“If [the vaccine] came out today, I wouldn’t take it, “said Lonzo Bullie, a retired school principal who called Tuskegee, Alabama, home for 26 years.” I’m still reluctant … because I don’t have enough information about it. “
The two FDA-approved COVID-19 vaccines are more than 95% effective in preventing symptomatic disease, and reported side effects are minor. Studies – which included more than 30,000 volunteers each – have shown that vaccines work just as well among people of all races and ethnicities.
But Bullie, who is also president of the NAUSP’s Tuskegee-Macon County branch, said skepticism about the vaccine in the African-American community stems from “the history of the U.S. government experiencing black people” and years of “abuse.”
Tuskegee, where Bullie lives, is the zero point for the infamous study of syphilis in the 1930s. The American public health study at the Tuskegee Institute, which recruited 600 black men, was designed to record the natural progression of syphilis infection, but researchers they did not inform the participants nor did they ask for their consent. The study lasted 40 years and left an indelible mark on the black community.
Residents of rural communities of color face not only widespread ubiquity about vaccines and the health care system, but also multiple obstacles as vaccine distribution begins, including lack of access to medical facilities.
Almost one in four rural Alabama residents (24.1%) is black or Latino, according to the 2018 US survey.
Focus groups in Alabama are meeting to address the vaccine’s hesitation among communities of color, especially among African Americans and Latinos, according to Dr. Mona Fouad, director of the University of Alabama at the Center for Health and Minority Health Research in Birmingham.
“Tuskegee came back again, again, again, to every group we talked about,” Fouad told ABC News. “People are starting to remember Tuskegee.”
She said that before the pandemic, awareness groups were gaining traction by “overcoming” distrust in the health care system in communities of color, but now COVID-19 “brought nerves back about Tuskegee.”
“I learned that distrust comes from a lack of information and transparency,” Fouad said.
In a statement to ABC News, the Alabama Department of Public Health said: “ADPH has addressed access to testing in rural and color communities, working with partners, including historically black colleagues and universities, faith communities and authorities. housing ”in an effort to combat anxiety about a COVID-19 vaccine.
However, lawyers and local leaders said more inclusion and transparency will be needed to increase the participation of communities of color.
“As we see more people taking it, people of color in particular taking the vaccine, people will be better able to [taking it]said Benard Simelton, president of the Alabama State Conference of the NAACP.
He also added that explaining the “technical aspects” and providing clearer public messages about the vaccine will help people living in rural communities to better understand this. In addition, diverse messaging is needed to ensure that all communities understand the information.
According to Ana Espino, executive director of the Alabama Coalition for Immigrant Justice, the language also presents a huge barrier to access to COVID testing because people “do not have information distributed in a language other than English.”
It is important to involve local community leaders in rural Alabama to ensure that the vaccine is safe and to explain it in ways that people can relate to, Simelton said.
“The key is to develop this factor of trust in the community,” he added.
Distrust is not the only challenge in providing vaccines to rural communities
In some parts of rural America, vaccine administration is set to address unique health care barriers, including understaffed clinics, lack of vaccine storage facilities, and hard-to-reach residents within a few miles of the country. important hospitals, experts say. State public health systems, already overworked due to the pandemic, will be responsible for ensuring the daily delivery and accessibility of rural residents.
Geographical isolation and labor shortages in rural hospitals in America add to the burden of providing vaccination.
According to a 2018 survey by the Pew Research Center, rural Americans live on average 16 miles from the nearest hospital, and in the neighborhood of rural Americans who travel the most to reach an acute care unit, the average journey time is 34 minutes by car.
“Access to hospitals is difficult because you have people who don’t have transportation or they don’t have reliable transportation, distance is definitely a barrier,” Espino said. “In rural Alabama, black and brown people would really struggle with accessibility.”
According to the Administration of Health Resources and Services, 64.6% of rural counties in Alabama are considered “areas of shortage of health care professionals” who do not have enough primary care, dental and mental health care providers to serve residents. . In addition, 55.7% of rural Alabama does not have adequate health care services, HRSA said.
When the vaccine becomes available to the general public, people living in rural communities will have to travel long distances to access larger hospitals in cities where doses can be properly stored in refrigeration units, Simelton said.
“There is a significant portion of the community that will not be able to get the vaccine they might want,” Simelton said. “We need to make it available in large enough quantities for everyone in the community to take.”
And in places like rural Alabama, the burden of providing vaccines amid a pandemic is already severe.
In a December 16 briefing, Army General Gustave Perna, COO of Operation Warp Speed - the Trump administration’s program to accelerate vaccine launches – described minor mishaps with delivery to Alabama, including when the vaccine shipments arrived, but were stored at wrong temperature.
Because the impact of vaccine storage at the wrong temperature is unclear, the vials were not used and shipped back to Pfizer.
“When COVID came, we felt we were being pushed back two more decades,” Fouad said.[COVID] they have affected our poorly served rural communities in our cities far more than anyone else. “
In addressing vaccine access disparities for rural communities, the Alabama Department of Public Health “works with rural health clinics, federally qualified health care centers, county health departments and other providers to provide access to VOCID vaccines.” 19 at national level ”. according to a statement from medical director Mary G. McIntyre.
Fouad said the lessons learned from state surveillance during COVID, with limited access to testing and few quarantine options for underserved rural communities served as a “continuum” in informing state public health leaders’ decisions about vaccine launches.
“Now that the vaccine is out, we don’t want to make the same mistakes,” she added.
Mark Nichols of ABC News contributed to this report.