In marginalized communities, it isn’t enough to offer the safe and effective COVID-19 vaccines and explain why people should get them to dramatically cut the risk of hospitalization and death. Identifying the drivers behind vaccine hesitancy in African American and other populations, Harvard medical student LaShyra “Lash” Nolen is spearheading a national project to empower informed vaccine choices.

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Medical racism exists, said Nolen, founding executive director of the We Got Us Empowerment Project and president of her medical class at Harvard Medical School. We Got Us is a Boston-based group of Black community members, health-professional students and others offering education on medical racism, COVID-19 and vaccination.

“Where a lot of organizations can go wrong is they jump straight into ‘Here's why you should get the vaccine’ without recognizing the trauma of the past and the present, and the fears of trauma in the future that a lot of communities have,” Nolen said during a recent episode of the “AMA COVID-19 Update.”

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Nolen also discussed how to build trust by providing culturally sensitive, accurate information and allowing opportunities to address questions and concerns. Even if people don’t get vaccinated right away, at least they have the tools to make the best decision for themselves, she said.

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Just about 5% of U.S. physicians are Black, according to the Association of American Medical Colleges. This translates into a lack of messengers in Black communities to introduce and discuss the vaccine in a relatable manner.

We Got Us leads this charge to connect Black messengers with Black communities, delivering information about the COVID-19 vaccines through the lens of these communities.

“Instead of trying to convince people to get the vaccine, we really want to convey information about the vaccine so that people could then make the best health decision for themselves,” said Nolen. We Got Us fosters these conversations through community gatherings called empowerment sessions.

Community members and groups can go to the We Got Us website and request a holistic presentation from an education team on the history of medical racism, how the vaccines were developed, and the benefits of other vaccines recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. There’s ample opportunity to ask questions.

“By having those conversations with organizations across the country, we've really been able to take a conversation that will usually happen at a barbershop or at a grocery store in the community level to a more expansive level that folks all over can have,” she added.

Nolen and colleagues also created an animated educational video on the history of medical racism and COVID vaccine development that leaders can use to start these vital conversations.

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She noted that history only partly explains the reasons for health inequities and mistrust in Black and other historically marginalized communities. Everyday experiences of racism are affecting these beliefs as well.

To address these systemic problems, institutions should first recognize and acknowledge the ways in which they’ve caused harm, and then commit to working with communities. Listen to what these people from these communities have to say, Nolen stressed.

Learn more about the AMA’s strategic plan to embed racial justice and advance health equity.

Through the work of We Got Us, many communities for the first time feel like they’re being prioritized. “We're putting vaccination clinics in communities. We're offering free rides to vaccination appointments,” said Nolen.

Communities need to know that these aren’t just temporary solutions geared toward COVID-19 vaccination, she emphasized.

“We have a really big opportunity to do sustainable work,” Nolen said. “And I hope that that's something that we really put our minds to.”

Get the latest news on the COVID-19 pandemic, vaccines, variants and more reliable information directly from experts and physician leaders with the “AMA COVID-19 Update.”

You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version.

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