Vaccine Hesitancy is Solvable

nineteen vaccine. Americans of color serve in essential jobs across society, which makes it even more urgent that they be vaccinated. They were to people who check people into the emergency room. They are the orderly, they are the ones in flood service, they are the ones in transport, so you know that they were at increased risk or being infected. According to the CDC, black Americans are one point four times as

likely to be infected with COVID nineteen. Indigenous, Black and Latin X Americans are at least two point seven times more likely to die than their white neighbors, according to American Public Media Research Lab. As COVID nineteen vaccines roll out across the country. The medical establishment faces this problem. How do you re establish trust or establish it in the first place. If there's ever a time to understand history and to understand how that has influence people's ability

to trust the health system, the time is now. Doctor Valerie Montgomery Rice is the president and dean of the Morehouse School of Medicine. She was among the first people to be vaccinated in the United States. Her shot with broadcast live on CNN. She thinks this is a problem we can solve. I believe that we can move from vaccine hesitancy to vaccine certainty. Doctor Montgomery Rice, I'm so happy to be able to talk to you about this today.

You know, I think a lot of us have been watching the catastrophe within the catastrophe or one of them, which is that COVID nineteen has disproportionately infected people of color, and I think even more disproportionately killed people of color. You know, one would hope in that situation that African Americans would be at the front of the line to

get their vaccines. And I wonder if you can talk for a minute about where we are and why African Americans are in some cases more reluctant than others to get the vaccine. We know that this virus has disproportionately impacted people of color, not just African Americans, but Latin X and questions were raised early on, was there something unique about race or ethnicity that put people at greater risk.

What we really recognize when you looked at the science that this virus did not discriminate that if you were in proximity with someone who was infected, you had a

higher chance of being infected. Latin X and African American were the people who were the essential workers because they are the people who check people into the emergency room, they are the orderly, they're the ones in food service, they're the ones in transport driving your buses, who were picking up your trash, who were working in restaurants, etc. So you know that they were at increased risk of

being infected. So it was not that this virus was discriminatory per se against people because of their race ethnicity. It's the social determinants they have led to this. Now, having said all of that, we know that we see a disproportion number of health disparities because of the social constructs that have not allowed for greater access to care and then access to the greatest level of quality of care.

And so we have made a valiant effort in the science community to make sure that black scientists have been at the table of the vaccine discovery and development, the valuation of the data in the clinical trials, and then the decisions at the FDA and CDC of the allocation. Yeah, and of course people saw you getting your first dose of the vaccine on CNN, and one of the other first recipients of the Visor vaccine was an African American

nurse in Long Island. So they've clearly been efforts, which you've been in the center of, to have prominent trust African American voices publicly getting vaccinated. If someone sees you getting vaccinated on CNN, sure that builds trust the institution. You represent all the things you're talking about. But at the same time, what my friends are saying, or what my neighbors are saying, or what I feel like the people I know are going to do, it's going to

have such a big impact. How do you create influence at that level around vaccines? So you know, I take a lot of phone calls, I answer a lot of emails, and I tell people to truth always. So when we didn't know stuff early on, Jacob, I told them we didn't know yet, we needed to give time for the studies to be completed with the vaccine trial. And then as we started to know more, we then shared more. And so what I've tried to do is to be transparent about what we don't know and open even more

open about what we do know. And at no point have I asked people to deviate from those healthcare practices though, of the three ws washing your hands, wearing your masks, and watching your distance, and recently I added a P on that, so it's three ws N a P now being patient for when is your turn to receive a vaccine? And so I think it's really really critical that we, as healthcare providers and as scientists let people know that

this is evolving. That's what I've tried to do with my peers is to make sure that they understand that we don't know everything, but what we do know, be confident in that we have enough smart people to help figure out most of these things. I mean, when I hear about white people who don't want to take the vaccine, I just have a gut reaction and that's irrational, that's conspiracy thinking they're anti vaxxers. I have no sympathy whatsoever.

When I hear about African Americans who are reluctant to take the vaccine, I think, well, there's a whole history there, very specific things that happened in the past. Am I right to draw that distinction? Or is anti vaccine anti vaccine? I mean, are they versions of the same thing or are they different things? They are not versions of the

same thing. So, you know, Jacob, if there's ever a time to understand history and to understand how that has influenced people's ability to trust a health system, the time is now. There is a book called Medical Apartheid by

Harriet Washington. It is a very difficult read, but it is a book that gives you a historical perspective on what has happened from the time four hundred years ago when we were brought to this country, when blacks were brought to this country against their will, and how they were used throughout their bodies and their minds for medical experimentation, whether it was with the person who was named the grandfather of gannacology, Maryon Sims, how he used black women

slave women against their will to perfect surgical procedure and they were not given anesthesia, etc. Or whether or not you're looking at how he addressed tetani in children and how he used bondage to close their sutures and their and their head that are usually closed on their own over time, or you get to more modern day times when you're talking about Tuskegee the actually we're not injected

per se with syphilis. They developed syphilis, but they were not given treatment and it was intentional, right, And there are other instances. You can think about the Mississippi appendectomies, and we've had throughout the South challenges and history of women having hysterectomies performed on them without their knowledge or consent. And so while I would never be dismissive of people's concerns,

what I've tried to do is address their fears. And the one way that I know to address a Jacob is to acknowledge what has happened in the past and talk about how we've learned from that for the future.

And one of the things that we learned was that we needed to have trusted voices in the room, trusted voices at the table of decision when clinic core experiments were being designed, we needed to understand the science of how the disease, whatever it is, impacts one race or ethnicity or gender over another, and to make sure that those persons were represented. And then we needed to understand the social constructs in our society that prevent people from

having the greatest level of access or inclusion. And we are doing that with this vaccine development and roll out, and hopefully we're going to move us from this vaccine hesitancy to vaccine acceptance. Yeah. I wonder if you can tell me a little more about your own story and how your family played into your approach to healthcare and science. I mean, so much of this comes with you. How we what we hear growing up, of course, And I just I wonder how you became so passionate about healthcare

and the black community in particular. Well, you know, I was raised in a single parent household. My parents divorced when I was six, three sisters, and my mother raised us. She started to work eventually in a paper factory. She worked there twenty five years, seventy three, three to eleven, eleven to seven, and became the highest ranking woman in a paper factory in making Georgia. What I saw there was resilience. I saw grit. I saw a woman who came home every morning or evening a night when she

was finishing. And she only had a high school diploma, but I believe she had a PhD. In my mind. She would whisper things in our ears, Jacob, all things are possible. You can do anything. And when you're growing up, it's a nuisance because somebody's in your ear while you're trying to sleep, right, it's a nuisance. And so she was trying to instill to us what was possible. And I went to Georgia Tech based on the fact that my science teacher said, you're good in math and science

and they're looking for black kids to be engineers. And I got a scholarship to go to Georgia Tech. Really didn't hardly even apply to other places, and I coopered Proctant Gams, the chemical engineer and major, and they offered me a job. And that scared me to death because

I actually didn't want to be an engineer. And I looked up in an encyclopedia math, science, and people, and one of the things that had come there is medicine, and I went over to Spellman College because Georgia Tech did not have a pre mad major at that time. Told my advisor, I think I want to go to medical school. And she said, you don't seem to know a lot about going to medical school. And I said to her, I didn't know a lot about being an engineer,

and that's working out okay. And so I really believed that all things were possible. So the rest is here. I decided to leave Georgia Tech with a chemistry degree. I went to Harvard Medical School and now I've had a daughter to graduate from Harvard Medical School. And so when you look at this history, I think it was built on resilience and grid. So the presence of African American medical researchers and medical practitioners at every level is

crucial to establishing that greater trust. But we have a real lag there, don't we in medical school? And you know, the numbers of African Americans enrolled is going up, but it's going up slowly. And I don't even know what the statistics look like in medical research and in the development of the vaccine. But what are you able to point you there? So if you look at the Association of American Medical College is what we call the Double AMC.

Black physicians account are only five percent of all physicians in this country, even though we comprise thirteen percent of the population. You will see that black females outpaced black males at a ratio of about two point five to one, with there only being six hundred and nineteen black males who enter medical school in twenty nineteen. Now understand what

that does in a classroom setting. Imagine I'm in a classroom with one hundred, one hundred and twenty five students and there are there's one black male, and let's say that there are nine black females. Lots of medical school classes now occur in small groups, and let's just say that we're talking about gun violence, and so these medical students are forming an opinion about gun violence. And a lot of that opinion doesn't just come from the litera tour.

It comes from the conversations that are had in those small groups. Now, you may say, well, how does that

impact my care delivery? Well, let's say I'm now on the trauma team at Grady Hospital and every person that comes in is a black male with a gunshot woman Not only am I bias from the fact that in my small classroom setting, I haven't had the opportunity right to have conversation with a black male student who may have never been involved with gun violence, but it is also affirmed for me when I get into the clinical setting.

That is why diversity by race, ethnicity, gender, socioeconomic status, religion, sexual orientation is so critical to how we educate and train and how we remove ourselves. I'm a biases and are able to be more inclusive in our thoughts and our care delivery. Yeah, I have seen some studies that maybe as high as a third or thirty five percent of African Americans say they don't intend to get vaccinated or don't trust the vaccine. When people say that, what

are they afraid of? Specific? When you say why won't you get the vaccine? Do you what do you hear about? Most of the time, really, Jacob, they go back to the trust because they say, you know, it's hard for me now sometimes to get access to the highest quality of care. So why would I believe that somebody is really ready to give me access to a vaccine that's supposed to be great? And so it is about building

that trust. We did a vaccination program with civil rights leaders seventy five and above and Bassada, Andrew Young Herey, Hank Thomas Herey, Aaron and his wife Billy Aaron, doctor Lewis Sullivan, previous Secretary of HHS, previous president of more House School of Medicine. Those people were around when Tuskegee occurred. Those people actually lived through that history. Yet they were willing to step up and get vaccinated because they believe in science and because it was linked to more House

School of Medicine, that trusted entity. Yeah, when you project forward, say a year from now, when with hopefully you know, vast majority of the population vaccinated and the pandemic if it still exists, is a very manageable kind of problem. Do you think we'll look back and say this, the vaccine was a success story in relation to people of color and to African Americans in the sense that there wasn't a lag in when they got vaccinated the proportion

in which they got vaccinated. Do you think we're gonna eliminate that disparity, just as we utterly failed to eliminate the disparity the historic disparity reflected in who got the disease and who suffered most from it. So I look at this in two ways, Jacob. What I believe we will do is we will say the vaccine did what

we expected it to do. Along with the other healthcare preventaged strategies of the three WS, the vaccine helped us to mitigate the disease because first you're going to see decrease in death, then decrease in hospitalizations, but not necessarily rapid decrease in cases. Now, what the what I want to look back and say the virus did it though, was it showed us the chronicity of health disparities and

health in eques in this country. And as my daughter would say, it woke all of us up to how we should create interventions that are sustainable such that we never are here again. So that when we think about innovations that we will develop in cancer and diabetes and heart disease, that we will ensure the appropriate dissemination and allocation of that intervention and discovery to communities that have been left behind, ensure that people who are disproportionate impacted

have access to those interventions. That we will understand the impact of social determinants that you can't be talking to people about, oh, you should exercise three times a week and go get this medication field if they're not in a safe neighborhood or if they don't have a job, so that we will understand how social determinants influence access

to care and quality of care. Doctor Montgomery Rice. We always like to wrap up unsolvable by talking about things listeners can do, and in this case, I think the question is what can people do to help build trust in the vaccine. I think that people should do due diligence and listening and finding trusted advisors to help them understand the signence. Now I'm not saying they need to understand how a vaccine works, because we all take many of us take the flu vaccine right and we don't

necessarily know how the flu vaccine works. But what we have done is that we have found a trusted advisor, usually in our healthcare provider, that helps us to feel more comfortable we're taking that vaccine. So I want to continue to stress to people to go to trusted sources so that they can understand the benefits of the vaccine. The second thing that I would ask them to do is to continue the three ws, washing their hands, watching

their distance, and wearing their masks. Because if you do that and then you are patient, your time for the vaccine will come. But in the meantime you will decrease your chance of being a case, a hospitalization of death. And then the third thing that I will say is that we need to recognize that we have the power in this country to do most anything. Recognize who your circle of influence is, and continue to have open conversations about what got us here, but left not let the

past holders back from realize in our bright future. Doctor Mortcommress, I gotta tell you made me feel really good watching you get your shot out to see you're afraid of needles, just like I am. And I saw you doing the same thing I do, which is look away from the needle. About the dean of a medical school and a doctor has the same phobia, maybe it's pretty normal. And then let me just tell you it hurt way less than the flu vaccine ever heard. So it was it was

like nothing. I was like, oh my god, don't even like to watch a needle going into someone else's arm. I kind of just closed my eyes. Well, I don't mind putting the needle in somebody else bothered it just I just don't want it in my arm. Yeah, well, I wish you were here to give me a vaccine, but I think I'm gonna have to wait my turn right well, and certainly rather have my vaccine at more

house medical college than at a pharmacy. Is there any way to influence where we get these vaccines, you know? So we have been in discussions with our Department of Public Health, and I know other leaders around the country who run medical schools like I do, have been in conversations with their Department of Public Health, so talking about how do we make it more readily available to the public.

And one of the things that we're planning to do here is to have these vaccine vaccinations in our parking lot drive through vaccinations every Saturday for the month of January. We're also going to use our mobile research van to set up in many of the rural areas in the

state to be able to offer vaccinations. So we are encouraging the departments of public Health to partner with grassroots organizations, fairly qualified health clinics to really be able to get these vaccinations to the public versus the public having to come to an establish hospital setting where people are overburdened right now with COVID cases, so that they can really

get their vaccines. But I also would say to your listeners there are vaccine trials still going on, so right now I'm more House School of Medicine and at several other places throughout the country, the novavax vaccine trial that is going on, So look that up. You can go and find it on an NIH site. And rolling a trial, you got a fifty percent chance you're going to get the vaccine versus getting to placebo. And so I would

say try it. Well. Thank you so much for joining us Unsolvable, and thank you doctor Montgomery Rice for your leadership in helping America get vaccinated to end this pandemic as as soon as we can. Oh, thank you, I appreciate it. Doctor Valerie Montgomery Rice is the President and Dean of the more House School of Medicine. Be sure to check out our show notes for links to the facts about COVID nineteen vaccines that you can share with friends and family. Next week, Unsolvable, we'll talk about how

to make and break habits. It's a season of resolutions, but really setting yourself up to make changes in your life and behavior can happen anytime of year. Please join us for our conversation about achieving your goals, and here's a preview. It starts with friction Solvable. Senior producer is Jocelyn Frank, Booking by Lisa Dunn. Our managing producer is Catherine Girardo and Mia Lobell Is the executive producer of pushkin. I'm Jacob Weisberg.