What do you do when you match the demographic of disparity?
The COVID-19 pandemic highlights old wounds for the African American community. We’ve been hit harder by this disease, just as we’ve been hit harder by diabetes, high blood pressure and stroke. None of this is by coincidence — quite the opposite. The outcomes of these disease processes can be anticipated due to the health impact of systemic racism within our communities. And now we’re being asked to trust a vaccine from the same system.
As a doctor, as an African American, and as a woman, I got the vaccine, and I’m encouraging others to do it as well. But I understand the skepticism.
As a doctor, I take on the responsibilities required by the Hippocratic Oath: to first do no harm. In honoring that commitment, I’ve followed the data and studied the science.
The first glimmer of hope, as I followed the COVID-19 studies, came with the conclusions of the vaccine clinical trials and, specifically, their proven safety and efficacy. The study of mRNA as a vehicle of therapy is not new. In fact, it has been used in a number of modalities for the past 15 years, but the timing of its use to halt a disease process causing the deaths of millions worldwide is unprecedented and is truly a marker of the innovative potential in medicine to save lives.
Traditionally, vaccines have used a live version of a virus to activate your immune system in order to make antibodies. The mRNA COVID-19 vaccine, however, does not. Instead, it activates a solitary protein specifically found in the virus’s outer DNA shell. Supplying this “code” teaches the immune system to immediately attack COVID-19 should it gain entry into our bodies. This immediate response reduces the likelihood of the virus being able to replicate and deters triggering of the inflammatory response seen in cases of severe COVID.
The mRNA vaccines are 95% effective at preventing symptomatic COVID in trials of more than 70,000 people. Even more important, of those who contracted COVID-19 following vaccination, none died. As a bonus, for the 150 million Americans who have received the vaccine since December, we have seen relatively few side effects, with the majority being 24 to 48 hours of fevers, chills, fatigue or headache.
I’m encouraged that all the available vaccines are safe and effective. Along with our preventative public health measures, they’re the keystone to stopping this COVID-19 pandemic and will serve as a safety net for my community. As a Black physician, I knew I matched the demographic of people dying at higher rates for COVID-19 and that my occupation placed me at higher risk of exposure.
In fact, while only 16% of all health-care workers are African American, we account for 32% of the health-care workers who have died from COVID-19. It’s this double-edged sword that caused me to scrutinize the clinical trials with a fine-tooth comb. After comparing the vaccine’s safety profile and effectiveness with the known disparities, I found the decision was easy. The benefit of vaccination far outweighs the risk.
And I would urge all in my community to do the same, to analyze your calculated risk. What science shows is that our caseloads of more contagious and deadly mutant strains are increasing nationwide. The potential impact this disproportionately will have on the African American community is unfortunately more likely than not. Vaccination will no doubt play a role in limiting the number of lives claimed by COVID-19 as we enter into the second year of this pandemic.
We’ve still got a ways to go in healing generational wounds of medical mistrust, but we’re getting there. As far as getting vaccinated, I strongly urge you to get your shot when your turn comes around.
Dr. Ebony Jade Hilton is an associate professor of anesthesiology and critical care medicine at the University of Virginia and a member of the Virginia Health Equity Work Group. She is the cofounder and medical director of GoodStock Consulting, which addresses disparities in the health-care system.