For many Americans, trust in the COVID-19 vaccine does not come easy and reluctance amongst the Black community to get vaccinated is even more prevalent. This compelled 60 Black members of the National Academy of Medicine to pen a February New York Times op-ed to make the case that all Black Americans should get vaccinated to protect themselves from the virus that has killed them at a rate of 1.5 times the rate of white Americans. Dr. Wayne J. Riley, HCA Healthcare Board of Directors member and president of the State University of New York (SUNY), Downstate Health Sciences University, was among the 60 healthcare leaders who signed the op-ed.
Below, Dr. Riley sits down with HCA Today to further address vaccine hesitancy and to delve into the roots of long-held medical mistrust.
It has been approximately one year since the United States Department of Health and Human Services declared a public health emergency to aid the nation’s healthcare community in responding to the novel coronavirus. Since then, the COVID-19 crisis has been defined by the heroism of caregivers and the resilience of patients conquering insurmountable odds.
While the end of the pandemic may not be in sight just yet, FDA emergency use authorization (EUA) of two vaccines in December signaled hope that a return to normalcy is in the reachable future. Data from the Centers for Disease Control and Prevention (CDC) shows that as of February 26, 2021 about 14% – 46 million Americans – have received a first dose of the vaccine. 21.5 million Americans are currently fully vaccinated.
And, as of February 25, 2021, HCA Healthcare has administered more than 507,000 first and second doses of the COVID-19 vaccine across our organization to help speed the pandemic’s end and further protect caregivers.
With vaccine hope, comes hesitation
The CDC conducted a survey from Sept. 3 – Oct. 1 to determine the number of Americans likely to get the COVID-19 vaccine. Additional surveys were issued Dec. 18 – 20. A CDC report released earlier this month cited that while vaccine hesitancy has decreased from September to December, a significant number of Americans are still hesitant about getting the COVID-19 vaccine.
Overall, 49% of adults surveyed in December said they were going to get the vaccine, up from 39% in September. The largest increases in vaccine adoption were seen in:
- Adults 65 and older (66% said they intended to get the vaccine, up from 49%)
- Essential workers (46%, up from 37%)
- Adults under 65 with underlying health conditions (42%, up from 37%)
Black Americans, younger adults and women were among the groups most likely to say they didn’t plan on getting a vaccine.
The most common concerns voiced by these groups were side effects, lack of trust in the government and worry that the vaccines were developed too quickly.
Further, the report highlights the need for ensuring “high and equitable vaccination coverage among all populations, including by addressing reasons for not intending to receive vaccination, is critical to prevent the spread of COVID-19 and bring an end to the pandemic.”
HCA Today sat down with Dr. Wayne Riley, HCA Healthcare Board of Directors member and president of the State University of New York (SUNY), Downstate Health Sciences University to address vaccine hesitancy and understand the roots of medical mistrust.
You received the COVID-19 vaccine in December. What inspired you to get it?
Dr. Riley: As a physician, a board member of HCA Healthcare and a leader of a health sciences university in one of the most populous boroughs of New York City, getting the COVID-19 vaccine was the right thing to do for a number of reasons.
First, this is science…and science matters to all of us.
We’ve been working on messenger RNA – or mRNA – technology for vaccines for nearly 20 years. The technology was jumpstarted by vaccine development for the SARS-1 epidemic of 2002 and the MERS outbreak of 2012. As soon as scientists were able to gather information about SARS-CoV-2, they began designing mRNA technology specific to the virus.
RNA vaccines have been studied before for other infectious diseases like flu, Zika and rabies. Like all vaccines in the United States, the mRNA COVID-19 vaccines were held to rigorous safety standards, which were established through clinical trials involving tens of thousands of subjects.
Second, I believe in vaccines.
If you look at the breadth of human history, one of the key medical interventions that has allowed us to live normal lives is vaccines. Conquering infectious diseases like smallpox and polio, as a result of vaccines, is one of the things that we have done well both internationally and nationally.
COVID-19 vaccines are a new tool to fight a new viral illness. When you look at the totality of all of the scientific evidence, the Pfizer-BioNTech and Moderna vaccines are very safe, and they are very effective.
Third, I take my responsibility as a physician to be a trusted messenger very highly.
There will be a point where all Americans need to make a choice to get the vaccine. As a leader in the medical field, I hope that I can educate and bring light to myths and misinformation. Ultimately, I want to help others make an informed choice to get the vaccine.
What was your experience with the vaccine?
Dr. Riley: I had two doses of the Pfizer vaccine and had no symptoms after the first dose. After the second dose I had two mild symptoms: a sore arm and runny nose.
The symptoms that people get after vaccines are actually an indication that your immune system is responding. Mild symptoms are completely normal, and in fact, a good sign that your immune system is revving up to learn the coronavirus and build protection. This is beneficial should you be exposed to the coronavirus later down the road, because your immune system will know what to do in order to protect you from infection.
The vaccine was personal to me. I have hypertension, a preexisting condition. Because I’m a physician, and I have high blood pressure, my first thought after getting the first dose was ‘I am so blessed to get this’. Because of science, even after just that first dose, I knew that the vaccine would prevent me from getting a bad case of COVID-19. I was relieved and comforted.
How does your experience help when you’re speaking with fellow colleagues or talking to patients, in terms of addressing fears about the COVID-19 vaccine?
Dr. Riley: I tell others that this is a time when we need all Americans to embrace and believe in science. The stakes could not be higher. The COVID-19 vaccine is a life-saving opportunity.
COVID-19 is a very deadly disease, far more so than the flu. The flu kills about 40,000 – 50,000 every year in the United States. In comparison, it’s now projected that our country will pass a half million people who’ve died of COVID-19 in February 2021. That makes the coronavirus 10 times more deadly than the flu.
I encourage all Americans to listen to the experts. It’s okay to challenge things with questions, but it’s important to deal in facts – not rumors or misinformation that can sometimes cloud our judgement.
We have great biomedical scientists who helped to develop the COVID-19 vaccines.
One of the chief scientists behind the vaccine is a terrific African American scientist, Dr. Kizzmekia Corbett, who said she would not put her name and reputation on these vaccines if she didn’t believe that it would help all Americans – and in particular African Americans.
More importantly, the trials showed that this vaccine helps protect people with preexisting conditions – including diabetes, hypertension and heart disease – which the virus targets. These are key preexisting conditions that African Americans suffer from. The added protection of the vaccine is another reason to consider receiving it.
The stain of the Tuskegee Study, the Henrietta Lacks case and other examples have spurred heightened hesitation to receive the vaccine amongst communities of color. How do we emerge from the rational skepticism to end the pandemic?
Dr. Riley: Vaccine hesitancy is complicated and comes from a long-held distrust due to institutional racism that African Americans have faced trying to access healthcare. My career and experience has shown that the U.S. has some of the best healthcare in the world, but there are health disparities and barriers that exist. With healthcare reform initiatives, we’ve come a long way but it’s clear that African Americans don’t receive the same quality of care in some parts of the country. There are certainly reasons for people to feel skeptical.
The distrust stems from things that have happened in the past. Case in point, the Tuskegee experiment was an unethical study conducted in rural South Alabama between 1932 until 1972. This was a very unfortunate episode in the history of our country where the United States Public Health Service found 600 African American men, 399 who had syphilis, 201 who did not.
During the timeframe of the experiment, penicillin was approved as the definitive treatment for syphilis. However, these men with syphilis were never offered penicillin and the study continued, at a point when it should have stopped. For 40 years, the study continued and the men with syphilis did not receive the treatment needed to cure it. Many of the men in the study died or developed other serious health issues.
The United States government eventually admitted that the study was unethical, and the men then received care for the rest of their lives. Even with reparation, there is a great deal of mistrust from the African American community that lives on today.
And today – amid the pandemic – we will not be able to have a sense of normalcy until a good portion of the U.S. population is vaccinated.
We are trying to achieve herd immunity, which is when 70% of the population is vaccinated. Once we reach this point, the virus will begin to have a lack of targets. It will slow down, and hopefully, it will go away.
With herd immunity, we will be able to get back to doing all the things we have missed since this pandemic started.
Many in communities nationwide have already rolled up their sleeves to receive the vaccine.
I encourage every American to put COVID-19 behind us by getting in line when it’s your turn.
Trust me, together, we can end the pandemic.
Nashville-based HCA Healthcare is one of the nation’s leading providers of healthcare services, comprising 185 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding ERs, urgent care centers, and physician clinics, in 20 states and the United Kingdom.