In Minority Communities, Doctors Are Changing Minds About Vaccination
Like many Black and rural Americans, Denese Rankin, a 55-year-old retired bookkeeper and receptionist in Castleberry, Ala., did not want the Covid-19 vaccine.
Ms. Rankin worried about side effects — she had seen stories on social media about people developing Bell’s palsy, for example, after they were vaccinated. She thought the vaccines had come about too quickly to be safe. And she worried that the vaccinations might turn out to be another example in the government’s long history of medical experimentation on Black people.
Then, one recent weekend, her niece, an infectious disease specialist at Emory University in Atlanta, came to town. Dr. Zanthia Wiley said one of her goals in making the trip was to talk to friends and family back home in Alabama, letting them hear the truth about the vaccines from someone they knew, someone who is Black.
Across the country, Black and Hispanic physicians like Dr. Wiley are reaching out to Americans in minority communities who are suspicious of Covid-19 vaccines and often mistrustful of the officials they see on television telling them to get vaccinated. Many are dismissive of public service announcements, the doctors say, and of the federal government.
Although acceptance of the vaccine is notching up, Black and Hispanic Americans — among the groups hardest hit by the coronavirus pandemic — remain among the most reluctant to roll up their sleeves. Even health care workers in some hospitals have declined the shots.
But the assurances of Black and Hispanic doctors can make an enormous difference, experts say. “I don’t want us to benefit the least,” Dr. Wiley said. “We should be first in line to get it.”
Many physicians like her now find themselves not just urging friends and relatives to get the vaccine, but also posting messages on social media and conducting group video calls, asking people to share their concerns and offering reliable information.
“I think it makes a whole lot of difference,” said Dr. Valeria Daniela Lucio Cantos, an infectious disease specialist at Emory. She has been running online town halls and webinars on the subject of vaccination, including one with Black and Hispanic employees of the cleaning staff at the university.
She believes they are listening, not only because she is Hispanic and speaks Spanish, she said, but also because she is an immigrant — her family is still in Ecuador. “Culturally, they have someone they can relate to,” Dr. Cantos said.
Many of the vaccine-hesitant are linchpins of health in their own families. Ms. Rankin, for example, helps care for Dr. Wiley’s grandmother, who is blind, and her grandfather, who cannot walk. Ms. Rankin looks in on Dr. Wiley’s mother, whose health is fragile. And she is the single mother of three girls, including a 14-year-old who still lives at home.
“If my aunt got infected, my family would be in tough shape,” Dr. Wiley said.
Dr. Wiley met with Ms. Rankin, her daughter and her mother in the living room of a brick ranch house on a quiet street — socially distanced and wearing masks. Dr. Wiley answered questions and explained the science behind the vaccine.
No, she said, the vaccine is not made of live coronaviruses that might infect people. No, just because someone was vaccinated and became sick, it does not mean the vaccine made them ill.
And yes, the vaccine was tested on tens of thousands of people and the data carefully scrutinized by scientists with nothing to gain and everything to lose by pushing it through prematurely.
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Answers to Your Vaccine Questions
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
- If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
- When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
- If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
Dr. Wiley told them she was looking forward to being vaccinated herself.
Dr. Virginia Banks, an infectious disease specialist in Youngstown, Ohio, who is Black, understands the community’s long-held distrust in the medical establishment.
But she has seen too many people — and not all of them old — suffer and die in the pandemic, she said. And Dr. Banks worries about her own risk while caring for patients. “I feel like I am playing Russian roulette,” she said.
So she recites stories to those who are hesitant about getting inoculated, like one about a patient she recently treated, gasping for breath. He asked her, “Am I going to come out of this alive?” She told him she did not know.
“We have to tell these stories” to Black Americans, she said. “And it has to come from someone who looks like them.”
“My friends and family say, ‘Even if the risk is one in a million, I am not taking it,’” she added. “I say, ‘I understand your mistrust, but this is beyond Tuskegee. This is beyond “The Immortal Life of Henrietta Lacks.” We are in a pandemic now. We have to put our faith in the science.’”
Dr. Banks stresses the ripple effects of individual decisions: “If you don’t take that vaccine and it is safe, we will be wearing masks for some time to come. If you want your life back, if you want normalcy back, you have to rely on trusted messengers like myself.”
Dr. Leo Seoane, a critical care doctor at Ochsner Health in New Orleans who is Hispanic, has already been vaccinated. When he began talking to friends and family and others in the community, virtually all of them said they would not get the shot.
They worried that the vaccine was developed too quickly, that it was not safe, that it might not be effective or might infect them with the coronavirus. Now, after gentle persuasion, “to a person, they all changed their minds.”
But few think all it will take is a conversation or two with a trusted doctor to convert vaccine skeptics into believers.
“When they first started talking about the possibility of a vaccine in April, I said, ‘No way,’” said Phelemon Reins, a 56-year-old federal government worker. He was leery of the speed of vaccine development, and he knew too well the history of mistreatment of Black people by the medical system.
“The Trump Administration has not done anything to inspire anyone to have confidence in anything coming out,” he added. “I dismiss everything they say.”
But Dr. Banks, a friend, has made him rethink his reluctance. “In the end, it will be people like her that I depend on,” Mr. Reins said. “I trust her.”
“How do they convince the African-American community?” he said. “They may have to have people who look like her.”