Per a survey-based study conducted by Langer Research, a New York-based research firm, only 48% of Black people and 66% of Latino people in the U.S. reported that they would either definitely or probably get a COVID-19 vaccine if it were offered free of charge. Given that communities of color have borne a disproportionate amount of the COVID-19 burden, understanding these low percentages is critical.* 

What did the study entail?

Conducted from September 1-15, 2020, the random-sample online study occurred before the interim analyses were released for the three major vaccines in the pipeline at the time and showed their high safety scores.

Without that reassurance, the findings showed that of the 1,050 Black adults and 258 Latino adults who responded to the survey:

• 14% of Black and 34% of Latino respondents trusted that the vaccine would be safe.
• 18% of Black and 40% of Latino respondents trusted that the vaccine would be effective in shielding them from the SARS-CoV-2 coronavirus.

Even as death rates across all races and age groups have fluctuated, death rates for patients of color have remained consistently higher than death rates for White patients. Because of this, government and health officials need to understand why just under half of all Black people and just over half of all Latino people trust the vaccine and those who administer it enough to want to get it.

What factors affect trust?

Focus group responses from similar studies indicated that many Latino people in the U.S. don’t feel confident that the government has their best interests at heart. Other factors influencing lack of trust included:

• Age
• Sex
• Education
• Partisanship
• Previous experience with flu vaccines
• Strength of racial identity

For many Black people, hesitation to trust the hastily-approved experimental vaccines is an outgrowth of slavery, medical experimentation, and other outrages perpetrated on the bodies of Black people by the U.S. government throughout its history, such as the Tuskegee Syphilis Study. 

Black leaders, from pastors to politicians, are encouraging their congregants and constituents to:

• Overcome their hesitation and distrust of government institutions
• Follow the prescribed public health safety protocols
• Participate in the vaccinations to protect each other and stop the spread of COVID-19 in Black communities 

The study also revealed that Black people were twice as likely to trust a messenger from the Black community than one who was White. As such, Black educators and physicians are leading the charge to urge Black citizens to opt-in for the vaccine by publicizing their vaccinations and taking part in clinical trials. Howard University President Wayne Frederick, who is also a physician, emphasized the need for Black healthcare providers to help their patients feel confident about receiving the vaccine.

Vaccine recommendations: How are they formulated?

Steps have been taken to avoid discrimination and achieve health equity in vaccine distribution and administration. The Centers for Disease Control and Prevention’s (CDC) recommendations to federal, state, and local governments are based on those of the Advisory Committee on Immunization Practices (ACIP), an independent group of medical and public health experts.

The group’s stated goals for its recommendations were to:

• Decrease death and serious disease as much as possible
• Preserve the functioning of society
• Reduce the extra burden COVID-19 is having on people already facing health disparity

Before making its recommendations, the ACIP reviewed all available clinical trial data, including:

• Who is receiving each vaccine (age, race, ethnicity, and underlying medical conditions)
• How different groups respond to the vaccine
• Side effects of each vaccine

The ACIP evaluated this data in light of four ethical principles they identified to guide their decision-making process, namely:

• Maximize benefits and minimize harms
• Mitigate health inequities
• Promote justice
• Promote transparency 

What are the current vaccine recommendations?

Currently, the phases recommended for vaccine distribution are as follows:

• Phase 1a
  • Healthcare personnel 
  • Long-term care facility residents 

• Phase 1b
  • Frontline essential workers, such as firefighters, police and corrections officers, workers in agriculture, mail delivery, manufacturing, grocery stores, public transit, and education
  • People from ages 75 and older

• Phase 1c
  • People from ages 65-74
  • People from ages 16-64 years with underlying medical conditions that increase the risk of serious complications from COVID-19
  • Other essential workers, such as food service, housing construction, communications, energy, law, media, public health and safety, etc.

The phases may overlap, and the recommendations will be updated and expanded as vaccine availability increases. Coordinated efforts are being made to encourage people to get the vaccine as soon as it becomes available for their demographic group. 

“It’s not having a vaccine that saves lives,” said Michelle Williams, dean of the Harvard T.H. Chan School of Public Health, and co-founder of the COVID Collaborative, the nonprofit that commissioned the recent study, “it’s people actually getting vaccinated.”

The CDC offers additional information on COVID-19 vaccine recommendations and information on who should be vaccinated first.

*Wan, W. (2020, Nov. 23). Coronavirus Vaccines Face Trust Gap in Black and Latino Communities, Study Finds. The Washington Post. https://www.washingtonpost.com/health/2020/11/23/covid-vaccine-hesitancy/