While West Virginia is one of the nation’s leaders in COVID-19 vaccine delivery, some folks in the state—notably people of color—may be hesitant to receive the vaccine. Experts at West Virginia University point to misinformation about how the vaccine works and a long-standing mistrust of government and medical institutions as reasons for lower vaccination rates among Black Americans.
“What educational activities are going on in the community to talk about these things? What do the people look like who are talking about this?” Murphy asks. “We don’t talk about race, and when we do, it can be perceived as pandering or ill-intentioned.”
He said he hopes to see information shared that is relevant to the community, through a cultural lens that speaks to him and people like him, or as he puts it, “authentic allyship.”
Murphy plans to get the vaccine when it’s available to him, but he says it’s with a high degree of hesitancy. He said, “I want to be healthy, so if that’s part of me being healthy, I want to stay alive. I want to see my kids and my grandkids.”
He said he works closely with students of color, many of whom have expressed their hesitancy about the COVID-19 vaccine. They’re navigating these decisions while mostly isolated and receiving the bulk of their information online.
“They’re trying to find real human connections and trustworthy humans to talk to. It’s our job to make sure to reach them.”
He envisions a grassroots effort to communicate the most accurate vaccine information to Black residents, in-person when possible. Meeting folks where they are is especially important right now. He encourages the messengers to ask what information the communities need.
“It shows we’re trying to figure out a way to better serve you, and to actually let the people have a voice in this crisis.”
Understanding the history
Nationwide, Black Americans are receiving COVID-19 vaccinations at dramatically lower rates than their white counterparts. In West Virginia, Kaiser Health News reported a white vaccination rate of 11.9% and a Black vaccination rate of 6.2%. The rates are especially concerning, as the coronavirus disproportionally impacts Black Americans.
KHN said the reason Black Americans are being left behind is twofold: “Because of barriers stemming from structural racism, as well as a failure to address nuanced hesitancy and mistrust about the vaccines and the medical system overall.”
“Vaccine hesitancy has a significant historical framework, which goes back as far as slavery,” said Candice Brown, an assistant professor with the WVU School of Medicine and Rockefeller Neuroscience Institute. Brown, a neuroscientist who studies the effect of inflammation and infection on brain disorders, is also a member of the Center for Basic and Translational Stroke Research and the Department of Neuroscience.
One of the most well-known ethical breaches was the Tuskegee Syphilis Study, a 1932 study in which the participants—600 African-American males, 399 of whom had latent syphilis and a control group of 201 who were not infected—were told they were receiving free health care from the federal government for “bad blood.”
The men, most of whom were poor or illiterate sharecroppers, were not informed the actual name of the study, “Tuskegee Study of Untreated Syphilis in the Negro Male,” nor were they told its purpose and potential consequences of the treatment or non-treatment they would receive. They were told the study was going to last six months, but it lasted for 40 years. None of the infected men were treated with penicillin—even though by the late 1940s, the widely available antibiotic had become the standard treatment and cure for syphilis—nor were they given the choice to quit the study when penicillin became available.
“The only reason it ended was because there was a newspaper exposé,” Brown said. “That has played a huge role in medical distrust.”
Dr. James Marion Sims, considered the “father of modern gynecology,” developed tools and surgical procedures for female reproductive health in New in the 1830s. The initial experiments were conducted on enslaved women without the use of anesthesia, as he believed Black people did not feel pain the same as white people. Unfortunately, this misconception is still prevalent in medicine. In a 2016 University of Virginia study, roughly half of medical students and residents surveyed wrongly believed Black people have thicker skin or less sensitive nerve endings.
Brown recommends “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present,” a book written by Harriet A. Washington, to learn more about the troubled history.
“Because of these incidents, that’s why there’s a history of mistrust,” Brown said. “The challenge is gaining that trust back.”
Establishing trust through relationships
For Brown, primary care providers are key in building and maintaining trustful relationships with their patients of color. Brown said when doctors acknowledge what’s happened in the past and communicate well with their patients, that effort can go a long way.
Brown also encourages Black physicians and scientists to help debunk myths and uncertainties about the COVID-19 vaccine on social media. Brown said one misconception she has heard is the lack of people of color included in vaccine trials. However, the Kaiser Family Foundation reports Pfizer and Moderna trials included approximately 10% Black participants and 20% Hispanic, which is roughly reflective of their representation in the U.S. population.
Brown also believes prominent community members can make a difference, such as church leaders, pharmacists or trusted officials. Long-time civic leader Charlene Marshall, who served as mayor in Morgantown in the early 1990s and was the first Black female mayor in West Virginia history, has been championing the vaccine among her former constituents.
“I had heard stories about some people in the African American community who may resist or be afraid or untrustworthy of the vaccine,” said Marshall, who also served as a member of the West Virginia House of Delegates for 14 years. “When I called the health department, I let the director know I was not one of those individuals, and as soon as they had a vaccine available for me, I was ready.”
She’s been calling Morgantown residents to share information with them about the vaccine and how to get registered to receive it. Hesitancy never crossed her mind, but she understands how the history of mistrust in the medical community could impact others’ decision.
“I can remember during segregation when we had swimming pool days for Black kids and days for white kids,” she shared. “If they had a day like that (for vaccines), maybe I’d be skeptical about who was getting the shot. But the thought never crossed my mind.”
Marshall said she’ll continue making calls, not to try and force anyone to participate, but to make sure they’re armed with accurate information. Her hope is that the recipients of her calls will at least consider what she has to say.
“When I think about my three children, I don’t want anyone having to take care of me. Think about your family. If you’re ill, what will they have to go through? Don’t put that burden on somebody else.”
The West Virginia Department of Health and Human Resources offers more information about the COVID-19 vaccine, including frequently asked questions, a distribution timeline, vaccine clinic information and pre-registration. A COVID-19 Advisory Commission on African American Disparities was also established to educate at-risk minority communities in the areas of prevention, testing and treatment.
Information about equity assurance and COVID-19 can be found at the WVU Division of Diversity, Equity and Inclusion.
CONTACT: Wendy Holdren
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