Here & Now

Racial Disparities and the COVID-19 Vaccine

Frederica Freyberg:

The COVID-19 vaccines brought new hope as we rang out the year 2020. And while many can’t wait for their number to be called to get the shot in coming months, some people in underrepresented communities are reluctant. But why? We turn to Dr. Tito Izard, president and CEO of Milwaukee Health Services, a health center working to improve health outcomes and reduce disparities among racial and ethnic communities. Thanks for being here.

Tito Izard:

Thank you for having me.

Frederica Freyberg:

Describe for us how your parents are responding to the possibility of getting the COVID-19 vaccine.

Tito Izard:

Well, I think our patients are responding just like all Americans. When we say “all Americans,” we clearly have a divide in how we’re interpreting the results. Some people are extremely excited about the fact that the vaccine is here and ready to get their shot yesterday. And others are a little bit more hesitant and reluctant, for a number of different reasons that are pretty complex.

Frederica Freyberg:

Well, I wanted to ask you about those. What are those kinds of concerns on the part of people who might be reluctant?

Tito Izard:

So the community I serve is 85% African-American and of the population here in Wisconsin and in the city of Milwaukee, most have historical lineage to slavery. When we think about health care, health care for American descendants of slavery has actually never been in parity with the majority of society. We’ve always experienced health disparities. At the beginning, the doctor/patient relationship it was not one of altruism or the Hippocratic Oath, which is to do no harm. Slaves were used to advance science but not at the betterment of the individual person. And even one physician, Dr. Marion Simms, who was known as the father of modern gynecology, actually performed over 30 surgeries on a 17-year-old slave woman named Anarcha without anesthesia. Between that and even up to the 1970s where you had a lot of doctors performing hysterectomies on black women without full consent, the Tuskegee experiment we all know regarding syphilis. There’s a longstanding history. Especially when you look at the African American/Black community and other minority communities, not having continuity of care with a primary care physician or provider where you can develop those long-term relationships, then you don’t know what you’re dealing with with a health care provider. You don’t know if they really have your best interest because relationships are actually developed over time and with trust.

Frederica Freyberg:

So how do you get past that developing of trust?

Tito Izard:

Well, unfortunately, that’s what everybody wants to know. How do you get past that? I love the statement to say always be cautious or weary of a simple solution to a complex problem. Well, the reality is in order to get past that, we have to address the historical health disparities that have existed. For native Blacks, being an American descendant of slavery is why we have health disparities. And health disparities, whether it’s in infant mortality, whether we see it now here with COVID-19, whether it was cancer rates or cardiovascular disease, asthma rates. All of these things actually link back to either the social determinants of health components which are all direct consequences of being economically excluded from American society. So in order to truly get past it, we actually would have to actually create a comprehensive reparations program, which one of the core components would be restorative health equity.

Frederica Freyberg:

What are you advising at this moment to your patients around the vaccine?

Tito Izard:

Yeah. And that’s a great point, because it is — it’s very difficult and when you look at it for ethnic minority populations like American descendants of slavery as I mentioned versus the general population, many people would consider getting the vaccine over a period of time. So what I’m recommending at this point in time, because the vaccine — we have to realize what do we really know and what are we making assumptions on. Right now the vaccine has been proven to reduce more severe symptoms. It has not been proven yet — and we hope it will — to reduce actual deaths. So at this time for those patients who are a little bit more leery of getting the vaccine, I’m not trying to denigrate them or make them feel bad. What I’m trying to do is educate them properly. So what I would say is if you are 60 or over or if you have any uncontrolled chronic health condition or three or more chronic health conditions, I would say you really should consider getting the vaccine right now. If you are someone who is between 40 to 59 and you may have two chronic health conditions but they’re pretty stable, then I would say if you wanted to wait, you know, three up to six months that may be reasonable for you. And if you’re someone who’s under 40 and you have no chronic health conditions, I think it’s completely reasonable for that person to wait six months if they decided to allow the science to better assess whether the outcomes are actually going to reduce mortality or not. And so I think that we don’t have to have this one size fits all. It can be a conversation for our patients. Clearly those that have high risk, your risk of dying or having severe illness from the COVID-19 virus, it may make you decide, yeah, I’d rather get the vaccine right now. But if you’re 27 and healthy, the reality is with the symptoms right now that we know, 63% have fatigue, 55% have headaches, almost 14%, 15% will have fever. So I think it’s reasonable for that person to wait six months.

Frederica Freyberg:

All right. That is great and reasoned advice. Dr. Tito Izard, thank you so much and good luck.

Tito Izard:

Well, thank you so much. Thank you.