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Op/ed: Beyond Vaccine Hesitancy

It’s Time to Shift the Focus to Ensuring Vaccine Access, Building Trust, Public Health Scholars Say

By Sandra C. Quinn and Michele P. Andrasik

Vaccine consent

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Vaccinating communities of color isn't just about changing minds, a new article coauthored by a UMD public health researcher in the New England Journal of Medicine says. Institutions must prove themselves transparent and trustworthy, and systemic barriers for people who want to be vaccinated but have struggled to obtain a shot must be removed, the researchers write.

Communities of color have been disproportionately ravaged by COVID-19, spurring alarm over low vaccination rates and discussion of “vaccine hesitancy”—particularly as it relates Black Americans, who have faced consistent structural racism limiting access to medical care, as well as a long history of abusive scientific practices in the United States that sometimes forced them into roles as medical test subjects.

But in a new perspective article in The New England Journal of Medicine, Professor Sandra C. Quinn, chair of UMD’s Department of Family Science, and Michele P. Andrasik of the Fred Hutchinson Cancer Research Center in Seattle argue it’s time to shift the emphasis away from changing hearts and minds, and focus squarely on ensuring institutions involved in the vaccination effort are worthy of the trust officials are asking communities of color to place in them:

Although BIPOC [Black, Indigenous, and people of color] communities have important reasons to be hesitant, increasing reports of disparities in vaccine access throughout the country point to broader systemic challenges, such as inequitable distribution of doses, failure to place clinics in sites accessible to BIPOC communities, and underinvestment in health care providers and services in BIPOC communities. Reliance on web-based vaccine-registration systems have disadvantaged communities with less access to technology, and real barriers such as work obligations and limited child care options that reduce their ability to chase vaccination appointments. Several systematic reviews have provided evidence that systemic racism and provider bias are associated with poor patient–provider communication and interactions, lower quality of care, and negative health outcomes. These ongoing challenges prompt an urgent need to address the inequities in access proactively to avoid turning the vaccine rollout into one more example of ongoing unfair treatment, providing additional evidence to confirm beliefs that the U.S. health system is fraught with structural racism.

Read the rest in The New England Journal of Medicine.



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