this first priority group and likely those to follow, as well.

Also, giving people incentives — financial or otherwise — can actually discourage them from getting vaccinated, especially if they already have concerns about side effects.

Many health systems are already working hard to ramp up communications strategies with workers, provide peer-to-peer discussion opportunities, and even talking to their employees outside of work.

“Health care workers are also community members, so reaching them through social media and our local media outlets, as well as internal communications, has been key,” Mike Dacey, president and chief operations officer at Riverside Health System in Virginia (where they have had about 60 percent uptake among workers), wrote to Vox in an email. “We are encouraging team members who are eligible to receive the vaccine to do so within their designated phase to best support the safety and health of our team and community.”

In a December JAMA viewpoint, Buttenheim and her co-authors also suggested five behavior-based strategies for getting more people to get the Covid-19 vaccine:

  • Have community and public leaders endorse the vaccine
  • Frame vaccination as a “public act” that benefits others; maybe even hand out stickers
  • Make getting the vaccine free and easy
  • Give people early access to the vaccine — if they sign up early
  • Eventually make vaccination a requirement for entry, such as to schools, workplaces, and even restaurants, gyms, or airplanes

Other experts note that being transparent about any potential side effects, small and large, will help engender trust. For example, some people balked at a January 6 report from the CDC that noted several severe allergic reactions — anaphylaxis — following Covid-19 vaccinations, at a rate of about 11 per 1 million doses, about 0.001 percent of people who get the vaccine, and haven’t caused any deaths (unlike the virus itself). But these events would have been unlikely to surface in the trials of tens of thousands of people, which is why the government keeps careful record of all vaccines after they go to market.

Lesser side effects are also important to communicate clearly to improve trust and transparency now and in the future. “Planning to survey the population on mild side effects experience and share those data with our health care workers will also be useful for the community and [larger] population,” Brita Roy wrote to Vox in an email.

“The sooner we can get more people vaccinated, the sooner we can get back to some semblance of normal,” Buttenheim says. And we have to get a whole lot of people vaccinated. Director of the National Institute of Allergy and Infectious Diseases Anthony Fauci (after revising his public immunity estimations upward) says we’ll need 70 to 90 percent of people immune to the virus to squelch the pandemic.

For health care workers who refuse their first chance at a vaccine, getting back in line could be tricky. There’s no guarantee of when people will be able to get a vaccine if they wait past their designated phase — until more doses are available to the general public. And even more immediately, some states, including Connecticut, are resupplying facilities based on the number of doses they were able to give the week before. So if uptake is chronically low, availability could dip, too.

That many health care workers are not refusing the vaccine outright and, instead, planning to wait and see provides some small glimmer of hope. Acceptance of the vaccine“is likely to grow as the social norm is established,” Omer says, with the result of more people getting it when they can.

For now, many advocate using the science and information we already have to meet people where they are, and help them feel comfortable getting the shot. “We just need to get ahead of it,” Robinson says. “So much of the response has been reactionary when it comes to Covid-19. I just hope we can break that cycle.”

Why do you think medical professionals are vaccine hesitant? What are your thoughts on taking the vaccine? Why or why not?

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Vaccine rollout hits snag as health workers balk at shots

By BERNARD CONDON, MATT SEDENSKY and CARLA K. JOHNSON
January 8, 2021
Source: Associate Press

Source: Associate Press, Jae C. Hong
Shidonna Raven Garden and Cook

In this Jan. 7, 2021, file photo, a nurse puts on protective gear in a COVID-19 unit in California. The nation’s biggest immunization rollout in history is facing pushback from an unlikely source: health care workers who witnessed COVID-19′s devastation firsthand but are refusing shots in surprising numbers. (AP Photo/Jae C. Hong, File)

The desperately awaited vaccination drive against the coronavirus in the U.S. is running into resistance from an unlikely quarter: Surprising numbers of health care workers who have seen firsthand the death and misery inflicted by COVID-19 are refusing shots.

It is happening in nursing homes and, to a lesser degree, in hospitals, with employees expressing what experts say are unfounded fears of side effects from vaccines that were developed at record speed. More than three weeks into the campaign, some places are seeing as much as 80% of the staff holding back.

“I don’t think anyone wants to be a guinea pig,” said Dr. Stephen Noble, a 42-year-old cardiothoracic surgeon in Portland, Oregon, who is postponing getting vaccinated. “At the end of the day, as a man of science, I just want to see what the data show. And give me the full data.

Alarmed by the phenomenon, some administrators have dangled everything from free breakfasts at Waffle House to a raffle for a car to get employees to roll up their sleeves. Some states have threatened to let other people cut ahead of health care workers in the line for shots.

“It’s far too low. It’s alarmingly low,” said Neil Pruitt, CEO of PruittHealth, which runs about 100 long-term care homes in the South, where fewer than 3 in 10 workers offered the vaccine so far have accepted it.

Many medical facilities from Florida to Washington state have boasted of near-universal acceptance of the shots, and workers have proudly plastered pictures of themselves on social media receiving the vaccine. Elsewhere, though, the drive has stumbled.

While the federal government has released no data on how many people offered the vaccines have taken them, glimpses of resistance have emerged around the country.

In Illinois, a big divide has opened at state-run veterans homes between residents and staff. The discrepancy was worst at the veterans home in Manteno, where 90% of residents were vaccinated but only 18% of the staff members.

In rural Ashland, Alabama, about 90 of some 200 workers at Clay County Hospital have yet to agree to get vaccinated, even with the place so overrun with COVID-19 patients that oxygen is running low and beds have been added to the intensive care unit, divided by plastic sheeting.

The pushback comes amid the most lethal phase in the outbreak yet, with the death toll at more than 350,000, and it could hinder the government’s effort to vaccinate somewhere between 70% and 85% of the U.S. population to achieve “herd immunity.

Administrators and public health officials have expressed hope that more health workers will opt to be vaccinated as they see their colleagues take the shots without problems.

Oregon doctor Noble said he will wait until April or May to get the shots. He said it is vital for public health authorities not to overstate what they know about the vaccines. That is particularly important, he said, for Black people like him who are distrustful of government medical guidance because of past failures and abuses, such as the infamous Tuskegee experiment.

Medical journals have published extensive data on the vaccines, and the Food and Drug Administration has made its analysis public. But misinformation about the shots has spread wildly online, including falsehoods that they cause fertility problems.

Stormy Tatom, 30, a hospital ICU nurse in Beaumont, Texas, said she decided against getting vaccinated for now “because of the unknown long-term side effects.”

“I would say at least half of my coworkers feel the same way,” Tatom said.

There have been no signs of widespread severe side effects from the vaccines, and scientists say the drugs have been rigorously tested on tens of thousands and vetted by independent experts.

States have begun turning up the pressure. South Carolina’s governor gave health care workers until Jan. 15 to get a shot or “move to the back of the line.” Georgia’s top health official has allowed some vaccines to be diverted to other front-line workers, including firefighters and police, out of frustration with the slow uptake.

“There’s vaccine available but it’s literally sitting in freezers,” said Public Health Commissioner Dr. Kathleen Toomey. “That’s unacceptable. We have lives to save.”

Nursing homes were among the institutions given priority for the shots because the virus has cut a terrible swath through them. Long-term care residents and staff account for about 38% of the nation’s COVID-19 fatalities.

In West Virginia, only about 55% of nursing home workers agreed to the shots when they were first offered last month, according to Martin Wright, who leads the West Virginia Health Care Association.

“It’s a race against social media,” Wright said of battling falsehoods about the vaccines.

Ohio Gov. Mike DeWine said only 40% of the state’s nursing home workers have gotten shots. North Carolina’s top public health official estimated more than half were refusing the vaccine there.

SavaSeniorCare has offered cash to the 169 long-term care homes in its 20-state network to pay for gift cards, socially distanced parties or other incentives. But so far, data from about a third of its homes shows that 55% of workers have refused the vaccine.

CVS and Walgreens, which have been contracted by a majority of U.S. nursing homes to administer COVID-19 vaccinations, have not released specifics on the acceptance rate. CVS said that residents have agreed to be immunized at an “encouragingly high” rate but that “initial uptake among staff is low,” partly because of efforts to stagger when employees receive their shots.

Some facilities have vaccinated workers in stages so that the staff is not sidelined all at once if they suffer minor side effects, which can include fever and aches.

The hesitation isn’t surprising, given the mixed message from political leaders and misinformation online, said Dr. Wilbur Chen, a professor at the University of Maryland who specializes in the science of vaccines.

He noted that health care workers represent a broad range of jobs and backgrounds and said they are not necessarily more informed than the general public.

“They don’t know what to believe either,” Chen said. But he said he expects the hesitancy to subside as more people are vaccinated and public health officials get their message across.

Some places have already seen turnarounds, such as Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana.

“The biggest thing that helped us to gain confidence in our staff was watching other staff members get vaccinated, be OK, walk out of the room, you know, not grow a third ear, and so that really is like an avalanche,” said Dr. Catherine O’Neal, chief medical officer. “The first few hundred that we had created another 300 that wanted the vaccine.”

___

Contributing to this report were Associated Press writers Jake Bleiberg in Dallas; Heather Hollingsworth in Mission, Kansas; Janet McConnaughey in New Orleans; Candice Choi in New York; Kelli Kennedy in Fort Lauderdale, Florida; Jay Reeves in Birmingham, Alabama; Brian Witte in Annapolis, Maryland; Jeffrey Collins in Columbia, South Carolina; John Seewer in Toledo, Ohio; Melinda Deslatte in Baton Rouge, Louisiana; and Bryan Anderson in Raleigh, North Carolina.

Why are so many medical professionals one of the main communities hesitant to take a vaccine created within their own industry? Some say it was politicized? Others say it has not been adequately tested? What do you say?

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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From Tuskegee to a COVID Vaccine: Diversity and Racism Are Hurdles in Drug Trials

Drug companies pushing to fight the coronavirus with a vaccine must overcome a legacy of suspicion, even as Black communities have been hit hard by the pandemic.

By Joseph P. Williams, Senior Editor
Nov. 19, 2020, at 1:35 p.m.
Source: US News

The Search for Diversity in Drug Trials

In this 1950's photo released by the National Archives, a black man included in a syphilis study has blood drawn by a doctor in Tuskegee, Ala. U.S. public health officials in the 1930s began a study in which syphilis was left untreated in Black men. Known colloquially as the Tuskegee experiment, the study didn’t end until 1972, and has become shorthand among African Americans for a legacy of racism and mistreatment in the medical industry.
Source: US News
Shidonna Raven Garden and Cook

In this 1950s photo released by the National Archives, a Black man included in the Tuskegee syphilis study has blood drawn by a doctor in Tuskegee, Ala. The once-secret Tuskegee experiment has become shorthand among African Americans for a legacy of mistreatment in medicine.(NATIONAL ARCHIVES)

AMID A SEEMINGLY endless pandemic, as a spiraling number of COVID-19 deaths presage what could be a long, dark winter, the news broke through like thin rays of sunshine: Two American pharmaceutical giants racing to find a vaccine separately reported that human tests of their experimental drugs have shown highly promising results.

The potentially game-changing data from drug manufacturers Pfizer and Moderna, however, obscured what some say is anotherkey development: Both companies reported that the pools of volunteers receiving the drugs included significant numbers of Black participants.[ 

The inclusion of Black people in trials for a highly anticipated drug might seem like a no-brainer, particularly for a vaccine to fight COVID-19, a contagion that’s been killing Black Americans at a rate higher than whites. Indeed, PhRMA, the drug industry’s influential trade group, just announced a new set of principles that urge diversity in human trials for new drugs to boost health equity, increase participation by people of color, ensure drug effectiveness – and tackle lingering suspicion of the medical industry among some African Americans.

“Between Latinx and Black or African American populations, we’re running at about 19% or so,” Dr. Bill Gruber, Pfizer’s senior vice president of vaccine clinical research and development, told Reuters this summer, describing a trial pool of 11,000 people for a vaccine being developed with German partner BioNTech. “We’re trying to push even higher than that.”

The company appears to have improved, saying as of Monday that 30% of U.S. trial participants had “diverse” backgrounds, with Black people and those identified as either Hispanic or by the gender-neutral term Latinx accounting for approximately 10% and 13% shares, respectively. Moderna, meanwhile, said its 30,000-person phase three vaccine study included more than 11,000 people from communities of color, including more than 6,000 Hispanic or Latinx people and more than 3,000 Black or African American participants.

Yet while the industry insists it is moving with deliberate speed toward diversity and inclusion in experimental drug trials, some say it’s taking baby steps and has a long way to go toward building trust with African Americans and other minority communities.

“There are a lot of outstanding questions,” says Jonathan Jackson, a cognitive neuroscientist and director of the Community Access, Recruitment, and Engagement Research Center at Massachusetts General Hospital in Boston. The center investigates the effects of diversity and inclusion on human subject research.

“A lot of people who have been running the COVID-19 vaccine studies have been really excited because they have recruited a more diverse population, compared to what they’re used to,” Jackson says. “The bar that you’re trying to clear shouldn’t be a study that you ran last year,” but the goal should be to mirror the population most affected by the targeted disease.

“So if those are our baselines, then what we’re seeing – even though it is a significant increase in diversity – is still nowhere near representative of COVID hospitalizations or COVID deaths,” Jackson says. “It’s hard to get excited when we still have so far to go.”

Jackson and others say the lack of diversity in medical trials has roots extending deep into U.S. history.

Dr. J. Marion Sims, onetime president of the American Medical Association and an esteemed physician dubbed “the father of modern gynecology,” made groundbreaking medical strides through research he conducted on female slaves, without anesthesia. Medical journals reportedly indicate it was common to conduct medical experiments on slaves with no pain relief; procedures ranged from amputations to brain surgery.

While research on slaves gradually faded over the decades, experiments on African Americans never completely went away.

World Braces For Another Wave of Coronavirus

In 1951, doctors at The Johns Hopkins Hospital in Baltimore – though segregated, one of the only leading hospitals to treat Black patients – harvested cells from Henrietta Lacks, a Black woman being treated for cancer, without her knowledge or permission. Though such harvesting reportedly was standard at Hopkins regardless of race, Lacks’ cells were abnormally reproductive and widely shared, and her “HeLa” cells are still in use for research today.

In perhaps the most egregious example, U.S. public health officials in the 1930s began a study in which syphilis was left untreated in Black men. Known colloquially as the Tuskegee experiment, the study didn’t end until 1972, and has become shorthand among African Americans for a legacy of racism and mistreatment in the medical industry.

Facing that ugly history is part of building trust and boosting participation in clinical trials by historically underrepresented communities, according to the PhRMA industry principles, which explicitly state that the Tuskegee experiment was unethical and featured serious mistakes. Still, the industry principles state that the horrible experiment became a conduit for “major changes in how clinical trials are conducted in order to protect the rights, safety, and well-being of clinical trial participants.”

Rather than lean into diversity and inclusion in medical trials, however, experts say the industry went in the other direction. For years, it wasn’t unusual for a drug to be tested on volunteers from the pharmaceutical research community, without any people of color in the pool.

In that world, “it’s not that we struggle to recruit racial and ethnic minorities; it’s that we’re really good at recruiting one type of person into clinical research,” says Jackson, the CARES director. “And that person is usually (a) white, wealthy male, and lives in an urban center, along the East or West Coast of the United States, and has some kind of advanced educational degree.”

Decades ago, the group that was easiest to reach were poor, minority individuals that were unlikely to speak up or speak out,” he says. “Now, the group that’s easiest to reach are extremely privileged individuals” who have the means and the time to participate

Dr. Georges Benjamin, executive director of the American Public Health Association, says diversity in clinical trials is important for two reasons.

“One is that it’s just better science – you then get a better idea of how your drug or your vaccine or anything else works in a more representative population,” particularly among people dealing with issues tied to social determinants of health, Benjamin says. “And the other aspect is, it helps with trust” among African Americans and other marginalized populations.

The data underscores the need: As of August and compared with whites, Black people had a COVID-19 case rate nearly three times higher, were hospitalized at a rate nearly five times higher and had a death rate more than two times higher, according to the Centers for Disease Control and Prevention. An APM Research Lab analysis as of Nov. 10 also shows Black Americans with a death rate close to double that of whites.

Yet recent polling indicates nearly half of African Americans are either reluctant or will refuse to get a COVID-19 vaccination. That’s despite the fact that some believe the disproportionate effects the coronavirus has had on their communities should put people of color near the front of the line for inoculation.

“Having a racial preference for a COVID-19 vaccine is not only ethically permissible, but I think it’s an ethical imperative,” Lawrence Gostin, a professor of global health law at Georgetown University, told STAT. It’s justifiable, he said, because of “historic structural racism that’s resulted in grossly unequal health outcomes for all kinds of diseases, and because COVID-19 has so disproportionately impacted the lives of people of color.”

To be sure, the racial and ethnic makeup of trial participants can vary: In 2019, for example, federal data snapshot says Blacks or African Americans – who make up about 13% of the U.S. population – accounted for 4% of participants in trials that led to the approval of 11 new oncology drugs, but for 25% of participants in trials that led to the approval of six hematology drugs and 29% in trials that led to the approval of five drugs in the psychiatry and sleep disorder category. Notably, a 2018 study indicated that African Americans were overrepresented in trials that did not require informed consent but are to be aimed at life-threatening, emergency conditions.

In its vaccine pursuit, Pfizer appeared to recognize the need for diversity and inclusion: A fact sheet sent by a company representative states that COVID-19 “is an urgent health crisis that disproportionately impacts diverse communities,” a problem that requires focused action.

The drug company’s efforts include information and ad campaigns to educate the public and recruit volunteers in “diverse” communities hit hard by COVID-19, according to the fact sheet. In addition to outreach in several languages and partnerships with grassroots community organizations, Pfizer also set up a website that shows its progress in including minorities in its vaccine trials.

“We are doing everything we can to ensure that the demographics of our trial population reflect the demographics of the states and communities that have been most impacted by COVID-19,” according to the fact sheet.

Benjamin says Pfizer and other drug manufacturers are making the right moves to increase inclusion in drug trials, including by embedding representatives in the community. Still, he says, it’s a long-term process that will yield concrete results in years, not months.

“You have to make sure you have the right people at the table,” Benjamin says. Drug companies, he says, have to “make a conscious effort” to include those affected by the disease they’re trying to cure, and “actually go to the patients and take that added step to ensure that you have a representative population” for a drug trial.

Jackson, for his part, says while the diversity numbers reported by Pfizer and Moderna are sunny, “I’m probably going to be the rain cloud.”

Outstanding questions include whether the percentages equate to the number of minorities affected by the coronavirus. Moreover, “even if we had exactly the percentage in the studies that we see, there are other issues that are really problematic” and could determine how effective the drug is when accounting for social determinants of health, Jackson says.

“It actually makes a difference where your racial and ethnic minorities come from,” he says. “Do they come from areas of town that are more rural? Poorer? Have worse insurance access than the white people that are enrolling in these studies?”

Ultimately, “it really comes down to one thing, which is just the importance of community engagement, which drives more inclusive enrollment, rather than just a record of diverse enrollment,” Jackson says. When a vaccine is developed, trust has to be there in order to get the African American community to buy in and get the shot to curb the spread of disease.

“And so you need to build that trust, when the vaccine is still being tested, rather than waiting for the vaccine to be approved by the FDA,” Jackson says. “Because that’s what’s really going to drive trust, is that people understand the whole process and can attest to their involvement in it.”

How do you feel about the COVID 19 vaccines? What questions do you have? Why?

Share your comments with the community by posting them below. Share the wealth of health with your friends and family by sharing this article with 3 people today. As always you are the best part of what we do. Keep sharing!

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