Overcoming vaccine wariness
Past, present injustices mean hesitancy among Black, Latino residents
Lino Acevedo has been on the fence about getting a COVID-19 vaccine.
First, there’s his age. The 57-year-old father from Albany says he feels “too old to be experimented on.” Then there’s how quickly the vaccines were developed. Although the timeline was accelerated by years of prior research and billions of dollars in government investment, to Acevedo and millions of other Americans, the vaccine’s sudden approval seemed too good to be true.
Then there’s history. As a Latino man, he’s well aware of the nation’s history of medical experimentation on — and forced sterilization of — people of color.
“There’s this theory of people thinking it’s something about crowd control, you know? Population control,” he said. “That’s a big issue out here in the Latino community. People are saying they trying to get rid of us.”
He’s not alone in those fears. Past mistreatment of communities of color by America’s medical establishment — in addition to ongoing racism and inequities in health care and other fields — come to mind for many Black and brown people, including those in the Capital Region, when they think about whether to receive a vaccine to protect against the novel coronavirus.
Leaders in these communities say the key to overcoming the hesitancy and reaching critical mass with the vaccine starts with taking the time to acknowledge and validate concerns that arise from past injustices. From there, government leaders and trusted messengers can aim to build trust through education and influence campaigns that help address many of the basic safety and health concerns people have regarding the new
A troubling history
“In each of our focus groups, the Tuskegee experiment came up at least once,” said Kate Strully, a University at Albany researcher who helped lead focus groups around the state last summer on the issue of vaccine hesitancy in communities of color.
The Tuskegee syphilis study — in which Black men in rural Alabama were never told they had the deadly venereal disease from the 1930s through the 1970s so scientists could observe what it did to them — is often invoked by Black Americans when asked why they might be hesitant to receive a coronavirus vaccine.
For people like Acevedo, the nation’s history of forced sterilizations also lingers.
Between the 1930s and 1970s, roughly one-third of Puerto Rico’s female population was sterilized as a result of U.s.-endorsed programs designed to reduce “overpopulation” on the island. During the 1960s and 1970s, Mexican-american women in Los Angeles were shamed and pressured into sterilization procedures while they were giving birth.
Black and Indigenous populations have faced similar sterilization campaigns, often without consent.
“They just don’t want to be a guinea pig,” said Micky Jimenez, executive director of Capital District Latinos, a cultural organization that operates a community engagement center near Albany’s Washington Park.
“I talked to Black men who say, ‘Oh, we ended up with syphilis,’” she said. “Or if they were Puerto Rican, ‘Oh, you remember our women were sterilized.’ And you know what? Those were true stories. So how do you dismiss that?”
This kind of justified distrust does not just stem from historical events, said Carolyn Mclaughlin, an Albany County legislator who is working to build confidence in the vaccine among the coun
ty’s Black citizens. Black people’s health concerns are downplayed by the medical community of today as well, she said.
“Acknowledge the Tuskegee incident, yes,” she said. “But beyond that, even closer to home, how are people dealt with by the medical community now?”
Mclaughlin has lost nine friends and family members since the pandemic arrived in New York, she said. Most of them died after contracting COVID-19, which is caused by the coronavirus. And she wonders if appropriate medical care was given to two others who died after they were sent home from the emergency room even though they had COVID-19 symptoms.
“Doctors in emergency rooms are so busy sending people home … and then they go home and all of a sudden they have some respiratory arrest,” she said. “Why? I believe it was the lack of medical treatment.”
Trusted messengers
The loss of so many friends and family — and the mental health impacts of prolonged quarantine — are why Mclaughlin is working hard to try to
boost trust in the vaccine in the county’s Black communities.
Black residents are also more likely to wind up in the hospital from COVID-19 than their white counterparts, county data show. And early on in the pandemic they were dying at higher rates, too, though those have since leveled out (racial disparities in COVID-19 deaths persist both nationwide and statewide).
“Think about if it wasn’t available to you,” Mclaughlin said of the vaccine. “I tell people,
don’t self-select out of the opportunity to get the vaccine without the proper and adequate information. That’s why people like me, we’re trying to make ourselves available as an influencer in the community, a voice that people are going to listen to.”
Mclaughlin is working with the Albany College of Pharmacy and Health Services and the South End Community Collaborative to circulate a survey that people can take to share their concerns about the vaccine.
The survey, available online at is.gd/covidvx, will be used to inform educational campaigns in the community, Mclaughlin said.
“We’re running up against barriers even in getting the survey out there in that we can’t really go door to door right now,” she said. “Plus, you’ve got to trust who’s giving you the survey.”
Mclaughlin said the goal is to hire “trusted ambassadors” who can hand out a copy of the survey to people — either with a self-addressed stamped envelope or to collect at a later date. They’re trying to get to 1,000 responses but were only a quarter of the way there as of Wednesday.
This concept of using influencers or other trusted messengers to promote vaccine acceptance in Black and Hispanic communities has been in play since the very beginning of the vaccine rollout. The first New Yorker to receive the vaccine was a Black ICU nurse and the first Capital Region resident to get a shot was a Black clerical associate specialist who registers patients as they come into Albany Medical Center’s emergency room.
“As a person of color, I personally am very much invested in seeing as many people as possible get vaccinated,” said Dr. Angela Antonikowski, a Black woman who last summer was named Albany Med’s first chief officer of health equity, diversity and inclusion.
The hospital, which is serving as one of 10 regional vaccine hubs statewide, has a health equity task force that is working on the issue of vaccine rollout in communities of color, she said.
“We are partnering with over 40 health care institutions and agencies in the region, with the stakeholders there to really identify, for example, who are the members in the communities that individuals trust in terms of information?” she said.
Jimenez, who heads Capital District Latinos, is one of them. At a wellness event for men of color last October, she asked everyone how they felt about the vaccine. There she encountered Acevedo, the Albany father who was unsure about whether to get the vaccine.
“Ms. Micky told me that she was going to do it,” Acevedo recalled. “When she told me that she would do it, I was like, ‘Really, you would do it?’ And knowing Ms. Micky — she’s a good person and she’s up on things, she talks to people and I have a lot of faith in her — I told her, ‘If you do it, then yeah, I’ll take my chances and do it, too.’”
Jimenez got her shot Wednesday, and made sure photos and video were taken so she can help spread the message that the vaccines are safe.
“It’s great to see (President-elect Joe) Biden and to see our leadership doing it,” she said. “But I think when it comes to the Latino community and men of color and people of color, it’s really at the ground level that they want to see it — that I trust this science and that I’m willing to take it.”
Logistical hurdles
Building confidence in the vaccine will not be enough on its own, Jimenez said. Logistical barriers — such as getting to a vaccine site or taking time off work or watching chil
dren — remain a major hurdle.
Jimenez, who is on both the state and regional vaccine task force, said she is working to try and get the Capital District Latinos community center at 160 Washington Ave. designated a vaccine distribution site. It has the space and is in an area of the city that would be easy for people to reach.
“But also, this has become a place people trust,” she said. “They’ve been here before. So we’re going to be applying for that and see how it goes.”
Mclaughlin said the Albany County Legislature has also been talking to religious leaders about using their sites for vaccine distribution.
“I haven’t spoken specifically to a pastor that said, ‘Yes, we’ll do that,’ ” she said. “But the conversation has been put out there, and I think there’s some who would be interested.”
Gov. Andrew M. Cuomo last week said that when vaccine rollout begins for the general public, the state will move away from hospitals as distribution sites and rely heavily on a “retail network” of distributors. These will include pharmacies, federally qualified health centers, local health departments, private urgent care clinics and private doctor networks.
The state has also begun building “community vaccination kits,” he said, and is working with public housing officials, churches and community centers that could erect makeshift distribution sites in underserved communities.
Jimenez said vaccine providers better start thinking now about how they’re going to get people back for a second dose. Migrant workers, for example, are highly transient and won’t necessarily be around in the three to four weeks after their first dose is administered, she said.
“There’s just a lot of idiosyncrasies that I think when we’re looking at these populations, all these things have to be taken into consideration,” she said.
“As much as we want to rush to reach herd immunity, we have to put time into the messaging and gaining their trust. If we do that, I really believe everyone will be better off.”