The Register Citizen (Torrington, CT)
The search for answers on vaccine equity
Dr. Tichianaa Armah, a force of nature in the medical world, doesn’t come to mind when we think about the imbalance between the number of white people sitting for the COVID-19 vaccine and the tally of people of color, especially Black people, getting inoculated.
We might imagine a poor neighborhood in East Bridgeport, a city that has seen a vaccination lag caused by a disconnect between public health outreach and demand by elderly, hard-to-reach residents.
That’s happening. But at least for a few weeks, after the vaccinations launched on Dec. 14, more Black people than white people in the health care profession declined the vaccine, in Connecticut. Same access, same ability to gain a dose of Pfizer or Moderna in their arms, but a different result between races.
Why it happened —
and might still be happening — is part of the complex, tragic, eye-opening story of race and coronavirus. Gov. Ned Lamont talked about it Thursday with concern but without clear answers.
“I’ve heard from the hospital administrators,” Lamont said in a meeting with the Hearst Connecticut Media editorial board. “A lot of the nurses are women of color, and African American nurses were a little less likely” — he corrected himself — “a lot less likely to get vaccinated in the first round.”
We don’t have data on this, though it might come out as numbers trickle in from hospitals and nursing homes. What he have is people — like Armah, a psychiatrist who’s head of mental health at Community Health Center Inc. and a Yale School of Medicine faculty member.
Armah has lived it. As in, lived it first-hand. Despite her position, or maybe because of it, the Norwalk resident who grew up in the Bronx was one of those health care professionals who skipped the first rounds of the vaccine, fearful of the treatment.
“Being a Black Christian wife, mother, and physician, all of these roles contributed to me being counted among the initially hesitant,” Armah wrote in an essay she posted on Medium.com. “I could say that despite being a physician, some of the wariness came from growing up Black in America. However, it is because of my medical training that I know more about how the medical community has mistreated, maimed, and caused the deaths of Black people.”
Wow. This from a physician with the bluest of blue-chip creds. It’s not just the shameful history of the Tuskeegee experiments, widely cited as a source of distrust, and worse, about medicine in the Black community.
“I have personally experienced how disparate treatment can be,” she wrote, citing her mother’s lupus. “Any Black person who comes to seek healthcare is justified in having a portion of skepticism that cannot be deemed paranoia.”
She was not alone. Many of her Black friends, family members and colleagues felt the same way. At Middletown based Community Health Center, which has 300,000 low-income patients and clinics all over the state, CEO Mark Masselli read me a few anonymous comments from staff members who filled out a survey on the vaccine.
One CHC staffer who didn’t take it: “On one hand I believe the vaccine is essential in the fight against COVID. However, I also understand the concerns/fears over vaccines, especially from under-represented groups in vaccine research. While current data shows it’s safe and effective, the study doesn’t represent everyone.”
That’s a deep wellspring of doubt. Lamont, his top staff and the state Department of Public Health are reaching out to churches, community centers and other places to get the word out, as new data points to possibly significant skewing of vaccination between races.
That’s what the state did for testing in 2020, sometimes renting a church parking lot for a couple of days. “I know we’ve stepped it up bigtime really over the last few weeks,” Lamont said Thursday.
“But here’s the good news,” Lamont added. In health care locations such as hospitals, “We came back for a second round and twice as many people got vaccinated. They just had a little more confidence, you know, it was three weeks later, they felt good.”
Armah was one of those people. After thinking long and hard, after COVID killed more people in her life, she not only got he vaccine on Jan. 15 — she became a trained inoculator. And she told me Thursday, she’s pretty much persuaded her hesitant Black colleagues and friends — or, she made clear, they convinced themselves — to take the vaccine.
“I reached out to every Black health care professional that I knew,” Armah recounted. “I said, ‘Let’s all get trained.’”
What changed? One day in January she was talking with an African American patient in a high-risk group, about the vaccine.
“She said to me, ‘Well, maybe the vaccine is okay because I see a lot of rich white people getting it,” Armah recounted. And the woman actually wondered alound whether clinics would “switch out the vials” and not give the real vaccine to Black people.
“Hearing her say that, I told myself two things. One, I have to model for her,” Armah said. “It’s not going to cause us harm.…. And then on top of that I said, maybe she’ll feel more comfortable if I were the person giving her the vaccine.”
Then there were the deaths. A family friend who was like a grandmother to her children. A husband and wife, closest friends of a close colleague. And more. “I would like to stop going to those funerals,” she said.
And so she took the vaccine at the CHC clinic in Stamford, and noticed on that Friday four weeks ago that she was the only Black person there.
Now it’s unclear what’s happening. Some Black people remain hesitant but as Lamont, his chief of staff Paul Mounds and Armah all said Thursday, that’s not the only reason for the skewing. Outreach is key, and access, for now, until the day in a couple of months when a flood of vaccines looks for willing arms.
“Unfortunately we sort of did hesitate and now there’s a significant number of people who are raising their hands,” Armah said, “and can’t necessarily get it.”