The Detroit News: As COVID-19 Vaccinations Ramp Up, Skepticism Prevalent Among Michigan’s Black Residents
December 23, 2020Dec. 22, 2020
The Detroit News
Sarah Rahal
As doctors and health officials celebrate the long-awaited arrival of the coronavirus vaccine, there’s a divide among Black Americans, especially in the hard-hit city of Detroit, with many saying they are skeptical of a “rushed medical breakthrough.”
Black Americans are nearly three times more likely to die from the virus than their white counterparts, the Centers for Disease Control and Prevention says. In Michigan, nearly 3,000 African Americans have died, roughly 25% of the state’s 11,700 deaths although they make up 14.1% of the state’s population.
A recent study conducted by the Detroit Regional Chamber showed that while 58% of those polled who were white said they will get the vaccine, only 33% of Black respondents said they would.
Because of a long history of mistrust caused by past government-sanctioned testing and experimentation on Black citizens, studies suggest Black Americans are less likely to get vaccinated than other ethnic groups.
“There is a higher level of distrust than you would expect,” Detroit Mayor Mike Duggan said Tuesday.
Starting Wednesday, the city’s first responders and emergency technicians with the Detroit Fire Department will receive the vaccine, in partnership with Henry Ford Health System. The vaccine will not be mandated, he said. Detroit has had nearly 25,000 confirmed cases of the virus and more than 1,600 deaths linked to COVID-19.
“We are going to lead by a positive example,” Duggan said. “We can’t have a conversation about whether to take a vaccine from the federal government, without acknowledging the history of racism that we have had in the health care system.”
As the vaccines become more widely available in the coming months, the country’s top doctor and state leaders say they must deploy education and outreach to combat skepticism and prevent additional disproportional impact on Black communities.
Nine months into the pandemic, the state launched the Protect Michigan Commission‘s Racial Disparities task force to create resources and outreach for impacted communities.
Gilchrist, who leads the Michigan Coronavirus Task Force on Racial Disparities, said the state has spent time on targeted information campaigns, building infrastructure around 23 neighborhood testing sites in communities of color, and partnering with local anchor institutions so residents could receive information from someone they trust.
“We’ve also seen during COVID-19 this pandemic that hit Black Michiganders harder than any other group of people in our state,” Gilchrist. “Thanks to the state’s interventions and thanks to people just stepping up and doing the right thing and listening to the public health experts. … We will encourage people to get the vaccine when their phase comes.”
Shortly after the FDA approved the Pfizer vaccine earlier this month, Dr. Anthony Fauci urged confidence in coronavirus vaccines during a conversation with leaders of a coalition of Black academics, doctors and faith leaders.
The nation’s top infectious disease doctor said he is “perfectly comfortable taking the vaccine” and will recommend it for his family. Fauci was vaccinated on Tuesday. To address the skepticism, officials must acknowledge and empathize with the reasons of mistrust as opposed to pushing back against it, he said.
“The speed in which this was done has nothing to do with compromising safety, it’s due to the extraordinary advancements which have allowed us to do things in weeks to months that formerly took several years,” Fauci said. “The data first come to a totally independent data and safety monitoring board that are made of experienced clinicians, scientists, vaccinologists, and statisticians.”
FDA scientists have deemed both the government-approved Pfizer and Moderna vaccines up to 95% effective after two doses. Side effects include fatigue, headache, muscle pain, chills, and fever up to 10 days after receiving the vaccine.
Approximately 42% of global participants and 30% of U.S. participants in Pfizer’s Phase 3 study have racially and ethnically diverse backgrounds, Pfizer said in a statement to The News.
Of the study participants in the U.S., about half were between the ages of 56 and 85, and 10% were Black, Pfizer said.
Should African Americans overwhelmingly opt out of vaccinations, the community could face an irreparable impact, Fauci said.
“The time is now to put skepticism aside. You’ll be saving yourself and your family illness, as well as that of your community,” Fauci said.
‘Fear on both sides’
Dr. Tiffany Sanford of Wellness Plan Medical Centers, a Detroit-based federally qualified health center, said she is already seeing major contention in the Black community, with many residents saying it’s too soon and the long-term effects of the vaccines are unknown.
The wellness center serves low-income and uninsured Detroit residents. Sanford was approached by the state to poll the center’s staff, primarily African Americans, on whether they would receive the Moderna vaccine if it was available to them in January.
“Not only amongst the staff but certainly amongst the patients, there is a huge amount of resistance in regards to the comfort level of getting the vaccine,” Sanford said. “It’s also the push from this administration and the way that they interact and engage with not only the CDC, but with the FDA in making decisions I think also has kind of put a secondary layer of mistrust.”
Black Americans are more vulnerable to the coronavirus as they face increased exposure at essential jobs, higher rates of preexisting conditions and years of health care disparities, she noted.
Sanford said staff members are asking if there will be an opportunity to receive doses later than January. Internally, they have begun strategizing how to improve vaccination rates among the community.
“It’s going to take a lot of marketing, it’s going to require a lot of folks who look like them, other minorities getting the vaccine, having no issues and being able to speak on the experiences they’ve had,” she said. “I’ve had a lot of patients mention they’re thinking the vaccine is a live coronavirus with the same perception as the flu vaccine … feeling like if I get the vaccine, I’ll get the virus.”
Mistrust of the health care system stems in part from the 1932 Tuskegee Syphilis Experiment when 600 African American men in Alabama participated in a study and were told by researchers that they were receiving free health care for “bad blood” from the federal government. In truth, they did not receive the proper treatment needed to cure their illness.
The experiment ran until 1972 and was conducted by the U.S. Public Health Service and the CDC, which deceived the men by not informing them they had syphilis. Skepticism is also rooted in the experimentation at John Hopkins Hospital in the 1950s on Henrietta Lacks, a Black woman whose cancer cells became the first immortalized human cell line.
But it’s rooted much deeper, community leaders say. From slavery to Jim Crow, ongoing Black Lives Matter protests and the disproportionate impact of the coronavirus on Black communities, “it’s hard to trust the process with constant misinformation during the pandemic,” said Pastor Barry Randolph, head of Church of the Messiah.
The mixed-race church on Detroit’s east side is prominently made up of African American men. Randolph estimates a majority of his parishioners will not take the vaccine, adding he, too, was skeptical and only recently decided to advocate for it “because the doctors within our clinic at the Church of Messiah have signed off on it.”
“We’re going to have to do education so that people would be more inclined,” said Randolph, who added people fear getting the vaccine but also what might happen if they don’t. “It’s ‘Can I trust the vaccine?’ but it’s also ‘I’m afraid of COVID’ and more people thinking ‘let’s wait and see.'”
Randolph said he can’t ignore history but is optimistic there are two vaccines.
“The vaccine is legitimate and we don’t need to be so fearful, but at the same, you cannot negate history,” Randolph said. “We’ll see. If COVID rates start going down, and there are less cases, and it is actually being attributed to the vaccine, I think more and more people of color will decide to do it.”
Yusef Shakur, who runs the Detroit-focused programs for the Michigan Roundtable for Diversity and Inclusion, said poor leadership and past history cannot be ignored.
“Absolutely not. Why would I trust it when my every day has not gotten any better? I don’t trust the medical field,” said Shakur, 47. “Building trust is about building relationships. People in charge have to approach it not just from a medical standpoint but also a social standpoint. There has to be a prioritization to show that we won’t just be another modern-day experiment.”
Others are more open. Richard Burden, a paramedic and firefighter for the City of Inkster for 24 years, said getting his first dose of the vaccine Tuesday was “awesome” and he wishes more people would choose to get vaccinated.
“As a full-time firefighter, I know this virus is real. It’s contagious and we need to help stop the spread,” said Burden, 49. “I understand people may be hesitant, but it’s a new day, new era, and we need to be safe. I’ve seen multiple deaths, families destroyed because of this virus.
“All we have is protective gear that we wear and hopefully, this vaccine provides the ultimate protection.”
Education and outreach
Last week, Henry Ford Hospital System received 5,000 doses of the Pfizer vaccine and is slated to receive another 13,000 doses of Moderna’s vaccine this week, said its president and CEO, Wright Lassiter.
More than 4,000 health care workers at Henry Ford and 1,500 workers at Detroit Medical Center have been vaccinated, although others are still hesitant.
Lassiter, born in Tuskegee, Alabama, joined Duggan and city health leaders on Tuesday to receive their first shots of the Pfizer vaccine and ask residents to “trust the science.”
Henry Ford Health System participated in two COVID-19 clinical trials, including Moderna’s.
“And we did that very specifically because we wanted to ensure there was access to a broad, diverse community who are participating in the clinical trials, so we’d have as much data available as possible to support decision making going forward,” Lassiter said. “We are confident in the data from these trials, as it relates to both effectiveness and safety. We’re just as confident in the FDA strict approval process.”
Michigan’s Chief Medical Executive Dr. Joneigh Khaldun said it was a privilege to receive her first dose of the vaccine on Thursday at Henry Ford Hospital, where she works as an emergency physician.
“Fighting this pandemic for the past nine months has taken a tremendous toll on the physical and mental health of healthcare workers. And this vaccine means there is hope that this burden can be lessened,” Khaldun said, adding she hopes the vaccine will be available to the general public by late spring.
“We are also working on messaging, having focus groups with communities of color so we can understand their questions and what messages may resonate,” she said.
Michigan Gov. Gretchen Whitmer signed an executive order in December to create a bipartisan commission aimed at raising awareness about the vaccine because she said they are “cognizant of skepticism.”
“We’re seeing confidence grow as people are seeing their colleagues and friends, getting them and that’s something that’s exciting, but we’re not just relying on that we are working really hard to increase that that confidence and educate the public,” Whitmer said Friday.
Veronica White, an ICU nurse at DMC for the past five years, was the first among her peers to receive the vaccine Friday. She said she wanted to set a good example.
“I feel like a selfish person. I have two little kids at home, older parents, and I just wanted to protect my family and my patients,” said White, 29, of Southfield.
“It was important for me to show others because a lot of my colleagues were on the fence of getting it. Some refused to get it while ICU nurses are more positive because we see the impact on people, especially Black people, in our state.”
Nationally, musician Ice-T and Debbie Allen, producer of “Grey’s Anatomy,” have partnered with Johnson & Johnson to discuss the importance of diversity in clinical trials, advocate for the vaccine, and explain how the virus has personally impacted their families. Their messages have been streaming across social media and radios as the vaccines begin distribution.
Support is growing for vaccinations. The sharpest differences are by age, with those older than 50 willing to get the vaccine and those under 50 not planning to get the vaccine, said Sandy K. Baruah, president and CEO of the Detroit Regional Chamber.
“The Chamber is confident that support for the vaccine will continue to rise when it is successfully administered to front-line workers and those most at risk from the virus,” Baruah said.
Rev. Wendell Anthony, head of Detroit’s NAACP, pointed to the work of Dr. Kizzmekia Corbett, a Black scientist with the National Institute of Health who was at the forefront of Moderna’s vaccine development, and Dr. Marcella Nunez Smith, who is on the advisory board of the coronavirus task force for the administration of President-elect Joe Biden, as reasons to receive the vaccine.
“I think people need to understand the times have changed,” said Anthony, who also leads Fellowship Chapel. “It might have taken 25 years for the vaccine discovery for polio. But those occurred back in the time when we did not have the research and the knowledge. I mean hell, we have got 300,000 people who are dead. What more does it take?”
Despite being victims of disparate health care in the past, Anthony said he’s pleased to see African American communities and disparities being addressed by the state task forces.
“I feel confident going forward, and I’m not afraid,” he said. “I’m just concerned that some people will slow it down and they may not be around. And I just hope that we can use this as an opportunity to advance us and not to diminish.”
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