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Removing barriers and fighting the narrative on vaccine hesitancy in BIPOC communities

Removing barriers and fighting the narrative on vaccine hesitancy in BIPOC communities

The COVID-19 vaccine rollout has been challenging across the county, from states securing doses to distributing them once they are in hand. But distributing the vaccines to certain communities of color—particularly Black and Brown ones—has been a challenge. 

But Dr. Rhea Boyd, a scholar, health care provider and public health advocate, is trying to change that. 

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Boyd co-developed a campaign called THE CONVERSATION: Between Us, About Us with Dr. Reed Tuckson, a founding Member of the Black Coalition Against COVID (BCAC). The Conversation is a project of the BCAC and the Kaiser Family Foundation (KFF), a nonprofit organization focusing on national health issues (no affiliation with Kaiser Permanente). 

“‘The Conversation’” started as a behind-the-scenes conversation between Black healthcare workers about the misinformation that was targeting black folks, particularly online, about COVID vaccines before any of the vaccines were available,” Boyd said. “Before the vaccines even reached emergency authorization, we were already planning a national campaign to provide Black folks with the information they would need to make this critical choice.” 

“The Conversation” features 30-60 second videos of Black doctors, nurses and researchers answering questions about COVID-19. The questions are asked by the familiar face of W. Kamau Bell, the Bay Area stand-up comedian, TV host, executive producer and author.  The videos are intended to combat misinformation online. 

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“We don’t have equal access to the vaccine, even though nationally Black folks are among those least likely to get the vaccines,” Boyd said. “Initially, I targeted exclusively Black populations because of their high COVID mortality rates nationally. Black folks have the second highest open mortality rate, so we are placing an informed focus on their needs. The newest information appearing now is Latinx populations are actually the least vaccinated population in the country. As we are entering Spanish speaking communities, we are hoping to highlight both the Afro-Latinx community and their concerns but also the Latinx community more broadly.”

KFF polled Americans about what their concerns regarding the vaccine, and saw similarities emerge across all racial groups, including whites, Blacks, Latinos, and Asians. The number one concern was if the vaccine was safe. Other top concerns were about the vaccine being development too fast, which was mixed across racial groups. And there were significant concerns around the cost—particularly among Black and Latinx populations—of the vaccine, not realizing that it’s free

According to APM Research Lab, current figures show Asian populations have the highest vaccine access and one of the lower COVID-19 mortality rates among communities of color. They are also the highest population to have at least one dose of the COVID vaccine, nationally. It’s worth noting that this is not representative of all Asians, for example, Pacific Islanders have the third highest COVID mortality rate nationally and in California and also have a disproportionate mortality rate. 

“Some barriers are shared across racial and ethnic groups, one of those barriers is language proficiency,” Boyd said. “For example, much of the COVID information we created for our first launch for Black folks was in English. For Asian populations, Latinx populations and for some Black folks, that is a barrier. That means that folks that don’t speak English or it’s not the predominant language at home, they will not have equal access for information about the COVID vaccine and they might find it difficult to navigate websites that are also predominantly English when it comes time to sign up. We also saw that having sign-ups for vaccination appointments online or over the phone was also a major barrier to folks being able to access it.”

Dr. Rhea Boyd

On March 11, Congressman Dr. Raul Ruiz, (CA-36) administered the COVID-19 vaccine to constituents at a Rite Aid mobile vaccine clinic hosted in conjunction with Desert Healthcare District at Coachella Valley High School. Ruiz has advocated for retail pharmacies to prioritize hard-hit, medically underserved communities like those in his district. 

“In Coachella and throughout the entire County of Riverside, 47 percent of the population are Hispanics that represent 65 percent of the cases of infections but have only received 19 percent of the vaccines,” Ruiz said in a recent interview with CNN. “These are gross disparities that put lives and communities in jeopardy.”

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Ruiz also told CNN that he’s been fielding questions and concerns about the vaccine from his constituents. And that after dispelling some of the myths about the vaccine, his constituents are willing to get it. 

“Why Hispanics, African Americans and Native Americans haven’t been vaccinated is not because the hesitancies. It’s very important to understand that the disparities exist primarily because of systemic barriers,” Ruiz said. “There are no doctors, no nurses and no vaccines in their communities. Once you bring the vaccines, you see the rooms are full. Yesterday in two hours we vaccinated 700 individuals who work in the fields because they are desperate to get protected to help their family and their community.”

Boyd noted models in Oakland that don’t require vaccine appointments at all, which are Umoja Health led by Dr. Kim Rhoads—and Roots Community Clinic—led by Dr. Noha Aboelata

“So, you don’t need the Internet, you don’t need a cell phone, you could just literally stand outside when they are open and get a COVID test or a COVID vaccination,” said Boyd. “These two sites are led by Black women that are doing this work. Instead of responding to the idea that people are vaccine hesitant, which is people outside our community labeling us inside our communities…folks of color and providers of color know what it means to build a healthcare infrastructure that’s not built on racism, that doesn’t have these barriers. They created sites like these from the beginning, which is a reflection of what it would look like to have like an anti-racist intervention that is available in multiple languages from the beginning because you know the communities you serve.”

Boyd dismisses the idea that mistrust in the Black community is rooted in memories of the ethically unjustified Tuskegee study. “Most black folks don’t have to bring up Tuskegee, they know from personal experience where they or a family member was mistreated when they sought medical care or didn’t have equal access to care,” Boyd said. “For other communities of color, I would venture to say it’s the same. In this national narrative, Black folks have been targeted, over any other group, to be labeled as vaccine hesitant. I am trying to shift the focus. Although Tuskegee was egregious and something that we as black folks will never forget, it is not what is shaping how people are deciding whether to get this vaccine. What is shaping that decision is that people haven’t been given information about the vaccine in communities of color, Black folks in particular. People who do have information or want to get the vaccine don’t have equal access in their neighborhoods. These are the barriers. I want us to stop talking about trust and hesitancy because when we do that, we pretend that if Black people just trusted the system, then all of the sudden, they would have access, that’s not how it works. If you just magically trust the system, that doesn’t put a vaccine site in your backyard. Our health care system at large and our public health infrastructure need to prioritize Black folks and other communities of color by making information available in multiple languages and removing the barriers to access to a vaccine site.”

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