Black folks are still getting sick. Still spreading COVID-19. Still flooding local ERs. Still dying.
Still giving the vaccine the side-eye.
While vaccination mandates are being issued and enforced more frequently, health officials still continue to come up against hesitancy in the Black community.
Local African American doctors are stepping up and speaking out, to allay fears and encourage people to make informed decisions about not only their own health, but also protecting others around them.
Dr. Kristin Gates, an adult primary care physician with Kaiser Permanente Elk Grove, and Dr. Mikah Owen, a pediatrician with UC Davis Medical Group, were guest speakers during a recent Zoom session aimed at training Black community leaders to become “vaccine influencers.”
The series of trainings were hosted by the Sacramento County COVID-19 Collaborative that includes The Center at Sierra Health Foundation and the Sacramento County Public Health Department. Participants in the sessions got vaccine updates, learned how to provide COVID-19 vaccination information and messages, how to address common concerns, and got communication tools to have effective conversations in their circles of influence.
Dr. Gates, who co-leads Kaiser’s African American Disparities Strategy Team in South Sacramento, offered strategies for having “honest” conversations about the vaccine.
“Our ultimate goal is to encourage, not convince,” she said. “Telling people that we trust them to make the safest choice for them and their family and then giving them the information to do so, allows them to step away and make their own decisions.”
With COVID-19, personal decisions have a larger impact.
“Even though this is an individual choice, it’s not a choice that has individual consequences,” Dr. Gates shared.
“Most of the people who we see infected, if mom’s infected, that means often that dad and all of the kids are infected as well, so it’s households who get sick, not just the individual,” she continued.
The “Vaccine Influencers” session was held in mid-August. At the time, only 7.1% of the vaccinations that had been given out in Sacramento County had gone to African Americans. “The thing that’s so crazy about this is, not only is this not equal to the percentage that we make up of the population, but we make up 13% of all COVID cases, but only 7.1% of the vaccinations. We’re seeing the dire differences between the amount of exposure compared to the amount of protection in our community,” Dr. Gates said.
The numbers haven’t changed in a month.
That, Black doctors say, warrants a sense of urgency.
“We only have two choices. Patients can either take their chances with COVID or they trust the vaccine. With how widespread this is, there’s not really an option to make it through 2021 the way many people made it through 2020.”
Dr. Owen is serving as a consultant with local school districts, assisting with the return to in-person instruction. Younger children ages 5-11 are expected to become eligible for the vaccine shortly. In anticipation, California just became the first state to pass a vaccine mandate for the younger students, from kindergarten to sixth grade to be vaccinated in order to attend school next year, once federal approval is granted.
Many parents haven’t been vaccinated and others haven’t allowed their older children to be vaccinated, even though they’ve returned to school.
Low risk doesn’t mean no risk, Dr. Owen reminds.
“We’ve seen it all over the country, parents filled with regret that they did not do it because they weren’t expecting their kids to get sick. We have seen children get sick and unfortunately we’ve seen children who have died of COVID-19,” he said.
Dr. Owens wants people to think about the implications of not getting vaccinated, especially in communities that are predominantly people of color.
“The higher the percentage of people who are unvaccinated, the more likely an outbreak in schools is going to be. The more likely there is an outbreak in schools, the more likely that we potentially may have to quarantine a class, quarantine a daycare, quarantine a particular school,” he said. “Not only do we see the disparities in vaccination, but as these disparities grow, it’s likely that a disparity in our response and how we actively react to COVID is going to change as well and it’ll slow recovery efforts and school efforts in communities of color if we don’t see an increase uptake in our community soon.”
A ‘Pregnant’ Pause
Black health professionals also took center stage during a recent pandemic-related discussion hosted by the Northern California Section of The National Council For Negro Women and its Good Health Wins campaign.
Panelists for the virtual, “Baby Talk: Addressing COVID Vaccines & Fertility” session included Dr. Oliver T. Brooks of the Watts Healthcare Corp.; Kimi Watkins Tartt, director of Alameda County Public Health; and Dr. Sara Whetstone of the UCSF Medical Center. The discussion was moderated by Dr. Jann Murray-Garcia, director of UC Davis’ Betty Irene Moore School of Nursing.
Both Dr. Murray-Garcia and Dr. Whetstone voiced concern over seeing an increase of pregnant women in the ICU. In the days prior to the Aug. 26 presentation, there were four being cared for at the UC Davis Medical Center, including one who was on a ventilator.
“You never hear that. Out of 20/30 beds, four pregnant women?” said an incredulous Dr. Murray-Garcia.
“This is something different now,” she shared. “We need to have a different conversation about the importance of all of us getting vaccinated.”
According to Dr. Whetstone, an obstetrician who has dedicated her career to caring for Black women and their babies, this pandemic has been like nothing they’ve seen in medicine before.
The pandemic is still going strong 18 months later. And Dr. Whetstone says they now have more data and are able to say things with greater confidence.
“Although there are still lingering questions, we know the overall risk of severe illness for pregnant people with COVID-19 is low, and we see that pregnant people are at much higher risk of severe illness in comparison to non-pregnant people,” she said. “They are three times more likely to be admitted to the ICU, two times more likely to need a machine outside of their bodies to oxygenate their lungs, and also two times more likely to die and this was before Delta. Black and Latinx women face even worse outcomes given the reality of being Black and brown in this country.”
The Black doctors shared information and relayed the continued questions and concerns of patients they serve. Panelists addressed mixed public health messages about whether or not pregnant women should be vaccinated, if vaccination negatively impacts breastfeeding moms and a failure to include pregnant women in clinical trials. The sole male on the call, Dr. Brooks, also touched on postmortem studies that have found traces of the coronavirus in men’s sperm.
He spoke of vaccine hesitancy in the Black community.
“I have a good friend, Dr. Mike Lenore, out of Oakland, California, who says, ‘don’t fall for the okey doke.’ Quite frankly as African Americans, if you’re choosing not to get vaccinated, you’re falling for the okey doke. With all this information that is out there, theoretically I could postulate that it’s put out there so we don’t get vaccinated and we do get COVID.”
Dr. Brooks admits he was originally hesitant about the vaccine because it hadn’t been widely used before, but studied the science behind it and changed his view.
“I’m much more afraid of COVID than I am of the vaccine,” he said.
Many point to mistrust of vaccines and medical studies because of the famed Tuskegee Experiment that saw Black men go untreated for sexually transmitted diseases so that the sick could be studied.
Dr. Brooks can’t totally dismiss those concerns, he says, because they’re rooted in real and aggregius history. Tuskegee wasn’t an isolated wrong, he points out.
“They grave robbed cadavers, or bodies, from the enslaved down South and brought them to the North to work on them. Down in Texas, on the border, they were doing forced sterilization procedures on Latinx women. We as a people have had issues with the healthcare system. There’s racism. We have higher rates of everything bad and lower rates of everything good, I understand all of that.”
Both Dr. Brooks and Dr. Murray-Garcia are in agreement: the realities of COVID-19 and the deadly Delta variant should outweigh fears.
“I study racism in medicine as an issue and I find it very important to put myself in front of folks, Black folks, to say, ‘yep, there’s racism in medicine today like there’s always been, and I got the vaccine,’ ” Dr. Murray-Garcia said.