Dr. Torian Easterling is the First Assistant Commissioner and Chief Equity Officer for the New York Department of Health
There is one essential element to the success of a vaccination program: people’s trust in the vaccine and the institutions that give it. Trust in the Covid-19 vaccine is just as valuable as our vaccine supply. But after decades of racist divestment and medical abuse, the black and Latin American communities have every reason to be skeptical.
A recent CDC vaccine reluctance survey yielded disappointing – if not surprising – results. In September, 56% of black Americans reported not being vaccinated, and by December – after the FDA approved Pfizer and Moderna vaccines for emergency use – that percentage had dropped to 46%. This is a step in the right direction, but still higher than for other races and ethnic groups. By comparison, 70% of white Americans responded that they intend to receive the vaccine in December. Another Kaiser Foundation survey found a similar trend among Hispanic Americans that only 42% would like to receive the vaccine.
But more revealing in these polls is exactly why blacks and Latinos aren’t ready to get the shot. The main reasons were side effects concerns, the vaccine being developed too quickly, and many said they don’t trust the government.
It is clear that much remains to be done. To win the trust of New York Black and Latino people we need to be inclusive, reach communities, hear voices, values and opinions. The responsibility cannot lie with the individual. It must be up to institutions and public health officials to treat people with respect so that they have a reason to trust and make informed decisions. Imagine we put our arms around communities and let them know we have them.
In the past few months, I have participated in dozens of listening sessions with ward groups, faith leaders, and local health care providers in black and Latin American churches. We talked about misconceptions and fears about the Covid-19 vaccine and how decades of racism and poor treatment by the medical community have created suspicion.
When comparing the medical experiences of Black, Latino, and White, the contrast is unsettling and begins literally from the moment we are born. As we know, there are persistent and intolerable differences in maternal health outcomes.
Unfortunately, the unequal treatment continues into adulthood. People of color are less likely to receive the same treatment for everything from palliative care to treating chronic diseases. In many large cities, there is also unequal access to quality healthcare and, often, hospital segregation.
In my own conversations with New Yorkers, trust in government and medicine has been an ongoing issue. And while they are painful, they give us the opportunity to move into a place of healing.
Last summer we heard the call for change when hospital stays and deaths in Covid-19 exposed the health impact of racism and the murder of George Floyd exposed structural racism in our country. The movement prompted the health department to declare racism a public health problem and the city to set up the task force on racial inclusion.
Now we are maintaining that commitment as we introduce vaccines to the city. To build confidence in the vaccine, New York City unveiled a share plan rooted in 33 neighborhoods with high Covid-19 case and death rates, and historical inequalities such as disease burden and crowded living conditions.
Our central topic is community-oriented public relations work at the neighborhood level. Townhalls and webinars provide information about the safety and effectiveness of the vaccine. However, empowering people to make their own decisions needs to be done in small groups with trustworthy voices. That’s why we partner with hundreds of community-based organizations to be trusted ambassadors. We need to meet people where they are – on the phone, at home, online, or door to door – in the languages New Yorkers speak. Communication must – and was – be open, honest and clear.
We also use data to inform our work. We sent a letter to health care providers across the city asking them to collect the race and ethnicity of the Covid-19 vaccine recipient and report it to the citywide vaccination registry. We’re releasing race and ethnicity data on Covid-19 tests and positivity, and we’ve just added postcode-level data.
We want to know who is receiving the vaccine and where there are gaps so we can get the vaccine to the right places. As the vaccine supply grows, we are working with community partners to identify the best locations for people to be vaccinated and to ensure connection with resources and services. The majority of our city vaccination sites are already in the 33 priority neighborhoods, but we are growing and prioritizing communities with longstanding inequalities that need the vaccine the most.
As we move forward with our vaccine rollout, racial justice will remain our most enduring core value. We know that we have to identify racism, take responsibility and do the necessary work to instill trust in everyday people for our vaccination strategy to be successful.