The Trump-Pence administration, to no one's surprise, has punted distribution decisions to the states. But how best to distribute the vaccines shouldn't be hard to decide if we heed the advice of medical experts like members of the Advisory Committee on Immunization Practices. Although this panel has failed to answer all of the questions about distribution, such as what to do with prison populations and which essential workers to prioritize, it has provided the Centers for Disease Control and Prevention with a framework by which states can refine their plans based on the needs of their respective communities.
In essence, the panel is recommending that the country's 21 million health-care workers be vaccinated first. Next would be high-risk groups including 53 million adults aged 65 or older, many of whom are in long-term care facilities. After that would come the 83 million "essential workers" who interface with the public on a daily basis. There is a need to define which essential workers should be placed ahead of others, and there is overlap in all of these categories of groups which are being disproportionately hit hard by the pandemic: African Americans, Latinos and individuals from indigenous communities.
But as much as these latter groups suffer from pre-existing health conditions and have been hurt the most by COVID-19, they have been ignored by society for decades — or worse. In a number of well publicized and tragic cases, with the sanction of government at all levels, these communities have been victimized by secret medical experiments for which they did not consent or were not even aware. This history has eroded underserved communities' confidence in the medical profession and government.
The African American community, for example, still remembers the infamous Tuskegee syphilis study: From 1932 to 1972, Black patients were not given penicillin to treat the disease, though they thought they were receiving the drug. In another study, conducted by the CDC, Black children were given the measles-mumps-rubella vaccine prior to the age of three, which contributed to them being three times more likely to develop regressive autism. Then there was the case of Henrietta Lacks, whose story was developed as a biopic for HBO. Lacks' cells were cloned in an experiment in the 1950s without her knowledge. Although the experiment proved that human cells could be cloned, it was a tragic example of medical malfeasance at its worst.
The stench from these incidents still lingers, and those memories present challenges for government leaders trying to gain public confidence in vaccinations. Yet retired physician Herbert Jones, formerly affiliated with the Morehouse School of Medicine, told me that despite the medical establishment's sketchy past with communities of color, it would be "unwise for Blacks and others to refuse taking a vaccine to protect them from the coronavirus today."
Reflecting upon my conversation with Jones, it became apparent that he and others in similar positions can play an important role in bridging the credibility gap between those from underserved communities and health and government officials. While there is still a shortage of medical doctors of color, there are many today who hold degrees from historically Black colleges like Meharry Medical College in Nashville, Howard University College of Medicine in Washington, D.C., and the Morehouse medical school in Atlanta. If public officials invite them to play a major role, they can help spread the word of the importance of the vaccine to understandably suspicious minority communities.
Going a step further — and taking a more grassroots approach — public officials could work closely with community- and faith-based organizations, community health centers, and neighborhood-oriented pharmacies to help get the word out about the vaccine. If logistics can be worked out, such as how to keep the vaccines properly cooled, community facilities could be used as points of distribution. Residents would be more comfortable being vaccinated in their own communities.
Addressing the credibility gap with minority and underserved communities will go a long way to establish trust, but it won't solve the entire issue of Americans not trusting their government. Ever since the public was informed about the deadly potential of the coronavirus — and even after contracting the virus himself — President Trump has downplayed it and suggested it was a political hoax hatched by his political adversaries. Millions of his followers still believe him and will not wear a mask or social distance. It is going to take more than Dr. Anthony Fauci telling them the vaccine is safe for Trump supporters to be convinced.
Finally, and of critical importance, public officials must vow to never again allow politics to influence public health decisions. Most elected officials take an oath of office wherein they swear to protect the public's welfare. Spurning advice from health experts on common-sense health measures does not constitute protecting the welfare of the public, nor does conflating one's right to spread potentially dangerous droplets to others by not wearing a mask equate with freedom of speech.
Public officials have more to address going forward than simply how to distribute the coronavirus vaccine — they must address how to heal the deep fracture in society that keeps Americans apart at a time when they need so much to be together.
Governing's opinion columns reflect the views of their authors and not necessarily those of Governing's editors or management.
