Dr Torian Easterling is the first deputy commissioner and head of equity for the New York Department of Health.
For any vaccination program to be successful, there is one essential element: people’s confidence in the vaccine and the institutions that administer it. Confidence in the Covid-19 vaccine is as valuable as our vaccine supply. But after decades of racist disinvestment and medical abuse, black and Latin communities have every reason to be skeptical.
A recent CDC vaccine reluctance survey showed disappointing – albeit not surprising, results. In September, 56% of black Americans said they would get the vaccine, and in December – after the FDA cleared Pfizer and Moderna vaccines for emergency use – that percentage fell to 46%. In comparison, 70% of white Americans said they intended to get the vaccine in December. Another survey conducted by the Kaiser Foundation found a similar trend among Hispanic Americans that only 42% want to be vaccinated.
But more telling in these polls is exactly Why Blacks and Latinos are reluctant to get shot. The main reasons included concerns about side effects, the fact that the vaccine was developed too quickly and many said they did not trust the government.
Obviously, there is work to be done. To earn the trust of black and Latino New Yorkers, we must be inclusive, reach out to communities, listen to voices, values, and opinions. The responsibility cannot lie with the individual. It must be the responsibility of institutions and public health officials to treat people with respect, so that they have a reason to trust and make informed decisions. Think of it as wrapping our arms around communities and letting them know, we have them.
Over the past few months, I have attended dozens of listening sessions with community groups, religious leaders, and local health care providers in Black and Latin American communities. We discussed misconceptions and fears surrounding the Covid-19 vaccine, and how decades of racism and abuse by the medical community have led to mistrust.
When we compare the medical experiences of blacks, latinos and whites, the contrast is disturbing and it literally starts from the moment we are born. There are, as we know, persistent and intolerable disparities in maternal health outcomes.
Sadly, the disparate treatment continues into adulthood. People of color are less likely to receive the same level of treatment for everything from palliative care to chronic disease management. There is also unequal access to quality health care and often hospital segregation in many large cities.
In my own conversations with New Yorkers, trust in government and medicine has been a lingering theme. And although they are painful, they give us a chance to move to a place of healing.
Last summer, we heard the call for change when hospitalizations and deaths related to Covid-19 illustrated how racism affects health and the murder of George Floyd exposed structural racism in our country. The move led the health department to declare racism a public health issue and the city to form the Racial Inclusion Task Force.
Now, we maintain this commitment in the deployment of vaccines in the city. To boost confidence in the vaccine, New York City unveiled an equity plan rooted in 33 neighborhoods with high rates of Covid-19 cases and mortality, as well as historic inequalities, such as the burden of disease and overcrowded living conditions.
Our central theme is community-centered outreach at the neighborhood level. Public meetings and webinars disseminate information about the safety and effectiveness of the vaccine, but empowering people to make their own decisions should be done in small groups with trusted voices. That’s why we partner with hundreds of community organizations to be trusted messengers. 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 be – and has been – open, honest and clear.
We also use data to inform our work. We have sent a letter to healthcare providers across town encouraging them to collect and report the race and ethnicity of the Covid-19 vaccine recipient to the town’s immunization registry. We’re posting race and ethnicity data on Covid-19 testing and positivity, and just added data at the zip code level.
We want to know who is getting the vaccine and where there are gaps, so that we can get the vaccine to the right places. As vaccine supply increases, we are working with community partners to identify the best places for people to be vaccinated and to also ensure links to resources and services. Already, the majority of our city vaccination sites are in the 33 priority neighborhoods, but we are expanding and prioritizing communities with long-standing inequalities that need the vaccine the most.
As we move forward in deploying our vaccines, racial equity will remain our most consistent core value. We know that for our vaccination strategy to be successful, we must speak out against racism, shoulder our responsibilities and do the work necessary to instill confidence in ordinary people.