Black doctors want to vet coronavirus vaccine process due to mistrust from years of medical racism

When black physician Tina Carroll-Scott started working at South Miami Children's Clinic, she said none of her black patients would consider getting a flu shot.

A complicated history with forced vaccinations and experiments had undercut trust of medical procedures and immunisation within black communities. For more than a decade, Carroll-Scott, the clinic's medical director, toiled to build a relationship with those in the diverse South Florida neighbourhood, where the majority of residents are Hispanic and nearly 14 per cent black and African American, according to US Census data.

"After being at the clinic for 13 years and educating patients about the flu vaccine and dispelling any myths they had about it," Ms Carroll-Scott said. "I've now gotten my patients to a point where they talk to me, and they're willing to take it."

But now, as the Food and Drug Administration and Centres for Disease Control and Prevention repeatedly assure the public that the vaccine for the novel coronavirus will be safe, indications that the review process may be undercut by politics has turned off people in minority communities to getting the vaccine when it becomes available - worrying physicians that communities disproportionately devastated by the Covid-19 pandemic are most at risk of being left out of immunisation efforts.

To assuage fears within minority communities, a panel of black doctors will vet the federal review of companies' vaccines, said Leon McDougle, president of the National Medical Association, the largest and oldest group of black physicians in the country.

"We have concerns," Mr McDougle told MSNBC on Thursday about the vaccine's review process. "There's been a cloud of political influence dating back to hydroxychloroquine … following that, convalescent plasma," he said, referring to the various treatment options promoted by Donald Trump and other government officials. "We want to be that nonpartisan, independent voice, speaking to the African American community and our physicians of the National Medical Association."

When asked what would happen if the panel does not approve a vaccine vetted by the FDA, Mr McDougle said that black doctors are trusted within their communities and if they don't believe in the safety and efficacy of the vaccine, "it's not going to move forward".

Mr McDougle told NPR that he spoke to members of Operation Warp Speed, the project working on a vaccine for the virus, to make the trial data on it publicly available.

The FDA referred the Post to its past statements about the review process when asked about the panel, including testimony by commissioner Stephen Hahn on Wednesday that its investigations into coronavirus vaccine candidates would be thorough.

"I want to assure you and emphasise every one of the decisions we have reached has been made by career FDA scientists based on science and data, not politics," Mr Hahn said. Hours later, Mr Trump hinted in his news briefing that he may not sign off on stricter review guidelines recommended by the FDA, calling the change "a political move more than anything else".

The National Medical Association is not the only group vetting the oversight of vaccines, as New York will also conduct a review, Democratic governor Andrew Cuomo announced on Thursday.

Additional checks by outside organisations can further the scientific process, according to Richard J Baron, the president and CEO of the American Board of Internal Medicine, which is based in Philadelphia. Mr Baron said any disagreements between the NMA and New York on the one side and the FDA and CDC on the other should raise concerns about the federal agencies.

"I would not lay the blame at the feet of the organisations that are trying to maintain a scientific approach," he said in an interview. "I would lay it down at the feet of the federal organisations that are chartered to oversee a scientific approach and don't seem to be demonstrating a public commitment to that."

Polls show Americans have increasingly expressed concern about a vaccine that is available within the year. Three-quarters of US adults surveyed by Pew Research Centre in September said it is at least somewhat likely that a coronavirus vaccine will be approved before it's fully known whether it is safe and effective.

The trust of a first-generation Covid-19 vaccine is significantly less among black Americans compared to White or Hispanic people: less than 30 per cent of black people said they would be willing to take the vaccine, as opposed to 51 per cent of white and 56 per cent of Hispanic people, an Axios-Ipsos survey in August found. The gap waned when those surveyed were asked about getting a flu shot.

Suma Vupputuri, an epidemiologist and research scientist for Kaiser Permanente, who studied the rates of flu vaccination across races, said oversight over the safety of a vaccine may be a more effective way to recruit black patients and garnering trust than a blind effort to disseminate a vaccine in black communities that is not safe.

"You almost go the other direction if you're trying to push a vaccine that may not be safe at a black community and if something does go wrong, and there are ill effects, then all of a sudden, all those good intentions went exactly in the opposite direction," Ms Vupputuri told the Post.

More black voices are needed in science, argued Kevin M Ileka in the Harvard Business Review, citing a recent racist suggestion by two French scientists that trials to determine the effectiveness of a tuberculosis vaccine against the coronavirus should take place in Africa.

Ileka, an analytical chemist at pharmaceutical company Bristol Myers Squibb, compared the proposal's apathy to black lives to the infamous Tuskegee Syphilis Study, where doctors beginning in the 1930s left hundreds of black men untreated with syphilis for four decades to evaluate how the disease ravaged their body even after penicillin was developed.

In South Miami, Ms Carroll-Scott informally surveyed her own patients about their likelihood of getting a coronavirus vaccine and found "a lot of the patients were concerned about the speed".

"Overwhelmingly the answer was no. I would say that that was the consensus. I don't think I had one patient who said that they would be willing to take this vaccine," she said.

Mr Trump's rhetoric calling for the speedy arrival of a vaccine has concerned patients, Ms Carroll-Scott said, as some worry that Mr Trump's priority is "reelection rather than a safe and effective vaccine".

"I think just the name, 'Operation Warp Speed,' invokes a lot of fear and suspicion," Ms Carroll-Scott said of the name given to the White House's efforts to scale up vaccination. "The education is paramount, and, unfortunately, this whole conversation with the vaccine and the pandemic, there's a sense of urgency, and I feel like we are behind the 8-Ball in terms of educating the community."

Ms Carroll-Scott said she welcomes the news of the NMA panel because the oversight may help to assure those most at risk of the virus's life-threatening symptoms.

"We are the trusted messengers in these communities," she said of black doctors. "And so if we're questioning things and not fully confident in this process, there's no way that we're going to be able to get our patients on board."

The Washington Post