Public Health

Communities’ concerns about COVID-19 vaccines must be put in context

Andis Robeznieks , Senior News Writer

Black, Hispanic, Indigenous, Asian, and Pacific Islander health care workers share the memories, stories and trauma of their communities, so it shouldn’t come as a surprise that they have similar concerns and questions about COVID-19 vaccines.

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“Health care workers are part of these communities and they know—even if they don’t know the details—they still have the lived experiment, they have the stories, they have the trauma that’s been passed down for generations, and they have those experiences of discrimination and exclusion and harm from our institutions,” said AMA Chief Health Equity Officer and Senior Vice President Aletha Maybank, MD, MPH.

Dr. Maybank made her remarks at the Centers for Disease Control and Prevention (CDC) National Forum on COVID-19 Vaccine Agenda, a three-day event that also featured leaders from the CDC and the White House’s COVID-19 task force.

Dr. Maybank participated in a town-hall discussion that focused on health care workers’ roles as trusted messengers regarding vaccines and the concerns some have expressed regarding vaccination safety.

“It's critical to name it and to contextualize where this hesitancy may arise from,” Dr. Maybank said. “Health care workers are not separate from their own communities and there's lots of data that we have now that's demonstrating amongst Black workers and Latinx workers the concerns and fears that they have at this point in time.”

The AMA COVID-19 vaccines guide for physicians offers evidence-based messaging guidance and best practices for consideration in external communications on COVID-19 vaccine topics.

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She mentioned that more people are learning about the U.S. Public Health Service Study at Tuskegee, but many similar episodes are only now beginning to surface.

Dr. Maybank said there were federal government programs involving the Indian Health Service that sterilized women without their consent and similar programs in Puerto Rico. Both lasted into the 1970s.

While it’s “absolutely critical” to base vaccine conversations in science, she noted that it’s also important to recognize the conditions that created mistrust.

The goal should be “to make sure this is an informed decision that folks have the power and the autonomy to come to on their own,” Dr. Maybank said.

Dr. Maybank noted her role as a physician “vaccine champion” to strike up conversations and address concerns, but she added that this also involves listening.

“A patient told me the other day, ‘Don't feel like it's beneath you to entertain the conversations and the things that people are concerned with,’” Dr. Maybank said, adding that “the conspiracy theorists—they feel just as strongly about their positions as we do as scientists.”

Dr. Maybank expressed concern that inequitable COVID-19 vaccine distribution could perpetuate mistrust.

And while there has been a focus on answering questions about vaccine safety, there are many others in the same communities who are ready to get a COVID-19 vaccination now but who lack access.

“We need to focus on the yesses,” Dr. Maybank said, explaining that this requires reallocation of resources.

She cited the work of Chicago’s West Side United, where the AMA is working with local health care institutions, the city public health department, businesses and community organizations to boost public health in an underserved part of the city.

“We need more models of that type of coordination between public health and health care and the community moving forward,” Dr. Maybank said. “When COVID came, the people were ready to respond.”

Learn more with the AMA about how to address Black patients’ concerns about COVID-19 vaccines.

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Dr. Maybank suggested that social media can be a big help to organize and bring clarity to where people can get the vaccine and how to make an appointment.

Fellow panelist Rose Marie Leslie, MD, agreed. The family medicine resident has hundreds of thousands of followers on the TikTok platform.

“We need to be having conversations with people where they feel comfortable, where they can feel heard, or where they can feel like they can ask questions without being judged,” she said.

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