S1E69 / With Us, For Us — Black Healthcare Workers Speak Out About Vaccine Safety / Jessica Anne Mitchell Aiwuyor, Rhea Boyd, Sandra Lindsay, Tierra Rich

The vaccine is what is going to help to get us out of this crisis and stop the death and the harm and the pain.

We can talk about misinformation all day, but until we provide information, trustworthiness, and access, we'll continue to have these problems.

You're listening to Epidemic, the podcast about the science, public health, and social impacts of the coronavirus pandemic. I'm your host, Dr. Celine Gounder. Sandra Lindsay is the director of nursing for critical care at Long Island Jewish Medical Center. The hospital where Sandra works is in Queens, one of the New York City boroughs hardest hit by the pandemic.

Every day was just physically and mentally exhausting, just seeing how hard people were working to save lives. Seeing the number of patients that required our services, it was overwhelming.

Sandra says that the virus was totally unpredictable. People who looked perfectly healthy would get COVID and die. It felt like no one was safe.

Every day leaving home, I would look in the mirror. Last thing I did before I left home and said, I don't know if I'm making it back home today. I saw myself in just about any one of those patients in the bed.

Seeing this every day gave Sandra a lot of clarity. She wanted to get vaccinated as soon as possible.

So I was always saying, whenever this vaccine comes to market, I don't care where it's being given out. I've never gone Black Friday shopping or camped out at anywhere to get the first of anything. But I would camp out anywhere the vaccine was being offered.

Turns out, as soon as the vaccine was available, Sandra wouldn't have to wait long.

I got the call that the vaccine was coming to Long Island Jewish Medical Center.

On December 14th, 2020, Sandra showed up to work to get her vaccine.

It just so happened that I was, I was the first.

Sandra Lindsay was the first person in the United States to get a COVID vaccine outside of a clinical trial. It happened so fast, Sandra didn't even get a chance to tell her mom before the media started calling.

She started getting calls from the press for me, and then she called my brother to say, why are so many people calling here for Sandra? What is going on? Is she okay? And that's when he turned on the TV and realized the magnitude of what was happening.

This is a live shot —which we're about to take a look at now—of the first vaccinations in New York.

She didn't even flinch as critical care director Sandra Lindsey made U.S. history today, the first American to receive the COVID-19 vaccine in a non-trial setting.

A nurse in Queens got a round of applause when she got the first shot in the city.

ICU nurse, that's Sandra Lindsey. Sandra Lindsey.

Sandra Lindsey.

And seeing an ICU nurse named Sandra become the first American to get the shot is being compared to the greatest moment moment in our history.

Getting that vaccine changed Sandra.

Oh, it was like so much weight was lifted off my shoulders. I felt hopeful, a little safer. The burden was a little lighter. I know that we are not totally out of the woods, but the light in the tunnel got a little brighter on that day.

But if vaccines are going to make the world safer for everyone, a lot more people need to get vaccinated too. At this recording, fewer than 20% of people in the United States are fully vaccinated, and increasing rates of new infection and hospitalizations have some worried about a fourth wave. Sandra's a fierce advocate for COVID vaccines for everyone., and she's using her position as a Black healthcare worker to reach out to others in her community who have questions about the vaccine.

We have to be nonjudgmental and culturally humble because for some people it's history that still looms darkly over them. For some, it's knowledge deficit. For some, it's just that they've been so heavily influenced by the misinformation and the conspiracy theories that are out there. So you really have to take time to assess and engage in conversations with people as to why they are so anti-COVID-19 vaccine.

In this episode, we're going to hear from Sandra and other Black healthcare workers who are taking on the mission to inform and hopefully convince more people of color to get vaccinated.

We'll hear where this outreach has fallen flat in the past When we look actually historically just at children's vaccinations, we see that Black caregivers vaccinate their kids and that the barrier to them doing that in the past was actually common barriers like cost.

How Black healthcare workers are finding new ways to change hearts and minds about the vaccine.

I wanted people to, to dialogue in a public space along with me.

And what needs to happen next.

This is the perfect time to keep pushing forward to make sure that our communities get the healthcare that we deserve.

Today on Epidemic, Black healthcare workers speak out about vaccine safety. Reports show that Black Americans are less likely to get vaccinated than the general population. Seeing these numbers has led some to say Black Americans are, quote, "vaccine hesitant." My issue is that we have been misapplying that term to Black folks. This is Rhea Boyd. She's a pediatrician and public health advocate.

Rather, they've shared legitimate questions and concerns that they have about the process by which the current COVID vaccines were developed, whether the vaccines themselves are safe, and some folks just have questions about whether they're affordable.

Rhea says that when you look at the data, Black Americans are just as likely to get vaccinated as other groups. A program in the 1990s to eliminate disparities in childhood vaccinations shows how.

I was so thrilled to be able to share this data as a pediatrician. Back in the 1990s, our national government in the US said, we know that there are disparities in who has access to vaccination. There's disparities based on children's insurance level. There's disparities based on children's, you know, income and socioeconomic background. And there's really persistent disparities around children's racial and ethnic background.

The federal government created the Vaccines for Children program to address these disparities. The program makes sure any child can get vaccinated for free.

Quickly, the program started to narrow racial health disparities in who had access to children's vaccines. And then since 2005, for the last 16 years, there have been no disparities in who has access to really critical, commonly recommended children's vaccines.

The program covers vaccines required for public school attendance in the United States—vaccines for diseases like measles, whooping cough, and polio.

So some folks might say, well, of course Black folks get the MMR and polio vaccine because many school districts across the country require that vaccination.

But it's not the same case for the HPV vaccine. HPV, or human papillomavirus, is a common infection that can increase the risk of cancer in both men and women. The CDC recommends anyone between the ages of 11 and 26 get this vaccine. But because HPV is sexually transmitted, there's been pushback from some parents, and it's not required by public schools.

And so even for the HPV vaccine, we see rates of vaccination for Black children that's like 95% or above and little to no racial health disparity in who has access to that vaccine. And so when we look actually historically just at children's vaccinations, we see that Black caregivers vaccinate their kids and that the barrier to them doing that in the past was actually common barriers like cost.

Rhea says there are other barriers to Black Americans getting vaccinated besides costs. She points to the seasonal flu vaccine as one example.

For Black folks in particular, only about 4 in 10 end up getting the flu vaccine every year, whereas nationally it's a little bit higher, maybe 50 to 60 60% of adults get the flu vaccine. But actually, when you look at Black adults aged 65 and older who have Medicare Part B, which is a health insurance plan that covers a number of vaccines, the number one thing that shapes whether folks get the flu vaccine, Black folks get the flu vaccine, is if their provider just simply offers it to them. What they found is that when providers offer the flu vaccine to Black adults, they're just as likely to get it as any other racial and ethnic group. And that data sits upon decades of data that told us that providers who predominantly serve Black patient populations, they are the least likely to recommend preventative services to Black patients, including vaccination.

So why would a provider not offer Black patients flu vaccination at the same rates as they do other patients?

You know, why would a provider not offer routine screening mammograms to Black women, despite the fact that we know Black women have higher mortality rates when it comes to breast cancer, despite not having a higher incidence of breast cancer? Why wouldn't doctors offer children who come in with broken limbs pain medication at the same rate that they would offer a white patient? I mean, these are the challenging questions that we have to start to confront in healthcare because they're all a manifestation of how racism shows up.

Rooted in this is the kind of healthcare available to many Black people in the United States.

Often it shows up kind of structurally baked into how systems that serve predominantly Black populations are under-resourced to actually address their needs. So perhaps providers might not offer it if they're rushed during the visit because they have to see so many patients in a day. So perhaps they don't get time to actually deal with preventative services.

They're really just offering people crisis care. Cost and lack of access to quality preventative care have been big hurdles to vaccination among Black Americans. Rhea says that until our healthcare system acknowledges these disparities, debates about vaccine confidence can only achieve so much.

We have spent, as a healthcare system, tens of millions of dollars on trying to address vaccine hesitancy, quote unquote, in Black communities, instead of actually getting to the root of the problem, which is that folks need access to the vaccines and they need access to credible information about the COVID vaccine.

Scenes. We'll hear how Rhea and other Black healthcare workers are helping provide accurate information that speaks to their community's concerns. That's after the break. Combating misinformation about vaccines has been a struggle for public health officials during the pandemic. It takes a lot of work to craft the right message to reach all the different communities in the United States. Jessica Ann Mitchell-Ayewor has been tracking these efforts among Black Americans.

Black healthcare workers have really done an excellent job of taking control of the narrative and spending a lot of, a lot of time and energy in providing the information and the answers to the questions that people have.

Jessica is also the founder of the National Black Cultural Information Trust. It's an organization dedicated to improving online access to information about vaccines and countering misinformation.

It's not just misinformation that's the problem, it's undercommunication that's also a problem.

The undercommunication Jessica mentioned means people aren't getting answers to their questions from official sources.

Different people attempt to answer those questions based on the information that they find available, and that information isn't always accurate.

So Jessica's been following the efforts of Black healthcare workers to provide accurate information.

One of the things that they have been doing is making Twitter threads about how people can fight back against the virus, how people can protect themselves. They've entered into new social media spaces like Clubhouse.

If you haven't heard of it, Clubhouse is a social media platform that uses audio as its main medium instead of text or pictures like you'd see on Facebook or Instagram. People create spaces called rooms where others can join and talk about a topic.

There are many great conversations happening on there about culture, about life, about health, about business. But what can also happen on, on the app and has happened frequently is some people will create a room and not have the correct information about a subject.

Sometimes this misinformation gets out of control.

I do know that there has been bullying that has taken place on that app. Towards certain Black healthcare workers. I do know that for sure.

Jessica doesn't condone that behavior, but she says she understands that people see COVID, misinformation and all, as a life-and-death issue.

It's actually an issue of saying things that are simply not true about COVID-19 or about the vaccines. And this harmful information then goes to hundreds or thousands of people within a short amount of time. Time with little to no moderation.

And so when we saw that, we were like, you know, we need to create a campaign that at least in part lives on the internet so that right where the disinformation lives, we can create a credible rabbit hole people can go down regarding their questions.

The result was a campaign called The Conversation Between Us About Us. Rhea Boyd was one of the co-founders of the partnership between the Black Coalition Against COVID and the Kaiser Family Foundation.

Which is a national campaign created by Black healthcare workers for Black communities to learn about the growing evidence that tells us the COVID vaccinations are safe.

The campaign is a collection of 50 short videos that answer common questions about COVID and the vaccines. The videos are hosted by stand-up comedian and TV host W.

Kamau Bell. The vaccine happened fast, like super fast, like Usain Bolt headed to the bathroom fast.

Is that something we should be concerned about? Kamau was able to hold both the seriousness of this conversation, you know, Black folks have certainly suffered inordinately during this pandemic, but also the levity that we have when we are already having these conversations just casually, informally, in our kitchens, our living rooms. Barbershops, just between us as people. And what about side effects?

Uh, soreness from the injection site.

I had a little bit of arm soreness. Arm sore? Is that a side effect? My arm's sore right now.

The common things—

And so we wanted to just say, we know we're already having these conversations, and we as Black healthcare workers know that, you know, Black folks don't always have direct access to a healthcare provider to be able to ask their questions. So we wanted to just be able to say, we hear y'all and we're talking just to you.

Thank you, doctors. All right, I'll let you get back to work. And thank you for allowing me to ask you these questions.

Black doctors and scientists have an important role when it comes to informing their communities and the public. But stories about people's individual experience with the vaccine can go a long way too.

My name is Tierra Rich. I am an educator and activist from Washington, D.C., who resides in Philadelphia, Pennsylvania.

Tierra is a sexual health educator in Philadelphia schools.

My job was basically saying, hey, the schools are probably going to open back up and we're going to probably need you to go back in there. And just like anybody else, I was like, I'm pretty scared to go back in there without being vaccinated.

Tierra asked her doctor about the vaccines. Then Tierra spoke with a cousin who works in the pharmaceutical industry.

And during Thanksgiving Zoom, he was able to basically educate my family on the Pfizer vaccine. It was very interesting where I wanted to say, all right, let me go do my own research.

Tiara learned about the negative aspects of American medical racism, but she also found positive stories too. One thing Tiara learned in her research was a story of an enslaved man from West Africa named Onesimus.

I did not know about Onesimus growing up, actually.

Onesimus is credited with introducing the concept of variolation to the United States. Variolation was a precursor to vaccination and helped protect many from smallpox.

So this is not something that has been talked about widely in the Black community. Definitely something that I think we should teach more of.

So when the time came, Tearra felt confident about the vaccine.

So I thought about it long and hard, and I discussed it with my partner, and I decided to go and get the shot.

She got the Pfizer vaccine on Christmas Eve 2020. But then Tearra decided to do something else.

I'll tell y'all what I did experience today. Um, what I did didn't experience today and what you can expect possibly, um, if you take the COVID-19 vaccination.

Okay, she went on Facebook Live and broadcast her experience.

What I'm going to say is I feel great. I don't feel bad. Uh, my arm is a little sore or whatever, but I don't feel like I'm sick. I don't feel shortness of breath. I don't I don't feel a headache. My body doesn't hurt. I don't feel tired. It was good. I'm here to answer any questions. I got another dose to go.

When people saw Tierra's video, they listened.

Stay up off this, this here internet and reading everybody's comments because baby, we be reading people comments that ain't even passed 7th grade science class. Okay, so we gotta be careful who we listening to on this here good old internet. All right. So I would say knowledge is power. Your mind is your strongest tool and your body, for real. So use it.

Tierra says she had several friends who said they did not want to get the vaccine, but then they saw her video.

And they said, you know, just seeing you go through it and you talk about it more openly makes me want to go get it. I've seen probably about, about 5, 6 people who've gotten it because they watch my videos. So it's super important for us to be out here in healthcare because we are also educated in these things and we're aware. It takes sometimes someone who looks like you but also aware to actually communicate with you.

Sandra Lindsay, the nurse who was the first person to get vaccinated in the United States, agrees.

The only way to do this and to get people off the fence and get vaccinated is to present the facts, share the experience. If I alone do it or only a few people do it, it doesn't help the population. It doesn't help us eradicate COVID-19. We need much more of the population to get the vaccine before we can all be safe.

Epidemic is brought to you by Just Human Productions. We're funded in part by listeners like you. We're powered and distributed by Simplecast. Today's episode was produced by Zach Dyer and me. Our music is by the Blue Dot Sessions. Our production and research associate is Tamatayo Fagbenle. Our interns are Annabelle Chen, Brian Chen, Julie Levy, and Sophie Varma. If you enjoy the show, please tell a friend about it today. And if you haven't already already done so, leave us a review on Apple Podcasts. It helps more people find out about the show. Follow Epidemic on Twitter and Just Human Productions on Instagram to learn more about the characters and big ideas you hear on the podcast. We love providing this and our other podcasts to the public for free, but producing a podcast costs money, and we've got to pay our staff. So please make a donation to help us keep this going. Just Human Productions is a 501(c)(3) nonprofit organization, so your donations to support our podcasts are tax deductible. Go to justhumanproductions.org/donate to make a donation. That's justhumanproductions.org/donate. And if you like the storytelling you hear on Epidemic, check out our sister podcast, American Diagnosis. On American Diagnosis, we cover some of the biggest public health challenges affecting the nation today. Past seasons covered topics like youth and mental health, the opioid overdose crisis, and gun violence in America. I'm Dr. Celine Gounder. Thanks for listening to Epidemic.