Doctor from Montclair: We must build trust in vaccine for people of color
By ERIN ROLL
Chris Pernell, a Montclair resident and a doctor at University Hospital in Newark, remembers the first surge of the COVID-19 pandemic. Hospitals and clinics filled to capacity. And she remembers many of those patients were Black and brown people.
Pernell’s father, Timothy, died from COVID-19 at the age of 78 in April. Her sister, a front-line health-care worker and a breast cancer survivor, also contracted the coronavirus.
“I needed a way to be a part of the solution,” Pernell recalled. So she volunteered as a participant in COVID-19 vaccine trials — a sign of trust in the vaccines she’s hoping more Black people, like herself, develop.
When she volunteered for the vaccine trial, Pernell said, her family asked, “Are you sure you want to do this? We’ve experienced so much loss.” But she felt confident the vaccine trials were done ethically, with voluntary participation and informed consent by all parties, and there were frequent safety check-ins after each vaccine dose.
Pernell recounted those experiences as part of a recent town hall on the disproportionate impact that the pandemic has had on communities of color, including in New Jersey and in Essex County.
“What we do know is that during a crisis, because of systemic racism, communities of color often fare worse,” she said in the discussion, held with Mayor Sean Spiller on Jan. 27.
Pernell said that barriers resulting from systemic racism affect all aspects of a person’s life — where they live, where they attend school, what kind of job and earnings they have, and the quality of health care they receive. All of those issues are intertwined with the level of exposure and care people experience in the pandemic.
And she noted that the mortality rates for Black, Indigenous and Native American people, for Latino people and Pacific Islanders, have been significantly higher than for white people. According to the CDC, mortality rates for Black and Hispanic people were both 2.8 times as high as average, as of late last year.
Disparities are seen close to home. According to the state Department of Health, of the people who have received vaccines as of Feb. 9, about 3% are Black — in a state where census estimates as of 2019 show 15% of the population is Black. Additionally, 5% of those vaccinated are Latino (a group that represents 20% of the state population) and 6% are Asian (10% of the population). The state data say 50% of the people getting vaccinated are white, and the census puts white-only residents at about 55% of the population.
(The comparison between the figures isn’t perfect: The state data collection and census data represent different points in time, 18% of those vaccinated listed “other” for race or ethnicity, and 18% are unknown. But the discrepancies in some cases are significant.)
There are disparities in Essex County specifically as well — 10% of those vaccinated here are Black, in a county the census as of 2019 says is 41% Black. The state says 8% of those vaccinated in Essex are Latino (a group representing 23% of the county population), and 6% are Asian (5% of the county population). The state data say 43% of those vaccinated in Essex are white, and the census puts white-only residents at 30% of the county population. In Essex, 17% of those vaccinated were listed as of unknown race or ethnicity, and 16% were listed as other.
Another factor that should be considered is whether vaccine clinics are held at hours that are convenient for working families, Pernell said. Many people in front-line jobs may not be able to get to clinics held during 9-to-5 hours because of work schedules, she said. (Most of the county-run clinics in Essex are Monday to Saturday, 10 a.m. to 6 p.m.; a West Caldwell site is noon to 7 p.m.)
In addition to accessibility challenges, Pernell said the legacies of unethical medical practices directed at people of color in the past have resulted in a level of distrust toward medical care. As an example, she noted the syphilis studies carried out on Black men at Tuskegee, Ala., starting in the 1930s — a 40-year experiment in which those being observed weren’t told of their diagnosis or given access to medical care.
She pointed to the case of Henrietta Lacks, a Black woman who while undergoing treatment for cancer in the 1950s had cells extracted from her and used for medical research without informed consent.
And representation among medical staff is crucial, Pernell said.
“It matters who’s giving the message,” she said.
In the long term, more needs to be done to encourage and assist young Black and brown people who wish to become doctors and other health-care professionals, she said.
“I hope there’s some Black young girl in Montclair who says, ‘I can be a physician, I can be a scientist,’” Pernell said.
Hospitals can also do more to address implicit biases among staff, she said.
Pernell’s presentation focused on racial and ethnic disparities, but other groups have highlighted other potential inequities as well. Montclair’s Senior Citizens Advisory Council has raised concerns that people without reliable transportation or internet access may have difficulty making appointments for vaccination, or traveling to their appointments.
The Montclair YMCA will be a venue for COVID-19 testing in the community.
“We are examining avenues for education and outreach and are particularly interested in issues of health equity. Our vaccine awareness and education plans are still under development, but we plan on rolling out this messaging in the coming weeks and months as access to vaccines increases in our community,” Y spokesperson Suzanne Broullon said.