‘For the greater good’
Baltimore’s Black leaders volunteer for medical trials to fight against historical mistrust of research and improve community health
Freeman Hrabowski III and his wife, Jacqueline, volunteered earlier this year to participate in a local clinical trial for the COVID-19 vaccine candidate developed by Moderna, which is now seeking federal authorization for its use.
The couple wanted to set an example for others in the Black community.
“There’s always a little fear, but we look at each other and say, ‘This is for the greater good,’ ” said Freeman Hrabowski, the president of University of Maryland, Baltimore County.
As many Americans eagerly wait for COVID-19 vaccines to be distributed, Black Baltimore leaders are working — with some success — to confront the glaring lack of people of color who participate in the important clinical trials needed to develop such medications.
African Americans represent just 5% of the people in most clinical trials, but make up12% of the U.S. population, according the U.S. Food and Drug Administration. Not having enough people of color in medical trials can lead to problems with medications and treatments.
“There are issues of knowing whether a [COVID-19] vaccine will work on all subcategories including race, gender and age,” said Dr. Matthew Laurens of Baltimore’s Center of Vaccine Development and
Global Health. “As humans we are 99% similar, but that 1% can make a big difference.”
Efforts to convince Black and brown people to participate in clinical trials are crucial to overcoming a sometimes racist past in medical research and to improving health outcomes for racial minorities, experts say. Consider that African Americans are twice as likely as white people to develop Alzheimer’s disease and Black residents of Maryland represent nearly 50% of COVID-19 deaths, but only make up 31% of the state’s population, according to Pew Research.
Starting in August, representatives of the Center of Vaccine Development at the University of Maryland School of Medicine handed out flyers around Baltimore and worked to connect with minority communities. The goal was to find Black and brown people to participate in the Moderna clinical trial.
The trial was needed to determine whether the vaccine could prevent coronavirus infections. About 30,000 people were expected to participate at 89 sites, according to the National Institutes of Health. In Baltimore, 48 participants took part in the trial at the University of Maryland, with more than 50% of the volunteers being people of color.
The trial participants were given two intramuscular injections, one month apart from each other. They either got two shots of the vaccine or two shots of a placebo. Volunteers didn’t know which one they were getting at the time of injection.
After it was over, Hrabowski said the couple felt sluggish for three days. They recorded their symptoms in a journal. They are also required to have blood work done every six months to track how their bodies are reacting.
Hrabowski said he doesn’t feel that he is putting his life on the line by participating
in the trials.
“We have been educators and mentors for a long time,” he said. “We would not do something like this if we didn’t believe it was safe for other people.”
As the community effort to convince other reluctant potential volunteers continues, Thurka Sangaramoothy, a cultural anthropologist with a background in pandemics, said health care professionals need to ask themselves some serious questions about how to gain the trust of people of color.
“Do the people in the community know you? Are you an advocate? Are you competent in delivering a program aligned with the community?” Sangaramoorthy asked. “There are very few professionals who can say ‘yes.’ They are just in a race to find a cure.”
Until those concerns are acknowledged, Sangararmoorthy said, mistrust between communities of color and the medical field will remain an issue.
“A vaccine is called a magic bullet solution because it’s a quick fix, but people still feel like their concerns are being brushed off when they go to the doctor. That’s an issue a magic bullet can’t fix,” she said.
The Maryland vaccine development center is seeking participants for another COVID-19 trial launching this month.
Laurens said the progress made on the current vaccines could not have happened without clinical trial volunteers.
“I think that we should thank all of the volunteers and consider them to be true American heroes,” he said.
The effort to encourage more Black participation extends beyond clinical trials.
When Black people with certain health conditions die and their bodies end up in the Maryland medical examiner’s office, their families may receive a call asking a difficult question: Would the deceased’s loved ones agree to donate the person’s brain to science?
The call comes from a group of top-tier scientists, Black Baltimore leaders and