Vaccine researchers seek to include Black, Latino people.
Told vaccine must be tested on Whites and people of color
Each fall, the Rev. Rob Newells urges the congregation at Imani Community Church in Oakland to get a flu shot. He builds bridges every day between the country’s most vulnerable, marginalized communities and the medical system, defusing suspicion about HIV prevention treatments and educating people about medical research. He prods healthcare leaders to think harder about their messengers: Don’t send a White doctor to tell Black people what they “need” to do for their own good.
But with the first massive coronavirus vaccine trial in people set to start today, Newells finds himself in an unfamiliar place: on the fence about what to tell his colleagues, his community, his cousins. Biomedical research, Newells knows, is a long and painstaking process — and he is concerned about a vaccine campaign that seems so narrowly focused on speed.
“What are we doing that we haven’t done before? I haven’t got good enough answers for me to tell my community, ‘This is just like we have been doing in HIV, where I’m comfortable there’s community at the table,’” Newells said. “What are we sacrificing for the speed, and if we’re not sacrificing anything, why couldn’t we move at this speed with other studies?”
The unprecedented scientific quest to end the pandemic with a vaccine now faces one of its most crucial tests, and nothing less than the success of the entire endeavor is at stake. A vaccine must work for everyone — young and old; White and people of color. To prove that it does, many of the 30,000 volunteers for each trial must come from diverse communities. It’s a scientific necessity, but also a moral imperative, as younger people of color die of coronavirus at twice the rate of White people, and Black, Hispanic and Native Americans are hospitalized at four to five times the rate of white people in the same age groups.
“If this is a vaccine trial that enrolls a bunch of 20somethings or White college graduates, it will not give us the information we need,” Francis Collins, director of the National Institutes of Health, said in an interview.
Newells has experienced the reality behind the grim statistics within his own family. A cousin in St. Louis was on a ventilator for three weeks in March. An aunt and an uncle were hospitalized with COVID-19, the illness caused by the virus. His professional experience as a biomedical advocate and executive director of the AIDS Project of the East Bay has taught him how crucial it is to include minorities in trials, if a treatment or drug is to succeed in the real world.
A decade ago, a revolution occurred in HIV, when the first pill regimen to prevent HIV was shown effective. But a trial in San Francisco was dominated by gay White men, Newells said, and as the drug became available through an extension to the clinical trial, it was those men and their social circles who embraced it.
“The Black people in Oakland didn’t really know about it, hadn’t been learning about it for a couple years,” Newells said. “We know from that experience that we have to engage people early in the research end of it, so by the time something gets approved, it’s not something brand new. I think it’s going to take time to talk to people about vaccine research.”
Unethical research abuses, including the Tuskegee experiments that withheld syphilis treatments from African Americans and Guatemalan experiments that deliberately infected prisoners with sexually transmitted diseases, have become cultural touchstones for many people of color, sowing deep distrust of medical authorities. That mistrust — coupled with unequal access to health care, information barriers and racial bias — means they are underrepresented in research trials.
“Now, along comes the pandemic, and it’s more important now than ever that we have minorities included. We should be jumping over mountains to try and make this work,” said Consuelo Wilkins, vice president for health equity research at Vanderbilt University Medical Center.
Johnson writes for The Washington Post.