In a little over a month since the first vaccines were authorized for emergency use, there have been more than 16 million COVID-19 vaccine shots administered in the United States, but even as millions more people are eager to get the vaccine as soon as possible, not all of those who are eligible already have taken the opportunity. Vaccine hesitancy is one reason why — and it can make racial and ethnic disparities in the impact of COVID-19 even worse.
On January 15, the CPUP Antiracism Committee hosted the Penn Medicine town hall “The Vaccine Experience in the Black and Brown Community” which addressed this reluctance, particularly for people of color. According to the Kaiser Family Foundation, a December 2020 survey reported that 35 percent of Black adults say they definitely or probably would not get vaccinated, citing mistrust as a primary reason for not getting vaccinated.
To an audience of more than 700 attendees, the virtual town hall served as a platform for conversation about the COVID-19 vaccines and the disparities in vaccine uptake among Black and Brown communities. The town hall is one among a set of broader efforts to address vaccine hesitancy at Penn Medicine, including ambassadors and a poster campaign, ensuring an open dialogue that will allow people to make an informed decision about receiving the vaccine.
Moderated by Florencia Greer Polite, MD, chief of the division of General Obstetrics and Gynecology, the town hall’s panel consisted of Black staff and faculty including Nicole Brown, LPN, a nurse at the Helen O. Dickens Center for Women, John Dixon, a chef at HUP, Meghan Lane-Fall, MD, MSHP, an associate professor and vice chair of Inclusion, Diversity, and Equity in Anesthesiology and Critical Care at the Perelman School of Medicine, and Kenya Pitt, manager of Human Resources of the Clinical Practices of the University of Pennsylvania (CPUP), additionally featuring Neil Fishman, MD, chief medical officer of HUP, as a special guest.
We’re sharing key highlights from the discussion here. Some of the questions and responses have been edited for clarity.
Is the vaccine safe?
Neil Fishman: About one person for every 100,000 people vaccinated will develop a severe allergic reaction. It’s not life threatening. The mortality rate of COVID-19 is much higher. The death rate from the disease is 95 in100,000 white peoplewhereas it’s around 230 per 100,000 people in our Black and Brown populations. Therefore, a Black or Brown person is more than 200 times more likely to die from COVID-19 than they are to develop a severe reaction to the vaccine.
Why is it important to address systemic racism when discussing vaccine hesitancy in the Black community, as opposed to just saying we have folks who are hesitant to get the vaccine?
Meghan Lane-Fall: We all know that the differences that we’re seeing in the uptake of the vaccine are related to the mistrust that many of us have in the health care system and in science. That mistrust is well-founded. There have been so many instances of our communities being abused, misused, mislead, that this is what we see as a result. We have to acknowledge that history. What’s different about this situation is that there is a level of transparency here that we have never had. There are so many eyes and ears and cameras on everything that’s happening, and what we’re seeing is a vaccine that’s being offered to everyone. It’s the same vaccine. It’s not Black folks get this one, white folks get this one. I wouldn’t do that either. There are some really important differences here, but we can’t have this conversation without talking about racism.
What were your initial feelings about the vaccine, and what went into your decision to get the vaccine?
Kenya Pitt: It really does center on our relationship as people of color and what our relationship has been to health care in this country, specifically when you think about other experiments in the past, like Henrietta Lacks, an African-American woman whose cells were used for cancer research without her consent. Naturally, I thought of those things, and I thought about what the experience has been just as a patient sometimes feeling a little disenfranchised, not really listened to or taken seriously. It made me have a lot of hesitation about taking the vaccine. My initial thoughts were, “Has the vaccine been well studied? How much time have scientists really had to really dig into this vaccine and study it in a way that would make me confident about taking it?” I don’t want to be a guinea pig, and I’ve heard that echoed in my own community, among my friends and family, and that was really my initial hesitation in choosing whether or not I wanted to take the vaccine.
Nicole Brown: My hesitation for receiving the vaccine was my fear. Also, I had to think about it because I did have coronavirus and the symptoms that I went through were challenging. I didn’t want to go through that again, and I didn’t know what kinds of products were used to produce the vaccine. I did draw some form of anxiety, but the more I started seeing my colleagues get the vaccine, I felt more encouraged and ready to get it.
Meghan Lane-Fall: As soon as I heard vaccine efforts were underway, I wanted to know more about what was happening and what type of vaccine it was. I dug into information very early to understand what type of vaccine was being produced, what is an mRNA vaccine, what are the implications of it, and who [did they enroll in the clinical trials to test its safety and effectiveness]. When you look at who has participated in studies, traditionally, it’s not necessarily folks who look like us. All of my questions were answered to my satisfaction. I know that tens of thousands of people got the vaccine before it got Emergency Use Authorization by the FDA, so I was ready to go.
John Dixon: I was a little hesitant and doubtful about the vaccine but then you look around and see all these people dying from COVID-19. We have to move forward as a Black community especially. The side effects when I first got it, I felt a little burning and that was it. The second dose didn’t bother me at all. If you have any underlying issues you might want to think about addressing that first, but I suggest that everyone be vaccinated. We need to move forward, to get past this. I watched my aunt pass away, my mom’s only sister. For holidays, we couldn’t be around my mom. I didn’t want anybody to be around her. She wanted to have Thanksgiving like we’ve been doing traditionally, and I said “no we can’t, not until everybody gets vaccinated, not until everybody is safe.” I got both shots of my vaccination, and I feel great.
Was there any new information that you learned about the vaccine that lead you to the decision to take the shot?
John Dixon: Yes, there was. I was really hesitant when I started looking at the information about the vaccine. I talked to certain people who had already got the shot, asked what their feelings were, and their feelings were the same as mine. The information was plain and clear, and I slept on it. It took me a couple days, and I [eventually] felt good about coming over and getting it.
As a white health care provider and supervisor of a diverse staff, what would be the most helpful way for me to address this with the people of color that I see and interact with, and how would you advise someone?
Kenya Pitt: Considering what the world has seen, what our country has seen over the last several months with all the social injustice and racial unrest, you need to position yourself as an advocate. When you position yourself as an advocate, it’s really critical to sit in a seat of non-criticism, to create safe spaces where people feel like they can come to you and you will listen. It’s important to listen to why people are afraid and to understand [them], but you should also listen to educate and create resources for awareness and information. Acceptance and validation is important, particularly for people of color who still feel disenfranchised and don’t necessarily feel like they have a voice or people want to hear what they have to say. It’s all about creating a space that is safe, where we can share our stories and bring awareness about our lived experiences as people of color, ultimately having non-judgement, openness, objectivity, and safety.
What can people without medical training, or limited medical training, do to support this effort to promote the COVID-19 vaccine in communities of color in Philadelphia?
Nicole Brown: Social media is a big platform in order to promote information in regards to the COVID-19 vaccine. For example, when I received the injection, I posted a picture on Instagram. I received so many text messages and DMs saying, “You did it, so I want to do it too.” It heightened their want to receive the vaccine which I thought was awesome. More and more, the vaccine is becoming available, and I feel like local drug stores, recreation centers, and pharmacies should have all kinds of information that can be available for people to receive.
Has anyone received negative feedback about getting vaccinated?
John Dixon: I got a lot of positive feedback. I want to move forward from this pandemic. Fear will never make you move any further; it will only keep you still. I try to overcome a lot of my fears. Of course I hear people say negative things about the vaccine, but in the long run I think they’re going to turn around.
Kenya Pitt: I received some negative feedback from family members and friends when I shared that I got the vaccine. I had to remind them of the tremendous grief that my family has experienced this year due to COVID-19. Between my husband and I, we’ve lost over 25 people, close family members and friends, people that we interact with every day to COVID-19. I can’t even hug my family members. We could barely go to any of the funerals and we had to remind them that the risk of getting this vaccine is far less than the risk of what COVID-19 can do. While we didn’t lose everyone we know to death, the downstream impact of having COVID-19 is having a lot of people with all these residual medical issues. The risk of getting the vaccine was far less and the reward was far greater for us. I’ve given people information and I see the change in their perspective. It’s worth the fight. It’s worth the debate for me for people who disagree.