How do you build trust in a new, government-funded vaccine within communities that have experienced the United States’ racist medical history?
People in power first need to admit and understand that shameful past, says State Rep. Jordan Harris, who represents part of Southwest Philadelphia.
“We have to have direct engagement with our communities,” Harris said, speaking on a virtual panel organized by WHYY. “It says something that we’re not prepared as a city, and I’ll even say as a state to have direct relationship with communities to engage them around this pandemic and how we provide services.”
WHYY hosted “The Trust Factor: Vaccines and Communities,” a town hall Friday featuring regional public health experts and community leaders, who discussed strategies to help raise confidence in the coronavirus vaccine in communities with reasons to be mistrustful.
As the largest vaccine rollout in history is underway, the last month has not been without its blunders and missteps. According to an analysis by the Associated Press, an early look at 17 states and two cities showed that Black people are getting inoculated at levels below their share of the general population — including in Philadelphia. Against the background of this stark racial disparity, the city made national headlines this week when the start-up Philly Fighting COVID, run by a 22-year-old graduate student, lost its contract to run Philadelphia’s first mass vaccination site after quietly creating a for-profit arm and amid concerns over data privacy. The group’s leadership was mostly white.
Situations such as these fuel people’s misgivings toward the government’s ability to equitably carry out vaccine distribution, and, as Harris noted, it’s important in times of emergency to find members of a community to be the trusted voice, particularly in communities of color. He offered the Black Doctors COVID-19 Consortium — a group run by Dr. Ala Stanford that has been providing coronavirus testing (and now vaccines) to people of color for several months — as an example.
“You can no longer talk at communities, you have to talk to those communities and go into those communities and have conversation,” Harris said. “The days are over of being in City Hall or the state Capitol or the White House and think you can have conversations with these people when crises come. You have to actually be in the community and that needs to happen immediately.”
Implementing community engagement during a crisis
Getting messages to hard-to-reach communities can be a difficult task during a public health emergency such as the pandemic, when many events and resources that otherwise would be available in-person are now virtual.
Amber Tirmal, Philadelphia’s immunization program manager, acknowledged that the city may not be doing the best job with that. Working with federally qualified health centers and organizations throughout the city is one good way of getting messages to communities, but there’s much more that could be done, she said.
“We need to hear what people’s concerns are before we can address people’s concerns, and I think often we do kind of skip that step in public health because we want to be solutions-oriented,” Tirmal said. “But you can’t be solutions-oriented if you don’t understand what people are really concerned about.”
Answering the questions of trusted community leaders, and having them then share that information with their constituents through social media or other means was one suggestion for getting people more comfortable with the vaccine.
Calming people’s fears about ‘Operation Warp Speed’
Tirmal said some concerns surrounding the coronavirus vaccine stem from the language used by the Trump administration, particularly in naming the national vaccine plan “Operation Warp Speed.”
“That’s not what people want to hear when you talk about creating a vaccine,” Tirmal said. “You want to feel like all the steps were taken.”
She said that discussing with people how the vaccine had to go through multiple phases of clinical trials is helpful and that part of the reason — in non-pandemic times — that vaccine development can take so long is because companies need to raise money. The U.S. government took care of that, as well as manufacturing, which helped speed the process.
Dr. Fran Abanyie, a medical epidemiologist with the Centers for Disease Control and Prevention who spoke during the virtual town hall, said it’s important for people to understand that vaccine research for the new coronavirus didn’t just begin in 2020. The team at the National Institutes of Health that helped create the Moderna vaccine had been conducting research on coronaviruses for several years already.
“There were no shortcuts in the science in creating this vaccine,” Abanyie said.
Meeting people where they are
Pastor Nick Taliaferro said he thinks proximity has a lot to do with trust in neighborhoods, especially in areas where trust “has been a marginalized item.”
“The further away you were from me, the more I could probably believe that my interests might not be your interests,” said Taliaferro, of the Seventh-day Adventist Church in West Philadelphia, who collaborated with the Black Doctors Consortium to provide testing to his community. “I think it’s very important that you bring the sources of healing and curing closer to the target audience that you are trying to reach.”
Taliaferro said just this week he had a meeting with a large health system in the region, in which representatives said they could provide vaccines to his community if people went out to the suburbs.
“You could see immediately on the faces of people in the room a bit of crestfallen expression because they’re saying, `Wait a minute, we are going far away from home here?’” he said during the panel. “And people need proximity to feel safe.”
Dr. Zupenda Davis-Shine, Burlington County’s director of health education, said access plays a big role in instilling faith in institutions with power.
She said it’s important to make it as easy as possible for individuals to get their shots, including addressing barriers such as transportation or times of the day when immunizations are available to accommodate varying work schedules.
Along with access to health care, access to information is integral too, said Samantha Whitfield, a Willingboro Township councilwoman and the president of the Willingboro & Vicinity NAACP.
“Getting the word out through churches, other groups that people participate in … there still has to be an element of meeting people where they are and being accessible and having the relationship readily available on a regular basis,” Whitfield said.
Davis-Shine added that providing people with good sources of information can help dispel myths and fake news: The CDC’s fact sheets, state and local health department websites, and hosting town halls are key to getting people the guidance they need to make decisions for themselves. For her part, she said she posts videos on Facebook to answer people’s questions.
Taliaferro said he can understand some people’s grave fears about the vaccine because of the United States’ long history of medical malpractice on communities of color. His advice is to respect and understand that fear.
“Respect the suspicion,” Taliaferro said. “But then take the bold step and say, ‘This might be to my advantage. I am going to take that risk, and I’m going to step away from my fears and take the chance of what will be in the best interest of my people.’”
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