A Lack of Trust and Access

COVID-19 has drastically changed our world and the release of vaccines, for it has provided some hope for the future. However, there are those who are more wary of this speedy vaccine release. According to World Health Organization, vaccine hesitancy refers to the “refusal of vaccines despite availability of vaccine services.” It can be influenced by factors of complacency, convenience and confidence. Especially with constant updates regarding things such as new variants and the side effects from the Johnson & Johnson vaccine, hesitancy surrounding the vaccine is rising. With vaccine hesitancy comes further vulnerability to the COVID-19 virus. Herd, or population, immunity is when a majority of the population is vaccinated, making it harder for the virus to spread, and is something that the Centers for Disease Control is aiming for. However, even with herd immunity, if communities continue to refuse the vaccine, this will put them at an increased risk of infection.

Vaccine hesitancy in marginalized communities is especially prevalent because of their rough past with the healthcare system, which has contributed to their distrust in it. A COVID-19 racial data tracker, created by the COVID Tracking Project and the Boston University Center for Antiracist Research, shows that the pandemic has hit communities of color the hardest. Those communities have the highest rates of vaccine hesitancy and the least amount of access. This hesitancy is demonstrated by a survey done by the Societal Experts Action Network. They found that 55% of Black Americans would take the vaccine if it were proven to be safe, while 70% of white Americans would take it. Data from a Harvard study found that Black and Latinx Americans die more often, and more prematurely, than the white population. This may be due to the fact that marginalized communities are subject to other factors, such as poverty, lack of access to healthcare, housing instability, lack of educational resources and more—all of which are exacerbated by COVID-19. Dr. Jose Paez, a Hispanic-Black physician in New York, expressed his worries concerning the healthcare system because of his identity. “I get scared or hesitant when it’s time to give my name for appointments. I was worried that once they knew my ethnicity I would either not get tested or have a date way in the future,” he said. This lack of trust in the COVID-19 vaccine is not an isolated issue; it is a combination of the spread of misinformation on social media, the lack of accessibility surrounding scientific knowledge and a lack of trust in the healthcare system, due to a history of exploiting marginalized communities.

This mistrust in the healthcare system can be traced back to the medical mistreatment of Henrietta Lacks, an African American woman. Medical researchers took Lacks’ cervical cells after her death, used it to develop their research and profited off of the research without crediting her or sharing the profit with her family. Another such example is the Tuskegee Syphilis Study exploring the effects of syphilis. Although the infamous study consisted of African American men with syphilis, the researchers did not inform the participants of their syphilis status, then proceeding to deny them treatment for syphilis. Further examples of abuse from the healthcare system and other general discrimination from the government toward these communities can be observed from the sterilizations from Indian Health Services in the ‘60s and ‘70s. This lack of access to scientific knowledge, combined with mistrust in the healthcare system, creates rumors and fears about the vaccine.

Even when folks from these communities do decide to get vaccinated, the inequity in vaccination distribution, spurred by a lack of access to vaccines, causes many issues. Older populations may not know how to make a vaccine appointment online. Additional barriers to vaccination include disability/lack of mobility, unpredictable work schedules and homelessness. Professor Colette Auerswald, an associate professor of community health sciences, emphasizes a more community-centered, rather than a clinical, approach to vaccine distribution; by providing greater access to these vaccinations, this community-centered approach can also help restore trust in them among marginalized communities.

During an interview with Dr. Marie Agleham, a family medicine physician at Kaiser Permanente in Union City, she emphasized how Kaiser has consistently been disseminating information to its members to prevent the spread of false vaccine rumors. For communities of color, Dr. Agleham says, “They will believe in people who look like them,” more so than government or healthcare professionals to whom they cannot relate. She suggests that promoting voices from these communities can in turn help promote the vaccine. According to Dr. Agleham, a Union City program posts informational videos about COVID-19 on its YouTube channel, with the goal of promoting the vaccine among different communities of color. One of its videos translates the COVID-19 information into Tagalog, allowing Filipino communities to feel more self-assured regarding this information, which is presented to them through a more accessible medium.

We can address these disparities in distribution in several ways. Dr. Wrenetha Julio from Rush University College of Nursing and Dr. Kenya Beard from Chamberlain University highlight four ways to build vaccine trust within marginalized communities. The methods include: establishing clear communication between health professionals and communities and working with communities to reach individuals from multiple generations. Also important is the recognition of the unique role of faith leaders in many communities of color and the complications of vaccine administration, especially in Black and Brown communities where healthcare access is usually limited. According to Temple Health, building trust in vaccines and answering patients’ questions helping patients to answer them are two integral parts in controlling the pandemic and helping these communities where COVID-19 rates are highest. This issue highlights the importance of having people from these communities in the healthcare field, in order to build a field centered around community care.

To close, there are some resources for COVID-19 vaccinations around San Francisco. They are without charge and are now open to the general public. One will be able to find and schedule vaccine appointments through websites such as vaccinefinder.org and myturn.ca.gov, which are offered at many vaccination sites, hospitals and local pharmacies. To combat COVID-19, it is important to work together to ensure community health.