Vaccine rush daunting
Blacks, Latinos unsure given history of mistreatment in health care system
Like many people of color, Michael Richardson of Allentown says he’s experienced racism in the health care system, such as receiving less attention than his equally fit white friend for the same type of first-time injury.
And, like many, Richardson, 45, grew up hearing stories about the infamous Tuskegee syphilis study performed by medical professionals on Black men in Alabama.
“Because of this, I have a general distrust of the health care system,” said Richardson, a dog breeder whose business has been affected by pandemic-related shutdowns and layoffs. “And I don’t trust this COVID vaccine. When I first heard about it, I thought, ‘Oh, I’m not taking that.’ There needs to be more information. They’re going to have to sell me on it.”
Though many people are eager to get the vaccine as the best defense against the coronavirus, Richardson and other Lehigh Valley residents of color fear what the effects might be of something about which they know so little. To help overcome this distrust, health care providers are partnering with community groups so everyone feels comfortable taking the vaccine.
“I’m younger and haven’t had as much interaction with the [health care] system,” said Richardson’s daughter, Zahnia, 21,
who’s struggling after being laid off from restaurant and nonprofit jobs due to shutdowns. “I do know that Black people in the past have been used as guinea pigs, which is definitely wrong and why many people are hesitant about vaccines.”
Michael Richardson has many questions about the vaccine.
“What’s the racial breakdown of the people they tested this vaccine on before rushing it out to the public?” he asked. “What are the side effects? Did anyone die?”
To answer these and other questions, health care providers are working on various efforts with local government, community and faith-based organizations influential among Black and Latino residents.
“Medical institutions on their own can’t hold solutions to [people of color’s distrust of the vaccine], but instead need to listen to and work with communities in disseminating public health awareness information,” said Hasshan Batts, executive director of Promise Neighborhoods of the Lehigh Valley, one of the organizations partnering with health care providers.
Lehigh Valley Health Network is working with its community partners on a series of videos for its website and social media pages on facts and myths about the COVID-19 vaccine, said Carmen Guzman-McLaughlin, administrator of LVHN’s Department of Community Health.
“The videos will be in both English and Spanish and include topics such as whether the vaccine protects only the person who gets it, how long it protects against COVID, what happens if you forget your second dose and whether you still need a mask after taking the vaccine,” LVHN spokesperson Brian Downs said.
Along with publicizing these videos, health care providers plan to “dig a little deeper” to get at the root of Black and Latino fear about the vaccine, Guzman-McLaughlin said.
We have to be cognizant of these invisible barriers to engaging communities who need the vaccine the most. Carmen Guzman-McLaughlin, Lehigh Valley Health Network.
The health care system has a history of mistreatment of minorities, including the Tuskegee syphilis study. From 1932-72, the federal government, while studying the deadly disease’s effects on Black farmers near Tuskegee, Alabama, promised them free medical care, but never informed them of their diagnoses and provided false, ineffective treatments.
During the same time period as the Tuskegee study, Latina women in California were coerced into sterilization procedures often without getting proper information about the procedure.
Such historical injustices create a distrust in people of color toward vaccines in general, Guzman-McLaughlin said.
“Some people even think the COVID vaccine contains an electronic chip for the government to monitor and spy on them,” she said. “So we have to be cognizant of these invisible barriers to engaging communities who need the vaccine the most, as well as barriers like lack of personal transportation to get to our mass vaccination site at Dorney Park.”
Awareness efforts
Other LVHN efforts to enlighten the community about the vaccine include its website in both English and Spanish.
“We continue working to provide the latest updated information about the vaccine and the process for receiving it,” Downs said. “This includes letting the community know how those who have been vaccinated with the first and second doses are doing.”
Future endeavors include discussions with organizations, leaders and activists in communities of color “to find out what we may be missing and what else people have heard about the vaccine,” Guzman-McLaughlin said, adding that no dates have been set yet for any such discussions. “We want to create a space where people feel safe to ask any questions they have, speak their truths about their own experiences and share what they’re hearing from their neighbors. We want everything on the table.”
St. Luke’s University Health Network, likewise involved in website and social media efforts to raise awareness in communities of color about the vaccine, is part of a strategic response team of community organizations, leaders and health care professionals formed by United Way of the Greater Lehigh Valley.
“We’ve been meeting regularly since April and ... have started discussing a vaccine campaign,” said Rajika Reed, senior network director of epidemiology and strategy at St. Luke’s. “The goal is to have our community participate in this process to educate and dispel myths.”
She said providers are sharing information with minority communities about the importance of the vaccine.
“The strategic response team has also discussed having a panel with experts, such as our physicians, who mirror our community to have open dialogue sessions,” she said.
“A successful vaccination campaign would include transparency coupled by the voices of our community partners and leaders,” she said. “This is instrumental in building trust and moving toward greater vaccination rates that in turn protect our community as a whole.”
Community leaders, like the Rev. Jimmie Rivera, pastor of City Limits Assembly Of God Church in Allentown, agree people need to get and understand information about the vaccines.
“I, too, would support any efforts to educate the community about exactly what this vaccine is, what to expect, what to worry about and what not to worry about,” Rivera said. “You hear doctors talking about the vaccine on the news and you have to be a doctor yourself to understand what they’re saying. They need to present it here at the Main Street level, where we common, everyday people in the community can understand more about it.”
The vaccines
The U.S. Food and Drug Administration has so far given emergency use authorization to two vaccines to fight the coronavirus, one by Pfizer, and one by Moderna, though other companies continue to develop vaccines.
“We developed and tested our vaccine in accordance with high ethical standards, sound scientific principles and the rigorous requirements of regulatory authorities like [the U.S. Food and Drug Administration],” Pfizer spokesperson Keanna Ghazvini said. “In addition, we followed all of the regulatory and operational steps that we would normally take for our vaccine trials.”
Moderna did not respond to The Morning Call’s requests for comment.
Pfizer and Moderna began testing their vaccines on volunteers in clinical trials in July and reported their findings in November and December, respectively.
Clinical trial results showed Pfizer’s vaccine as 95% effective and Moderna’s vaccine as 94.1% effective in preventing the coronavirus in people who have not had it previously, according to the Centers for Disease Control and Prevention website. The vaccine appeared “highly effective” among people of diverse ages, genders, races and underlying medical conditions, the CDC site states.
Pfizer provided only a worldwide total number of volunteers who had taken its vaccine during clinical trials in six countries, including the U.S. As of Dec. 21, 45,302 volunteers worldwide took the Pfizer vaccine, of which 43,125 received second shots. When asked how many U.S. volunteers took the vaccine, Pfizer did not give a direct answer, but a percentage breakdown shows 13% of U.S. volunteers were Latino, 10% were Black, 6% were Asian and 1.3% were Native American.
Pfizer provided a list of 155 locations where clinical trials took place, but the list shows no numbers of volunteers for any of these locations.
One location was at the Lehigh Valley Health Network’s Office of Research and Innovation at North 17th and West Chew streets in Allentown. Seventy-five people, most of whom are LVHN employees, volunteered to receive the vaccine during clinical trials from Sept. 1 to Oct. 2, said Dr. Joseph Yozviak, infectious disease specialist and principal investigator for the Pfizer COVID-19 study at LVHN.
“Because racial and other demographics are considered results in a clinical trial, we are not authorized to provide sitelevel data on the demographic breakdown of volunteers,” Yozviak said. “We recruited volunteers, including those of color, via an intake survey. Notice also was posted on our health network website. The response was overwhelming in the first day so we closed the survey soon after.”
When looking for people of color to volunteer for clinical trials, Pfizer identified areas in the U.S. most affected by the coronavirus and searched there, Ghazvini said.
Pfizer put out English and Spanish public service announcement videos to Blacks and Latinos, encouraging them to represent their communities in clinical trials and help build trust in the vaccine, she said.
Other efforts involved partnering with local leaders and organizations, such as the National Black Nurses Association and Dia De La Mujer Latina, to help overcome community distrust, language barriers and other challenges, she said.
Dia De La Mujer Latina President Venus Gines said she was unable to comment because her organization is “launching a national call center for community health workers and promoters to handle disparity issues.”
The National Black Nurses Association has a southeast Pennsylvania chapter in Philadelphia, the closest chapter to the Lehigh Valley, chapter President Monica Harmon said.
“There’s a lot of skepticism in the Black community about vaccines in general because of a historically racist health care system that’s performed illegal experiments and procedures on some of our people,” Harmon said. “So, we as Black nurses, have worked to educate and reassure our community about vaccines, how they’re made and how they operate.
“And it’s the same with the COVID vaccine,” she said. “People in the community trust what we say because we’re medical professionals and, more importantly, we look and talk like them and come from the same neighborhoods they do. We understand them.”
What helped nurses persuade Black residents to volunteer for COVID-19 vaccine clinical trials is showing the racial diversity of the scientific and medical teams who made the vaccine, Harmon said.
“We encourage more people of color to take part in clinical trials because we won’t know how vaccines impact people of color unless we have people of color in the trials,” she said.
Safety, side effects
In finding suitable clinical trial volunteers for testing the vaccine, “safety was [Pfizer’s] No. 1 priority,” Ghazvini said. “We’ve worked closely with clinical trial sites, experienced investigators and regulatory agencies to ensure high quality and safety standards are rigorously applied to our development program. Researchers have been required to follow strict rules to make sure participants are safe.”
Both Pfizer’s and Moderna’s clinical trial results showed the vaccine’s most common side effects are pain, swelling and redness at the injection site after the first shot, accompanied by headaches, chills and fatigue throughout the body after the second shot.
Most side effects were “mild to moderate,” occurring within seven days after injection, according to the CDC website.
“However, a small number of people had severe side effects [affecting their] ability to do daily activities,” the site states.
Although a few of Pfizer’s clinical trial volunteers went to the hospital or died after being injected, tests showed such outcomes were less likely with those who received the vaccine than with those who received a saline placebo, according to the site.
“The part about ‘a few clinical trial volunteers dying’ is somewhat misleading,” Yozwiak said. “No one died from the vaccine. As with any large group of thousands of people, there likely will be deaths from other factors. Such as preexisting medical conditions that would have claimed people’s lives anyway, regardless of whether or not they got the vaccine.”
Yozwiak cited one section of Pfizer’s 92-page report on its findings. This section lists six volunteers who died during clinical trials, stating, “None of these deaths were assessed as related to study intervention [receiving the vaccine].”
Four of the six deaths were attributed to arteriosclerosis, cardiac arrest, hemorrhagic stroke and myocardial infarction, none of which are listed among the vaccine’s side effects. The two remaining deaths are listed as of being of unknown causes.
Despite the CDC’s information on the pharmaceutical companies, the Rev. Phillip Davis of Greater Shiloh Church in Easton remains hesitant.
“The fact that only 10% of Pfizer’s clinical trial volunteers in the U.S. were African American gives me pause as it relates to what the vaccine’s effect could be on the Black population,” said Davis, who is Black.
“If you don’t have a large enough group of members from a racial demographic, you don’t know what the outcome will be on that demographic. I personally have angst when it comes to the medical profession, in regards to anything dealing with mass vaccination, because of the history of abuse on the Black community at the hands of health care providers.”
In talking to local medical professionals who’ve taken the vaccine, Davis heard “nothing but positive responses, but I still have my own personal doubts.”
Davis plans to continue his own research into the vaccine, including keeping in touch with health care providers, and watch for any delayed side effects of the vaccine on those who’ve taken it.
“A pastor’s voice does have influence in the community, so I want to be as careful as I can to ensure I’m not rushing into this and leading people into a space that’s unsafe for them,” he said.
Greater Shiloh Church’s congregation hasn’t gathered for in-person worship since March, when the pandemic hit the Lehigh Valley. In that time, Davis has spoken with many church members who feel the same way he does about the vaccine.
The church plans to reopen for in-person worship in late March, with safety protocols of social distancing, sanitizing and wearing personal protective equipment in place.
“By then, I should have a more solid position on the vaccine and will make that known from the pulpit and via our social media platforms,” Davis said. “People can then decide for themselves whether to take the vaccine.”
Rivera, the City Limits Assembly pastor, shares Davis and others’ concerns about potential side effects, particularly on Blacks and Latinos, of a vaccine that had to be developed so quickly.
“I’d like to see those who are promoting this vaccine take it themselves,” Rivera said. “When people tell you things like how they think the vaccine has aborted baby parts in it, and when you’ve heard stories about how people of color have been experimented on in the past, it makes you want to look into it yourself to find out what’s really going on. I’m looking online, I’m keeping my ear to the ground and I’m monitoring all news outlets for the latest on the vaccine and how it’s affecting people.
“I think seeing leaders taking the vaccine and showing no ill side effects would help quell a lot of the suspicion toward the vaccine, but even some leaders themselves are hesitant,” he said. “I’m glad to see health care professionals taking it because I think it gives some hope. I know of very few people in our community who’ve taken it. There doesn’t seem to be a mad rush among people who aren’t in that category of being at higher risk for COVID.”
Rivera spoke to five people who received the vaccine in its first phases of dissemination to higher-priority groups. These are residents over age 65, with underlying medical conditions making them more at risk for the coronavirus, who so far have reported no lasting negative side effects, he said.
As for the majority of other residents of color Rivera has spoken with, “there’s caution, but there’s also hope that this vaccine is everything [its promoters] say it is,” he said. “There’s hope that our kids can go back to school and we can return to some sense of normalcy, shaking hands, hugging each other and visiting each other’s homes.”
If he reaches a point where he feels more comfortable about the vaccine, Rivera will take it himself and encourage others.
“I’ve done four COVID-related funerals in a week at our church, something no pastor should ever have to do,” he said. “I was emotionally spent. I was around people who wanted to hug and touch and console each other, but they couldn’t.”
First-hand account
One resident of color who has taken the vaccine is Yamelisa Taveras of Allentown, founder of Unidos.
“At first, I didn’t want to be in the first groups to receive the vaccine due to my diabetes,” Taveras said. “After some research and speaking to health care professionals as well as individuals involved in the development and studies of the vaccines, I reconsidered.
“I was given my first dose on Jan. 8,” she said. “There was arm pain, body aches, chills, fevers and fatigue, but all were gone within 48 hours. I got my second dose on Friday and, so far, I feel great. Now I’m happy I did it, mainly because I know I have immunity to catching COVID and potentially passing it to someone else. That peace of mind makes it worth it for me.”
Taveras plans to encourage others to take the vaccine by sharing her own experience.
But others still need more persuading.
“I personally haven’t done any research on the vaccine, but I’m not too keen on reports or stats that look good just on paper,” said Richardson, who’s not reassured by Pfizer’s and Moderna’s information. “All I’m saying is they need to be [fully transparent] with the people.”
Richardson is content to continue social distancing and wearing a mask.
“I already take vitamins and keep my immune system up to par,” he said. “I’ve never taken the flu vaccine and I’ll probably never take the COVID vaccine either.”
Information about the vaccine is available also by calling the LVHN hotline at 484-884-1767 or St. Luke’s University Health Network at 866-785-8537.