After successful use in clinical trials proved their COVID-19 vaccines to be roughly 95% effective in preventing the infection, two drug companies have received approval from the U.S. Food and Drug Administration for emergency-use authorization of their COVID-19 vaccines.* While some people celebrate this step in the fight against the global pandemic, others are cautious about welcoming possible vaccines. University of Pittsburgh researchers want to know more about the reasons people have vaccine hesitancy.
The World Health Organization defines vaccine hesitancy as “the reluctance or refusal to vaccinate despite the availability of vaccines.” People are hesitant about vaccines for a variety of reasons. For Black and Indigenous communities and People of Color, some of those reasons stem from their mistreatment and abuse at the hands of academic and medical institutions (infamous examples are the Tuskegee Study the Guatemala Syphilis Study). Other reasons may include systemic racism and its effects in medical settings or even a lack of health care access.
Whatever the cause may be, vaccine hesitancy may influence COVID-19’s impact on communities that are already hardest hit by the pandemic. As reported in the COVID Tracking Project, marginalized communities in the United States get infected and die from COVID-19 at rates more than 1.5 times their share of the population. But people who disproportionately bear the burden of COVID-19 may also be the groups most unsure about getting a vaccine. According to a poll conducted by the COVID Collaborative, Langer Research, UnidosUS and the NAACP, fewer than half of Black people and 66% of Latinx people said they would definitely or probably get the vaccine.
In Pittsburgh last summer, a community group-including people from the Urban League of Greater Pittsburgh, UrbanKind Institute, University of Pittsburgh, Casa San José and the Neighborhood Resilience Project-gathered to make sure marginalized communities were represented in COVID-19 vaccine trials. The Community Vaccine Collaborative is a community-academic partnership that is centered on addressing the disproportionate impact of COVID-19 on marginalized communities.
“We started thinking about the idea of trustworthiness—of the vaccine, of research and of health care professionals,” says Maya Ragavan, MD, MPH, MS, assistant professor of pediatrics at the University of Pittsburgh School of Medicine. “We’re trying to shift the narrative from ‘We just need to keep educating people until they trust research’ to ‘How can research and medical institutions be more trustworthy?’”
The Community Vaccine Collaborative members are working to understand and acknowledge the past and histories of mistrust and trauma perpetrated by research and medical institutions against communities of color, particularly in Black and Latinx communities, as a means to build trustworthiness.
As a member of the Community Vaccine Collaborative, Dr. Ragavan is also currently coleading a study (funded by the Allegheny County Health Department) that is investigating Black and Latinx adults’ thoughts about COVID-19 and possible vaccines. People taking the survey are asked where they are getting information about COVID-19 and which sources of information they trust. They are asked whether they would get a COVID-19 vaccination for themselves or their children (when one is available). Additionally, survey respondents are asked about the flu vaccine, which has traditionally had slower uptake rates compared with traditional childhood vaccines.
Another study the Community Vaccine Collaborative is developing would also be used to help build trustworthiness by surveying researchers. Taylor Scott, health advocate with the Urban League of Greater Pittsburgh, and Dr. Ragavan are creating a survey that asks researchers what they know about past histories of mistrust and trauma and how they think trustworthiness can be built. Results from this study will not only inform our understanding of addressing vaccine mistrust but also have implications for building trustworthiness more broadly.
“As a pediatrician, I strongly believe in vaccines,” says Dr. Ragavan. “They save lives, and I’ll always encourage families to get vaccinated. However, I strongly understand that people may be hesitant in general about trusting vaccines and medical professionals.
“If people are wary of vaccines, they should discuss their concerns with their health care provider. We are here to listen and talk about your questions and concerns. Having a discussion about concerns or questions could help allay some fears,” she says.
*As of January 6, 2021, people have begun receiving Pfizer’s and Moderna’s vaccines.
To participate in this study, you have to identify as a member of the Black or Latino communities (Black, African American, African, Latino, Latina, Latinx or Hispanic), live in or within 50 miles of Pittsburgh, be 18 years old or older and be able to complete the survey in English or Spanish. If you would like to take the survey or have any questions, please email Maya Ragavan (firstname.lastname@example.org) or call or text 412-515-9048. We can email or text you the link or, if you prefer, read the questions out loud.
You will receive a $25 gift card for participating.