The reports that Pfizer’s vaccine is 95% effective with no serious side effects and that Moderna’s vaccine candidate had demonstrated 94.5% effectiveness in trials are the latest beacons of hope in an otherwise bleak public health landscape.
While these breakthroughs are a giant step, a vaccine is only as good as its uptake. That means policymakers and public health professionals need to start planning now to make sure the vaccine reaches all Americans — and in particular, that people of color, who have been disproportionately affected by this pandemic, are able and willing to get vaccinated early.
Unfortunately, trends show we have a long way to go to make that happen. According to new research published by the COVID Collaborative, fewer than half of Black adults and just two-thirds of Latinx adults say they would “probably or definitely” get vaccinated if the vaccine were available and free. Although majorities of both groups believe the vaccine would likely be effective, the low rate of intended uptake is driven by skepticism about its safety. Only 14% of Black adults and about one-third of Latinx adults trust the vaccine will be safe, and Black adults are 19% more likely than others to doubt the vaccine will have been tested for safety in their own ethnic group.
These findings are alarming, but hardly surprising. From the Tuskegee Study to the Mississippi appendectomies, the U.S. medical establishment has a long history of experimenting on people of color without their consent. Cultural barriers have also sowed reluctance among Latinx residents to seek health care.
For this to change, there are things policymakers and public health professionals must do starting now to build trust among Black and Latinx Americans.
First, we must employ trusted health-care messengers to reduce safety concerns. Public health professionals, frontline health-care workers, the media, and government officials should front-load accessible information about how COVID-19 vaccines are being developed, what safety measures are in place, and what thresholds of safety need to be met before vaccines are approved — especially if emergency-use authorization designation is used for licensure. Providing clear, consistent messaging about vaccine safety will be key to increasing trust in the vaccine. And messages on vaccine safety should be led by trusted health-care professionals, with other prominent community voices taking more of a support role.
Second, we must build a pro-vaccine social norm in communities of color. Surprisingly only around 30% of each group said they trusted religious leaders and elected officials in their communities in terms of COVID-19 vaccination. This highlights a case where peer influence can be a game-changer — by helping to increase vaccine uptake.
In the COVID Collaborative study, nearly nine in 10 Black adults who believe most of their friends and family would want them to get vaccinated reported that they would do so. However, among Black adults who believed few of their close contacts would want them to get vaccinated, only two in 10 said they would do so.
This is where community messengers, such as pastors, teachers, community organizers, and local elected officials, can help lead by example by talking about their own plans to get vaccinated early, and by encouraging the people they encounter to do the same through ongoing dialogues.
The influence of peer norms also means that social media platforms like Facebook will need to step up and stop vaccine disinformation from spreading on their networks. Such disinformation can meaningfully impede efforts to build population immunity through vaccination.
Finally, this is our warning to address the impact of systemic racism in health care. To begin to combat these long-germinating seeds of distrust, policymakers should prioritize expanding health-care access, making health care affordable, and investing in education, housing, jobs, family, and quality-of-life improvements in the communities of color that have suffered the brunt of the COVID-19 pandemic.
The bottom line is clear: A vast majority of Americans will need to get vaccinated to bring an end to this pandemic. Taking these steps now to head-on address sources of mistrust among Black and Latinx residents will increase our chances of making sure that, once a COVID-19 vaccine is approved, vulnerable Americans actually make the critical choice to get inoculated.
Valerie Montgomery Rice is president and dean of Morehouse School of Medicine. Michelle A. Williams is dean of the faculty at Harvard T.H. Chan School of Public Health.