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Vaccine Hesitancy and Health Justice

 
About the Newsletter

The COVID-19 pandemic has disproportionately affected Black and Latinx communities in the United States.This month's newsletter focuses on COVID-19 vaccines, mass-scale public health interventions, and vaccine hesitancy in communities of color. 

Back in November of 2020, a survey by the COVID Collaborative, Langer Research, UnidosUS, and the NAACP found that the majority of Black and Latinx people did not trust the vaccine to be safe or effective. The report also noted that despite the disproportionate impact the pandemic has had on communities of color in the United States, only 48 percent of Black Americans and 66 percent of Latinx individuals surveyed would receive the vaccine even if it was available for free.2  Months later, vaccine hesitancy continues to evolve as more of the population gets vaccinated and trusted community leaders take the lead in sharing information and bringing vaccines to their neighborhoods. This month, our newsletter delves into vaccine hesitancy and some public health recommendations for ensuring equitable vaccine distribution. 
 

Get oriented
Vaccine hesitancy: disinterest or delay in acceptance of a vaccine despite evidence of its efficacy

Messenger RNA (mRNA): genetic material that contains instructions for making proteins. mRNA are related to DNA because they are copies of DNA information, but they do not alter our DNA.

Virus variants: a version of a virus that differs from those related to it because it has a slightly different portion of codes in its genes. It is normal for variants to appear because viruses sometimes make errors when they are making copies of themselves. Some variants will disappear while others may persist. Stay informed about COVID-19 variants through this CDC webpage. 

Medical mistrust: suspicion of healthcare providers, organizations, and/or medical systems 

Trust: belief in the reliability, truth, and strength of a person or thing

Vaccine equity: the equitable distribution of vaccines worldwide


Essential vaccine information
Three Vaccines
The U.S. Food and Drug Administration (FDA) has granted emergency use authorization (EUA) to two mRNA COVID-19 vaccines developed by Pfizer-BioNTech and Moderna.According to leading experts and clinical trials these vaccines are safe and have had a 95% and 94.1% efficacy, respectively.4,5 As of February 27, 2021, the FDA has also authorized the single-dose Johnson & Johnson vaccine for emergency use. 

What is in the mRNA vaccines?
Both the Pfizer and Moderna vaccines contain mRNA which is a piece of genetic code that provides information for our bodies to make proteins. In this case, the mRNA tells our bodies how to make the unique "spike proteins" that lead to the illness called COVID-19.  In order for the mRNA to find the right type of cell in our bodies, the mRNA is also wrap with a small ball of fat, known as a lipid nanoparticle.6  To better understand how mRNA vaccines work, watch this video.

What is not in the mRNA vaccines?
The vaccines do not contain any carcinogens, mercury, human cells, preservatives, no robots, nor tracer devices or micro-chips.4,5,6
Building systems worthy of trust
 

"I've heard Tuskegee more times than I can count in the past month — and, you know, it's a valid, valid concern," notes Dr. Dr. Nikhila Juvvadi, the chief clinical officer at Chicago's Loretto Hospital, in an interview with NPR news.7 The legacy of experimentation and unethical research in Back communities, such as the infamous Tuskegee experiment and the non-consensual cloning of Henrietta Lacks' cells, have rightfully led to distrust in the scientific and medical communities. In addition, persistent discrimination in the health care system whereby people of color experience a different quality of treatment contributes to the hesitancy to access care. In Latinx communities, misinformation and immigration status are additional factors that foster vaccine hesitancy. The historical legacy of such events highlights that vaccine uptake depends not only on mass-scale public health interventions, but also on creating awareness and drawing attention to the ways in which medical and scientific systems have perpetrated harm and reproduced inequities in communities of color.  

Learn more

Some ways to address vaccine hesitancy in communities of color
  • Disseminate accurate information about the realities of COVID-19 and the risks and benefits of vaccination. 
  • Acknowledge rather than dismiss people's concerns about COVID-19 vaccines. 
  • Collaborate with trusted messengers to share information in their own communities.
  • Prioritize equity and fairness in the distribution of vaccines. This includes neighborhood pop-up sites that accept walk-ins. An exemplary initiative is the event hosted by Mi Villita Neighbors at St. Agnes of Bohemia Catholic Church in Little Village on Feb 28. 
  • Partner with trusted community-based organizations and faith-based organizations to help increase uptake. UIC SPH's Associate Professor Jeni Hebert-Beirne discusses this approach in an NPR article
  • Think broader than vaccines and work towards health justice more broadly as a way to build trust in medical and scientific systems.

Share why you vaccinate
 
The COVID-19 vaccine provides hope for disrupting the injustice of Black and Latinx communities being disproportionately impacted by COVID-19. At the same time, we cannot overlook the valid medical mistrust of our friends, loved ones, and neighbors who are hesitant to get vaccinated. It’s time to have a collective and transparent conversation about how each of us came to the decision to vaccinate. Share your story.
 
 
See examples on our social media
 
For another spotlight on COVID-19 vaccinations, listen to the Collaboratory's latest Spotify podcast episode featuring SPH's Dean, Dr. Wayne Giles. In this interview, we discuss how COVID-19 has impacted his family, what motivated him to get vaccinated, and how he felt after receiving the first dose. 
Listen Now
 
UIC Spotlight: Health Justice Doctoral Fellow, Ayo Olagoke

 
 
Ayo Olagoke is a Doctoral Candidate in the School of Public Health.  She has been involved in COVID-19 research and mitigation since the beginning of the pandemic. Ayo led a team of researchers in exploring the relationship between news exposure and mental health that led to a publication in the British Journal of Health Psychology. Following that, she collaborated with researchers from the CDC, University of Georgia, Penn State University, and UIC to develop a contact tracing curriculum for communities of color. This piqued her interest in the possibility of COVID-19 vaccine hesitancy leading to another publication in the Journal of Religion and Health. She is now working on the Chicago Community Based Contact Tracing Corps and on projects addressing vaccine hesitancy.
1. How does your doctoral research connect with the work you are doing around vaccine hesitancy? 
My dissertation is focused on human papillomavirus (HPV) vaccine hesitancy for adolescents among religious parents. I designed a religiously framed vaccine message, which is being shown to increase vaccine intention significantly. We are currently beginning to see some shared risk-factors between COVID and HPV vaccine hesitancy, which provides an opportunity to tackle both in a cost-effective way and share lessons learned. For example, psychological, sociocultural, and socioeconomic factors are shared across board.

2. What are some things you have learned from being a part of COVID-19 efforts at the city level?
I have learned a great deal. The virtual platform has been helpful, it has created a boundless learning environment. A key takeaway for me is the role of interdisciplinary collaboration. There is public health in every discipline, and it is everyone's duty to ensure we have a healthy population. Research alone is insufficient to make changes. There is a need to think of how our research can make a difference beyond publishing it in a journal. People want real solutions beyond statistical findings. So, I am learning to think of the "so what" of research constantly. 

3. Vaccine hesitancy poses a challenge to herd immunity. What are some strategies that can be used to build trust and promote vaccine acceptance? 
Trust is a big issue among communities of color, and you can’t blame people for questioning a system that has a history of injustice towards them. At the same time, there has been a lot of ground shifting and push towards health justice, which will require us to trust again as people of color. We are currently working with credible messengers at the community levels; we hold listening sessions, town hall meetings and let communities take the lead with every form of cultural humility. We also provide evidence and facts without compulsion and allow the people to make informed decisions. We hope to flatten the hierarchical curve between medical experts and the people. The more we demystify the COVID vaccine development and mechanism of action, the more the people get to see that it has more good to offer.
 
4. What about your current work excites you?
We are in a war, and the enemy is not the medical experts or the scientist. It is the virus. So, every time we take a positive step, I celebrate. There is a limit to the changes I can achieve as a researcher, but collaborating with other people, communities, the governments, bringing recommendations from my empirical findings to the group, and translating them into practice has been very exciting for me.

 
Public health websites
1) Visit Chicago Department of Public Health for answers to common questions, data on who has been vaccinated, and to find a provider near you. 

2) Visit the Centers for Disease Control and Prevention for more detailed information on each vaccine and up-to-date information as scientists learn more.

3) COMING SOON! Visit the Collaboratory for Health Justice COVID-19 Resources page to find vaccine FAQs in several languages.  

 

References
 1. Owen Jr., W.F. Carmona R., & Pomeroy C. (2020). Failing Another National Stress Test on Health Disparities. JAMA : the Journal of the American Medical Association, 323(19), 1905–1906. https://doi.org/10.1001/jama.2020.6547 
2. COVID Collaborative. (2020, November 23). COVID Collaborative Survey: Coronavirus Vaccination Hesitancy in the Black and Latinx Communities. Retrieved from https://www.covidcollaborative.us/content/vaccine-treatments/coronavirusvaccine-hesitancy-in-black-and-latinx-communities
3. U.S. Food and Drug Administration. (2020, December 18). FDA Takes Additional Action in Fight Against COVID-19 By Issuing Emergency Use Authorization for Second COVID-19 Vaccine. FDA News Release. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-takes-additional-action-fight-against-covid-19-issuing-emergency-use-authorization-second-covid 
4. Baden, E. (2020). Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. The New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2035389 
5. Polack, T. (2020). Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. The New England Journal of Medicine, 383(27), 2603–2615. https://doi.org/10.1056/NEJMoa2034577 
6. Black Coalition Against Covid-19. (2021). Making it Plain: What Black America Needs to Know about COVID-19 and Vaccines. Webinar. Retrieved from https://blackcoalitionagainstcovid.org
7. Hopkins, C., & Valentine, A. (2021). Some Health Care Workers Are Hesitant About Getting COVID-19 Vaccines. NPR News. Retrieved from https://www.npr.org/2021/01/01/952716705/some-health-care-workers-are-hesitant-about-getting-covid-19-vaccines 
8. Moran, F. (2015). Information scanning and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women. Patient Education and Counseling, 99(1), 147–153. https://doi.org/10.1016/j.pec.2015.08.016 

And a big thanks to Daisy Magana, second year MPH student in SPH Community Health Sciences, for helping to develop this month's newsletter!
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