Clergy, doctors and activists tackle COVID-19 vaccine hesitancy, access in Black, Latino communities

The Rev. John Zayas says his congregants at Grace and Peace Church in Chicago's North Austin neighborhood have been peppering him with questions about the new COVID-19 vaccine, some expressing unease or indecision about getting the shot once it's available.

Is it safe? Would I be a lab rat?

Most importantly, many ask if the church leader intends to get the vaccine, once he's eligible.

His response is always compassionate but firm: The vaccine is critical to ending the pandemic, which has disproportionately hit predominantly Black and Latino communities like North Austin and other surrounding West Side neighborhoods where the church's faithful live and work.

"I would personally take it and be an example for the church," he says. "As a pastor, you have to show by example."

Yet Zayas and other leaders working to inoculate communities of color are often battling an entrenched mistrust of science and medicine, the fallout of long-term systemic racial disparities in health care and historical medical abuses of minority patients.

A Black physician and bioethicist on the city's South Side says she has already had to reassure about a dozen of her patients—all health care workers—that the vaccine is safe and should be taken.

Leaders of a South Side hospital recently expressed alarm after about a quarter of staff members said they don't intend to get the vaccine.

While distributing hand sanitizer and masks in the Little Village neighborhood, a university researcher talks to street vendors and community members about getting vaccinated against the virus, trying to dispel rumors and myths. But she worries that once mass distribution of vaccines begins, Black and brown communities will be left behind.

Although vaccine hesitancy is reported across races, several recent polls show Black and Hispanic Americans are more likely to refuse to get a COVID-19 vaccine than other races.

Only 24% of Black respondents and 34% of Hispanics plan to get vaccinated against the new virus, compared with 53% of respondents who are white, according to a report released earlier this month from The Associated Press-NORC Center for Public Affairs Research at the University of Chicago.

Minority races also expressed greater ambivalence about getting immunized, with 41% of Hispanic Americans and 37% of Black Americans saying they're not sure about getting the shot, the survey found.

Broad distrust in government and medicine could contribute to these decisions: Fewer Black and Hispanic adults reported putting their trust in physicians, local hospitals and the health care system than white adults, according to an October survey on race and health by the Kaiser Family Foundation and The Undefeated.

The same poll found 70% of Black Americans and 43% of Hispanic Americans reported very often or somewhat often perceiving discrimination in the health care system, compared with 40% of white Americans.

Roughly 1 in 5 Black and Hispanic adults "say they were personally treated unfairly because of their race or ethnicity when getting health care for themselves or a family member in the past 12 months," compared with 5% of white adults, the report said.

Zayas, the clergyman, has been urging state leaders to prioritize the vaccination of communities of color. He wants to hold vaccine drives at his house of worship, a place of comfort for those who might be vaccine wary.

And he would like to get the shot in front of his church members, to ease their concerns and encourage them to get inoculated too.

Even as he clamors for COVID-19 vaccination trust and access, the clergyman says he understands some of the wariness surrounding health care in the United States.

The pastor's mother was born and raised in Puerto Rico, and recounts the dark era of forced sterilizations on the island, from the 1930s to the 1970s. These medical atrocities are still fresh in the psyches of many immigrant families, he said.

"Don't underestimate the fear, the fear is real," Zayas says. "Because of the past, what has happened in our communities of color, there's reservations."

Yet he notes that those with the greatest skepticism of COVID-19 vaccines are also at greatest risk of contracting—and dying from—the novel coronavirus.

His congregation at Grace and Peace Church is roughly 80% Latino and 10% Black—races that are roughly four times more likely to be hospitalized because of COVID-19 and 2.8 times more likely to die of the new virus than whites, according to the Centers for Disease Control and Prevention.

"We are in a Black and brown community that has been hit tremendously," he says. "We need to make sure this vaccine comes to our communities sooner rather than later. The people that I serve, the people I love, they are my mission. Whatever helps them, I want people to stay healthy and not get sick."

On the city's South Side, Dr. Monica Peek says about a dozen of her patients—who all work in health care—have been calling and texting the past week, expressing uncertainty about the new COVID-19 vaccine.

Should I get it? My family's worried, they don't want me to get it. Are you getting it?

Even as the physician reassures them of the vaccine's safety and efficacy—and that she'll be getting her shot as soon as she can—Peek says she isn't surprised by their concerns. She points to deep-seated fears of medical abuse in the Black community, stemming from historical horrors like unconsented surgeries on slaves and the Tuskegee Syphilis Study, a 40-year experiment where rural Black men were misled about the research and forced to suffer from untreated syphilis, despite the availability of penicillin.

"The virus will continue to decimate Black and brown communities if it goes unchecked, and the vaccine is the one way we can stem this tide," says Peek, an internist, bioethicist and health disparities researcher at the University of Chicago. "The tool that we have to do so is one that people are afraid of because of the years of injustice that these communities, that our communities have had to endure because of structural racism."

Dr. Anthony Fauci addressed this mistrust recently, while highlighting that one of the scientists at the forefront of the Pfizer vaccine is a Black woman.

"So, the first thing you might want to say to my African American brothers and sisters is that the vaccine that you're going to be taking was developed by an African American woman," said Fauci, director of the National Institute of Allergy and Infectious Diseases. "And that is just a fact."

Locally, many Black and Hispanic health care workers were the first to get the vaccine last week, moments that were captured in newspaper photos and television newscasts. Peek says these diverse images could boost confidence in the vaccine for other people of color.

"I think that is part of the messaging, is to have Black people see themselves in these images and say, 'I see me in that person,'" she said.

At the same time, even some in the medical field are reportedly declining the vaccine.

Skepticism has been particularly worrisome at Roseland Community Hospital on the city's South Side, where an estimated 25% of staff members have indicated they don't intend to get the shots.

This includes several nurses who have told supervisors that they intend to wait at least a year before getting vaccinated to see if any complications arise from the early rounds.

The reluctance alarms hospital leaders, who have begun an education campaign inside the hospital to sway doubters. Roseland executives, including CEO Tim Egan, have been passing out flyers about the importance of the vaccine in recent days to bolster confidence.

Beyond wanting to protect his staff, Egan worries about the message it would send to the neighborhood if hospital workers are too scared to be vaccinated. He understands their fears—fueled by both the country's history of inhumane experiments on Black Americans and distrust in a system that has allowed deadly health care disparities—but he believes the vaccine is the only way to blunt the virus in the community, which is predominantly Black.

"Many of our employees live in the neighborhood," he says. "They have seen the decades of divestment and the health care world turn their back on them. There is an embedded mistrust of government. People in our community have been abandoned, and this is just a byproduct."

Dr. Brandi Jackson, a psychiatrist at Howard Brown Health and co-founding director of the Institute for Antiracism in Medicine, says the medical community has not done much historically to earn the trust of Black patients.

She calls on trusted sources outside of medicine to spread the message of vaccine safety, such as Black churches, nonprofits and community activists. She also urges traditionally powerful institutions within medicine to make "a move of humility."

"They're used to being the authority," Jackson said during a Tribune Facebook live event on Wednesday. "And I think the word 'authority' has been turned on its head during this pandemic."

Dolores Castañeda has spent the past few months walking the streets of the Little Village neighborhood on the city's West Side, talking to street vendors and passersby while distributing hand sanitizer, masks and information on COVID-19 testing.

She is a research associate at the Center for Healthy Work at the University of Illinois at Chicago, and much of her study focuses on the health needs of street vendors.

On a recent weekday, she talks with 74-year-old José Carmen Camacho, who is huddled in brown insulated overalls, a scarf, black gloves and a face mask, as he sells bread baked by his wife.

While he and his wife are hopeful the vaccine will help quell the pandemic, he adds that "we're not entirely sure that we would get it. Not now at least."

"It scares me a bit; that instead of doing good to me, it makes me more sick," he says in Spanish. "We have to wait and see what reactions people have to it."

Castañeda says that most of the skepticism in the Latino community is based on misinformation or lack of attention and messaging from local organizations and the government.

Some people she speaks with have concerns about their immigration status, and need to be reassured that their information won't be given to Immigration and Customs Enforcement. Language barriers can also be a challenge; even if information is available in Spanish, many organizations share it on social media or websites, and those without smartphones and computers can be at a disadvantage, Castañeda says.

"We're looking at the same pattern that we saw when COVID-19 hit," she said. "Our communities of color were left behind."

As the first COVID-19 vaccines in Chicago were administered at Loretto Hospital on Tuesday, Mayor Lori Lightfoot pledged the process of distributing immunizations would be equitable.

"Equity isn't part of our COVID-19 strategy, it is our strategy," she said. "And when it comes to our vaccine rollout, we will be leaving no one behind. … There is an unfortunate trust deficit nationwide when it comes to taking this vaccine, particularly among predominantly African American and Latinx communities. This is a challenge we must meet and we must conquer."

The city is crafting a marketing plan to spread the message that COVID-19 vaccines are safe and effective, says Chicago Department of Public Health spokesman Andrew Buchanan.

This will include a campaign similar to existing door-knocking efforts to hand out masks and informational flyers on safe practices. As of this week, the city and its partners are on track to reach 1 million phones through phone-banking and texting, and deliver care kits to 400,000 households around the end of January, he says.

The city plans to spread vaccination sites fairly throughout the city, Buchanan says, which includes working with City Colleges of Chicago campuses and community groups in neighborhoods with high positivity rates.

"We are working hard to push messaging and outreach to the areas that have been hardest hit by COVID-19 and who may have a historical distrust of the health care community," he said.

Last week, Ald. Byron Sigcho-Lopez, 25th, sponsored a resolution for permanent COVID-19 testing and vaccine sites in African American and Latino neighborhoods. He argues the measure is critical to ensure Black and Latino communities receive care after being disproportionately affected by the pandemic.

Castañeda, a Little Village resident, said the government has failed to protect Black and brown communities from COVID-19, and that she expects that once full rollout of the vaccine begins, those same neighborhoods will once again be without access.

"Because we are often thrown to the side," she says.

Abraham Valdez, 67, whose livelihood depends on collecting recyclable aluminum cans, says he is eager to get the vaccine. He says he doesn't want to get sick and not be able to work.

"Having this vaccine is better than nothing," he says in Spanish. "I'll trust God about it. But even if it works, who knows when I'll be able to get it?"

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