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  • Herbert C. Smitherman Jr., MD, MPH, FACP

Opinion | I’m a Black doctor. Here’s why we all should take the COVID vaccine

An excerpt reprinted from Bridge Michigan in partnership with the Southeast Michigan Journalism Collaborative

I have been a physician in Detroit for 33 years. I have seen patients every day of this coronavirus pandemic, even in the early days with scarce Personal Protective Equipment. Early in the pandemic, 10 percent to 15 percent of our patients were COVID-19 positive, and death rates were high. Several of our physicians and staff became COVID-19 positive, as we cared for patients.

This illness hit Detroit quick and hard, with African Americans, who make up only 14 percent of Michigan’s population, accounting for 33 percent of its reported infections and 40 percent of its deaths. Detroit, which is 79 percent African American, has seven percent of Michigan’s population, but represents 26 percent of the state’s COVID-19 infections and 25 percent of its deaths. The pace at which African Americans are dying has transformed this national health crisis into an abject lesson on racial and class inequality. African Americans are more likely to die of COVID-19 than any other ethnic group in the nation. That’s why Black Americans – and all Americans – must be vaccinated against COVID-19.

This disparity in COVID-19 infection and death rates among African Americans is not because this population is inherently more susceptible to getting the virus. It is because of the significant disparate poverty levels and its related higher burden of chronic disease. African Americans are more likely to have pre-existing health conditions (diabetes, asthma, hypertension, heart disease, cancer and obesity) that make the coronavirus particularly deadly. Higher poverty rates and higher burdens of disease are the result of 402 years of negative U.S. social, economic, political and health policies resulting from enslavement, Jim Crow, lynching, segregation, disproportionate mass incarceration secondary to an inequitable U.S. justice system destroying the Black family, redlining, unfair housing policies, unfair employment practices, job discrimination, discriminatory education polices, economic discrimination, disparate health care policies, etc. COVID-19 has simply exposed how a long history of racial discrimination and institutional race-based policies has uniquely tied African Americans to the bottom of the U.S. economic and class hierarchy.

A recent 19-year study titled “Dying Before Their Time,” monitoring the health of the older adult population in Detroit (79% African American), released by the Detroit Area Agency on Aging in July 2020, revealed that the older adults in Detroit are dying at two–two and a half times higher death rates compared to similar age groups everywhere else in Michigan. The study found that the death rate for Detroit adults ages 50 to 59 was 122 percent higher in comparison to those of the same age in the rest of Michigan and 48 percent higher for ages 60 to 74. These findings indicate a much more fragile and vulnerable older adult population in Detroit prior to COVID-19. Pouring COVID-19 on this fragile population is akin to pouring rocket fuel on an already raging fire. COVID-19 has Black America facing a Crisis within a Crisis within a Crisis.

But despite the disproportionate death rates for COVID-19 in Black and brown and low-income communities, the Pew Research Center survey reported in May 2020, that 72 percent of Americans said they would definitely or probably take the vaccine. By November, only 60 percent said they would. By ethnic groups, 40 percent of African American, 63 percent of Latinos and 61 percent of whites say they will take the vaccine. These are very low numbers of Americans who say they are willing to take the vaccine as we merrily go about rolling out the vaccine with no plan to address this problem of vaccine hesitancy (delay or refusal to take the vaccine). We are rolling out the vaccine as if vaccine hesitancy will magically correct itself. The vaccine will not eliminate coronavirus; vaccination will eliminate the coronavirus. Without communities of color getting vaccinated, the United States will not reach the 80 percent vaccination rate needed for herd immunity to stop the spread of the virus.

Vaccinated individuals are unlikely to contribute to disease transmission, disrupting chains of infection. We then stop the pandemic. That’s the plan. However, for the plan to work we must vaccinate people. We will see what the Biden administration will do, however at this point, public vaccination strategies are falling to the states. And what we should be doing rather than demonizing the level of mistrust in our health care system within communities of color, is focusing on making that same health care system trustworthy.

I was vaccinated for COVID-19 on Dec. 18, 2020. My wife, a pediatrician, was vaccinated Dec. 21, 2020. As of this writing, neither one of us has had any side effects. I got vaccinated not only to protect myself, my family and my patients, but also to protect you. This decision was based on science, not on politics.

I hear people say that they are concerned about how quick the vaccine was developed. Scientists have been working on mRNA technology for 30 years. The technology is not new, its application in a vaccine is new. We’ve been able to ramp up so quickly in applying mRNA technology to a vaccine because of 30 years of science and research in this area.

The only questions remaining are whether the vaccine is safe and effective. The answer is “yes” to both. This vaccine doesn’t play around with your chromosomes, your genes, or your DNA or the nucleus of your cell. The vaccine is an already produced piece of mRNA, a messenger, which goes into the cytoplasm of the cell, not the nucleus of your cell, and tells your cell to produce harmless pieces of the crown of the virus which evokes an immune antibody response and kills the virus. According to clinical trial results, the Pfizer and Moderna COVID-19 vaccines are 95 percent effective at preventing COVID-19, and even with the margin of error, it is at least 90 percent effective.

We are about to attempt one of largest logistical feats in human history, that is, vaccinate a nation and a world to stop a pandemic. We are the only generation in human history that has been able to fight back against a pandemic with science to end that same pandemic in real time. However, our state, federal and local governments need to work closely with the private sector and local communities to get this vaccine distributed and everyone vaccinated. These plans need to include funding that appropriately recognizes and resources against the U.S. legacy of mistrust in communities of color. And to communities of color, in the interest of our families, our friends, our loved ones, our neighbors, our country and our way of life, we need to end the madness of this pandemic. Eventually we will all be exposed to the virus. Doing nothing is not an answer. Science is the answer to stop the daily death toll of this pandemic.

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