Racial differences are an obstacle to the introduction of Covid-19 vaccine

LOS ANGELES – Despite the possibility of vaccination within weeks, black and Latin people still have a high level of distrust of the medical community, who have been disproportionately affected by Covid-19, as elected leaders and public health professionals work as a priority for vaccine distribution.

The dark history of medical experiments and unequal access to care feeds residents of the black and Latin community struggling with high Covid-19 rates among those least likely to be vaccinated, health activists say. Tackling systemic racism and related collective trauma will be paramount as officials rush to distribute vaccines to severely affected communities, they warn.

“The people who need it most are the same people who don’t trust it,” said Sernah Essien, of the Universities Allied for Essential Medicines, an international advocacy group working to ensure equal access to vaccines. “Without taking racial fairness into account, we are deepening the cracks that systemic racism has already created in our health care system.”

The message is heard at the highest level.

In an interview with the Associated Press on Tuesday, President-elect Joe Biden said that addressing racial differences cannot be ignored as the nation continues to fight the coronavirus, which has infected more than 14 million people in the United States and 276,388 people. killed him. on Thursday, NBC News counts.

Dr. Marcella Nunez-Smith, an expert on health inequalities at Yale University, said testing and vaccination programs really need to be fair and equitable along with safety.

“We can’t control this epidemic if we don’t address the country’s inequality problems,” he said. – There is no other way.

Several states say they want to consider color communities when vaccination becomes available.

California Governor Gavin Newsom said last month that disproportionately affected black and Latin residents should be among the first to be vaccinated. New York Governor Andrew Cuomo echoed these remarks while speaking at a Manhattan church on Nov. 15: “We know our black, brown, and poorer communities have fewer health facilities. Their communities all too often have health deserts.”

According to the Center for Disease Prevention and Control, race and ethnicity are risk indicators for other general conditions that affect overall health outcomes, including access to medical care and exposure to the workplace coronavirus.

According to the CDC, among blacks, Latinos, and natives, the hospital and mortality rates of Covid-19 are two to four times higher than those of whites.

Both black and Latin people report higher levels of vaccine insecurity and mistrust than white Americans, according to a recent survey by COVID Collaborative, a coalition of national experts in health, education and the economy.

Less than half of black adults said they would definitely or probably get a coronavirus vaccine if they were free. According to the survey, only 18 percent said they would get vaccinated anyway, regardless of the cost. Among adult Latinos, 66 percent said they would get a free vaccination and 31 percent said they would vaccinate themselves anyway.

The results were more unsettling in terms of trust. Only 14 percent of black adults and 34 percent of Latinos said they trusted the safety of the vaccines, and three-quarters of black and Latin respondents said they were less likely to receive a vaccine approved for emergency use by the Food and Drug Administration. COVID Cooperation.

The results pose an additional challenge to an already overburdened health care system, said Vickie Mays, director of UCLA’s Center for Research, Education, Training and Strategic Communication on Minority Health Disparities.

“Differences give birth to inequalities,” she said. “It’s not just a matter of pre-existing conditions. People who live in dense areas where sidewalks are very small don’t have the luxury of keeping a distance of 6 meters.”

Mays is one of several researchers at UCLA who has created a predictive model that identifies the populations in Los Angeles that are most at risk for coronavirus infection. The model, which can be applied in other cities, uses four indicators that can increase a person’s vulnerability to the coronavirus: pre-existing health conditions, barriers to health care, environmental characteristics, and socioeconomic challenges.

The researchers found that people living in urban centers and multi-generational households are more likely to be infected than people living in more affluent neighborhoods with large single-family homes and telecommuting.

Mays, an early researcher on HIV / AIDS, said many of the differences in black communities today in the light of the pandemic are what he witnessed in the 1980s.

When the AIDS epidemic peaked, messaging and outreach efforts were targeted at men who had sex with another man. Intravenous drug users were not in early focus, which meant that the entire category of people susceptible to infection knew little about it.

“If you have an epidemic, there are layers of science,” she said. “The colorful people arrived very late in the process, especially in California.”

As a result, California black men still have the highest rates of new HIV infections, he said, adding that lessons learned from the AIDS crisis could have been used in the pandemic.

“Not only were there lessons that should have been learned, but if we had learned these lessons well, we would have done better today,” he said.

Across California, which reported more than 1.2 million confirmed cases of coronavirus on Thursdays, Covid-19 destroyed color communities.

Los Angeles County had more than 400,000 confirmed cases this week, and infection rates remain the highest in the densely populated urban area, public health officials said. The lowest rates of infection appear to be found in affluent coastal cities, such as Malibu, which are separated from the rest of the county by their geographical and socio-economic location.

“It’s no coincidence that black and brown people are disproportionately affected by the epidemic,” said Priti Krishtel, co-founder of the International Initiative for Medicines, Access and Knowledge, which is running a campaign to make medicines accessible and affordable. “Structural racism is embedded in our health care system.”

One of the most serious examples was the 1932 study of syphilis in black men. The untreated syphilis, the name of a black male Tuskegee study, was undertaken by the U.S. Public Health Service with the goal of learning more about the disease and ultimately justifying the treatment of black men.

Decades later, in 1972, a news report found that the men in the study had misled the purpose of the study and refused treatment, causing unnecessary pain and suffering. Even when penicillin was widely used to treat syphilis in 1947, it was not offered to test subjects.

An advisory board later concluded that the Tuskegee study was “ethically unreasonable” and that a $ 10 million settlement was made in 1974. In 1997, President Bill Clinton formally apologized to the subjects and their families.

The damage caused by the Tuskegee study and persistent health inequalities, including a lack of access to affordable medical care and expensive medicines, continue today as blacks and Latinos continue to be the opinion of lawyers for potential vaccinations.

People living in the U.S. without proper authorization are afraid of being reported to the authorities and deported. This mistrust has been heightened by the Trump government’s previous family separation policy and ongoing anti-immigrant rhetoric, said Rita Carreón, vice president of health at UnidosUS, a national civil rights and Latin American advocacy organization.

“These anti-family policies that are in place keep our community away from the health care system,” he said.

In Long Beach, California, Mayor Robert Garcia, who lost his mother and stepfather from Covid-19, launched a mobile testing program of this kind in September that sends health workers to hard-to-reach communities. Mobile clinics offer free coronavirus tests provided by health professionals who speak the language of the communities they visit.

The program could run about 300 tests a day, Garcia said, and hopes the mobile model will help distribute vaccines to the communities most in need.

“It can’t just be a government effort,” he said, adding that the city is partnering with community-based organizations to increase information and education efforts even before vaccines become available.

“We need to make sure it’s all done through a stock lens,” he said. “The last person to be vaccinated is NBA players and billionaires.”

This report is part of NBC News’s in-depth coverage of the “Competition for Vaccination,” a network-wide, week-long series that appears on all programs and platforms, including “NBC Nightly News,” “TODAY,” “Dateline NBC,” MSNBC, NBCNews.com and NBC News NOW.