As the availability of vaccines increases in New York City and across the country, increasing attention is turning to those who remain reluctant to receive them. According to public health experts, between 70 and 90 percent of the population will need to be vaccinated to achieve herd immunity and bring the pandemic under control. Still, 14 percent of Americans say they definitely won’t get a vaccine, and another 13 percent want to wait and see how they work, or will only get one if needed, a survey by the Kaiser Family Foundation (KFF) found in July.
Much attention has focused on the reluctance of black and Hispanic populations, partly due to their distrust of the health system. That is why diversity leaders at Weill Cornell Medicine have launched ambitious community vaccination and education efforts with the aim of increasing uptake and helping those who are reluctant to overcome their concerns. The July KFF poll found that about 16 percent of Hispanic adults wanted to “wait and see” before getting vaccinated, compared with 11 percent of black adults and 8 percent of white adults. The survey also found that vaccine resistance is associated with younger age, lower levels of education, lack of insurance, and political affiliation.
Health professionals who work with and belong to black and brown communities say the focus must be on making the vaccine readily available as well as on hesitation. While everyone in the US 12 and older is now eligible to get an appointment, fluency on the internet may be required – plus free time and travel to one location.
In January, New York-Presbyterian opened a vaccination facility in the Fort Washington Armory in Upper Manhattan and prioritized appointments for eligible residents of Washington Heights, Inwood, Harlem, and the South Bronx. In addition, using information from Cornell Cooperative Extension-NYC, Weill Cornell Medicine Clinical and Translational Science Center (CTSC) worked with the Community Healthcare Network of State Qualified Health Centers to deliver over 8,600 doses of vaccine by the end of May. The effort, led by Jeff Zhu of the CTSC, was conducted in locations occupied by Weill Cornell medical students in churches and nonprofits in Manhattan, the Bronx and Queens. And in April, Weill Cornell Medicine’s prospective doctors teamed up with Hunter College nursing students to run clinics in churches in Jamaica, East New York and Harlem, with a goal of vaccinating 100,000 people by September.
Dr. Julianne Imperato-McGinley, director of the CTSC and professor of medicine, says it is important to make vaccinations available in your own communities, especially in “trusted places” like places of worship or a neighborhood organization. The CTSC had previously worked with a predominantly black church on a free health screening program called Heart to Heart; his pastor contacted the center and had himself vaccinated in front of his congregation.
The point about trust is essential. That is why we do this with denominations where the community knows the hosts of the event. And it works – they get vaccinated. “
Dr. Imperato-McGinley, Senior Physician at NewYork-Presbyterian / Weill Cornell Medical Center
During the launch of the vaccine, great attention was also paid to the health system’s historical mistreatment of color communities – particularly the infamous Tuskegee experiment, in which researchers withheld treatment of blacks with syphilis so they could study the course of the disease. But it’s not all history: COVID-19 is having a disproportionate impact on People of Color, some of whom are still underserved by the healthcare system. Because of this, the questions of why vaccines, which typically take years to develop, can be made so quickly, or whether they could cause future side effects, should be viewed as self-advocacy rather than hesitation, experts say.
To help healthcare professionals respond to these concerns, Weill Cornell Medicine in March trained “Vaccine Ambassadors” who serve as relatable, credible sources of information. “It’s not about convincing people,” says Dr. Susana Morales, Associate Professor of Clinical Medicine and Director of the Diversity Center of Excellence at the Cornell Center for Health Equity and Associate Physician at the New York-Presbyterian / Weill Cornell Medical Center. who directed the training. “It’s about providing information that is sorely lacking; it’s about empowerment and access.” During the training, which was partly supported by a $ 200,000 gift from the law firm Weil, Gotshal & Manges LLP, the panelists designed discussions as “knowledge gaps” and advised them to be receptive and empathetic to questions. “I tell patients, ‘I promise I have done my research to decide whether I can recommend COVID vaccines – and whether I would accept the vaccine itself,'” said Dr. Morales who informs them that she has been vaccinated.
In response to concerns about the pace of vaccine development, Dr. Morales how clinical trials enrolled thousands of different volunteers and achieved quick results due to the spread of the virus. Ambassadors respond to questions about side effects by advising that study participants will continue to be monitored for serious side effects that must be reported by investigators and disclosed by drug manufacturers and other study sponsors. They also point to long-term side effects of COVID-19 infection, such as neurological damage, that the vaccine protects against.
Ambassadors can share findings from the latest research with patients from populations who have not participated in vaccine studies. For example, none of the currently approved vaccines have shown negative effects on fertility or cause pregnancy abnormalities in animal studies, and the first data on vaccinated pregnant women are very encouraging, says Dr. Kevin Holcomb, Assistant Dean of Studies and Professor of Clinical Studies Obstetrics and Gynecology at Weill Cornell Medicine and an attending obstetrics / gynecology at New York-Presbyterian / Weill Cornell Medical Center. Dr. Holcomb has also spoken to people about historical comparisons when appropriate. For example, he has learned that some are under the false impression that researchers in the Tuskegee study infected participants with syphilis – when in fact they denied them penicillin as a treatment for the disease. Dr. Holcomb says, “What happened in Tuskegee is what we could do if we don’t use this vaccine.”