Restoring trust to save lives

Black and brown Americans’ hesitancy over the COVID vaccine was decades in the making.

A worker at the vaccination site at the Reggie Lewis Center spoke to people waiting in line on Tuesday.John Tlumacki/Globe Staff

In case you missed, oh, all of 2020, our bumpy COVID vaccine rollout is providing yet another lesson on American inequality.

So far, whether those eligible can get vaccinated comes down too often to whether they have the resources — the time, the technology, the support networks — to snag an appointment. We saw that imbalance come to life at the Reggie Lewis Center in Roxbury this week, as those who showed up for their shots were overwhelmingly white and from more affluent parts of the city.

In Massachusetts, Black residents make up 8 percent of COVID cases, yet only 4 percent of those vaccinated so far; Hispanic residents make up a whopping 29 percent of cases, but only 5 percent of those who’ve gotten the shot as of Feb. 1, according to the Kaiser Family Foundation. White residents make up 49 percent of cases and 56 percent of vaccinations so far.

This is the story of Black and Hispanic people who want the shot and can’t get it. But it’s also the story of those who can get it and don’t want it — not yet — because they don’t trust a health system that has let them down time and again.

“It’s not as simple as ‘Build it and they will come,’” said Charles Anderson, CEO of the Dimock Center, which serves Roxbury, Dorchester, JP, and Mattapan, and whose patients are 80 percent Black or Hispanic. “Every day, people in our community are experiencing unequal treatment, and that impacts trust.”

In a December Kaiser poll, 35 percent of Black adults said they definitely or probably won’t get the shot, compared to 26 percent of white and Hispanic respondents. That hesitancy is showing up in nursing homes where, nationally, 62 percent of workers (disproportionately Black and Hispanic) have declined the vaccine when it was offered, and at health centers like Dimock, where half of the employees have turned down shots. Some of those just want to wait, Anderson said, but a good 20 percent of the health center’s 500 employees — whose makeup mirrors the center’s patient population — are a hard no.

You don’t have to go all the way back to the Tuskegee experiment to see why people of color have less trust in our health care system: They live its injustices right now, intimately familiar with the well-documented fact that their pain is taken less seriously, that too many of them must battle for care white patients take for granted. So of course they’re more suspicious of a vaccine that has been developed at lightning speed. Even Anderson himself was hesitant at first.

“I don’t think it helped that they called it ‘operation warp speed,’” said the CEO, who is Black. “Did they skip steps?” Of course, Anderson could do research and call up expert friends to put himself at ease. Too many of his patients and workers don’t have time for that. They’re too busy dealing with more than their share of pandemic woes, like food and housing insecurity. And they’re sitting ducks for unhinged antivaccination conspiracy theories, which spread too fast on social media for the truth to catch up: that the vaccine will alter their DNA, or that it’s part of some secret scheme to implant microchips inside them. Added to those are more reasonable fears, like whether it’s safe for pregnant women, given that little testing was done on them during trials.

“That’s how racism works,” said Kiame Mahaniah, CEO of Lynn Community Health Center. “It makes you intensely suspicious of anything that society has to offer.” So far, 412 of his center’s 620 employees have said yes to the vaccine. Winning over the others, and the wider community, is going to take lots of personal contact, with those who have taken the plunge telling their stories. Without extra resources, getting people vaccinated in Lynn and Roxbury is going to take longer than in whiter places. So the pandemic might hold on longer in Black and Hispanic communities, just as the AIDS epidemic did.

“I have seen this movie before,” Anderson said. “Are we going to look up and say, ‘Whoo, this pandemic is behind us,’ and have Black and brown communities still [living] like it’s 2020? Will we care enough then?”