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Vaccine Doubts Threaten U.S. Rollout in Marginalized Communities

Feb. 3, 2021, 4:00 PM

Vaccine hesitancy and misinformation campaigns by anti-vaccination movements threaten to throw off state and federal vaccine roll out plans and further entrench health disparities, leaders warn.

The U.S. could return to a degree of normalcy by the fall, but that target date depends largely on the nation’s ability to vaccinate somewhere between 70% to 85% of the nation in order to reach herd immunity. But the two biggest stumbling blocks remain: supply—which the Biden administration has said it will ramp up—as well as ongoing skepticism about taking the vaccine.

Failure to vaccinate rapidly only increases the chances the virus will mutate in ways that make vaccines and antibody treatments less effective.

“While vaccination is a very private decision, it is something that depends on everybody making that decision so that we can have that public benefit,” Katharine J. Head, an associate professor at Indiana University whose research focuses on health communications in vaccines and cancer screenings, said in an interview.

Federal and local health leaders must fight off a concerted effort by anti-vaccination groups to spread misinformation by posting articles on their websites condemning Covid-19 vaccines that lack scientific merit. Some groups are targeting Black and brown communities who have been hit hardest by the pandemic.

Anti-Vaccination Efforts

Covid-19 vaccine protesters temporarily shut down a vaccine site in Dodger Stadium in Los Angeles last weekend, though officials said no appointments were canceled because of the disruption. These types of groups are a small minority among people hesitant to get Covid-19 shots, but they’re loud and often use social media to spread misinformation about the safety of vaccines.

One group called the Children’s Health Defense Team sows doubt about Covid-19 vaccine safety on its website despite a plethora of evidence showing side effects are typically minor—like aches or mild fevers—and go away in a few days. Serious side effects, like allergic reactions, are treatable and rare. To offset allergy risks, providers generally have people wait 15 minutes after they get their shot to monitor them for allergic reactions.

The Children’s Health Defense Team recently posted an article alleging a connection between Covid-19 vaccinations and the recent death of Hank Aaron, the Black Major League Baseball legend who broke Babe Ruth’s home run record. There is no evidence connecting Aaron’s death to a Covid-19 vaccine. Aaron, 86, received his shot Jan. 5 and said he hoped it would bolster vaccine confidence in the Black community.

Aaron died on Jan. 22 of natural causes.

The medical examiner for the county where Aaron died told the New York Times there was nothing to suggest Aaron had an allergic reaction to his shot.

“I was proud to get the COVID-19 vaccine earlier today at Morehouse School of Medicine,” Aaron tweeted Jan. 5. “I hope you do the same!”

Building Confidence

A National Academies report released Wednesday offered recommendations on how to build vaccine confidence at the local, state, and federal levels. Authors of the report, Strategies for Building COVID-19 Vaccine Confidence, called for detailed communications and community engagement efforts that are clear, credible, empathetic and respectful, while acknowledging any uncertainties.

These actions must happen now because it’s harder to change minds once someone forms an opinion, the report said. Vaccine confidence efforts should focus on people who are hesitant, not the ones who are adamantly opposed to all vaccines.

Between September and December, American confidence increased to 60% from 51% of those who said they would definitely take the vaccine, according to findings from Pew Research Center. But Black Americans remain the most hesitant, with 43% saying they would get vaccinated compared with 63% of Hispanic and 61% of White adults. Their hesitancy is due to a multitude of factors, from egregious historical events such as the Tuskegee syphilis study to ongoing racial biases in the health-care system.

“Our country’s history of scientific experimentation on vulnerable populations” along with “ongoing implicit and explicit bias that exists in the healthcare system” make outreach to historically marginalized populations especially important to restore trust in government, Joneigh S. Khaldun, chief medical executive and chief deputy director at the Michigan Department of Health and Human Services wrote in her Feb. 2 testimony to congressional leaders about state vaccine plans.

Hesitancy Fuels Disparity

Vaccine hesitancy is still among state leaders’ top concerns regarding vaccine administration, particularly hesitancy among historically marginalized communities.

“We don’t want to leave any group behind,” Ngozi Ezike, director for the Illinois Department of Public Health, told lawmakers at a House Energy and Commerce vaccine rollout hearing on Tuesday. “As much as rapidity is important, equity is important. Rapidity without equity will result in continued disparity,” she said.

Leaders from Michigan, Colorado, and Louisiana echoed similar concerns that vaccine hesitancy in already vulnerable populations would create even more health disparities. An October survey by Colorado’s Department of Public Health showed 70% of White Coloradans planned to get the vaccine, whereas only 53% of Black Coloradans and 56% of Hispanic Coloradans planned to get it, Jill Hunsaker Ryan, executive director for the Colorado Department of Public Health, wrote in her Tuesday testimony.

Research from the Centers from Disease Control and Prevention shows Black, Hispanic, Native American, and Asian populations are more likely to get Covid-19, be hospitalized for it, and die from it than White Americans.

Consequently, states have communication plans to reach out to minority communities. “People must not be shamed or stigmatized for their perspectives, and ample opportunities should exist to engage in robust and honest conversations so that people feel heard and can understand the science and facts about the vaccine development and distribution process,” Khaldun testified.

Communication plans must be collaborative and include trusted community members, she said. “Failure to do this well will only exacerbate the tragedy of the way this terrible virus has disproportionately ravaged communities of color.”

Anthony S. Fauci says he’s spending a lot of time talking to members of Black churches and leadership groups to discuss the importance of vaccination and answer questions about the vaccine. “I would say without hyperbole that a day does not go by that I am not out there in some form of outreach as well as so many of my colleagues,” the director of the National Institute of Allergy and Infectious Diseases and President Joe Biden‘s chief medical adviser for Covid-19 said Tuesday during a Washington Post event.

—With assistance from Alex Ruoff

To contact the reporters on this story: Jacquie Lee in Washington at jlee1@bloomberglaw.com; Jeannie Baumann in Washington at jbaumann@bloombergindustry.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloombergindustry.com; Karl Hardy at khardy@bloomberglaw.com

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