Ten years ago, my father-in-law fell 13 meters from the top of his tractor trailer. Only after completing his delivery, driving 35 km home and dumping, did he finally go to the emergency department. Although he had five broken ribs and a lung contusion, he was discharged. He returned to the doctor with difficulty breathing, but it would take several visits (during which the symptoms disappeared and the test results were misinterpreted) to diagnose fluid around his lungs and heart. He had to undergo surgery and suffered a cardiac arrest after the operation. Its survival is a miracle.
Our family remained vigilant throughout my father-in-law’s medical care. We closely monitored his interaction with providers to ensure that his pain was adequately treated, symptoms were taken seriously, and discharge instructions were well explained. We are black and know that these standards are not always guaranteed to us. I am a doctor and have seen black patients treated with disrespect; dismissed their concerns and symptoms.
I was thinking about this intricate link between racism and mistrust when I was considering taking the Covid-19 vaccine. As an emergency physician with regular exposure to Covid-19 patients, I knew I would be preferred for vaccination. For many months, however, I was determined to be one of the first. Instead, I planned to wait to see how others fared with the vaccine. I think I am wary of the system to which I have dedicated almost two decades of my career.
To be clear, I’m not a vaccine skeptic – my three children have been completely vaccinated and I get my flu shot every year. But I had serious doubts about the speed of the Covid-19 vaccine development process, which was a political tool for me when President Donald Trump tried to win re-election. How can a vaccine be developed under a president who reveals repeated acts of racism and who has actively enabled white supremacist groups? Across the country, many Americans are grappling with similar concerns.
And yet, on December 17, 2020, I receive my first dose of the vaccine.
This is what helped change my mind. First, I had to inform myself about how the vaccine was created. The mRNA technology behind the Covid-19 vaccine has been developed for decades. Yes, the compressed timeline was aided by government funding, but the vaccine has been worked on by thousands of scientists, has undergone a rigorous three-phase clinical trial and has been approved by two federal advisory councils (the Food and Drug Administration and the Centers for Disease Control and Prevention). . See also photos of Kizzmekia CorbettA black scientist at the core of Moderna’s vaccine development in her laboratory was powerful. Representation is important and is critical to the recovery of centuries of structural racism that contribute to medical mistrust.
Secondly, I read the experiences of coloreds and trusts Black doctors who participated in vaccine trials. Reading their thought processes, how they weighed the risks and benefits and what their symptoms were after the second dose, helped me take the vaccine. Never doubt the power of social media and the written word to influence behavior.
Third, my mom practically begged me to get the vaccine. Since March, she’s been hearing my own scary stories about Covid-19 patients. The tears of a young woman with only mild symptoms, who was worried about exposing her elderly father in their little house. The middle-aged, healthy health care worker who gasps for air; the fear in her eyes when we talked about the need for intubation. She survived. Many have not.
I was nevertheless decided until the Pfizer trial was published. The graph of the study showing the continuous increase of the Covid-19 infection in the placebo group compared to the almost complete decrease in those who received the vaccine will be etched in my mind forever. In addition to being a doctor, I am a scientist. And while the historical examples of experimentation on black bodies in the name of science are too many to count, and the concern about racism and prejudice in research continues, I still rely on strict science. I was almost ready to say yes.
My last concern was the risk of a rare, serious and yet undocumented side effect of the vaccine in the long run. The Pfizer study followed people for just two months. But I was reassured to learn that adverse reactions usually occur in the first days to weeks after vaccination for vaccines. I weighed these unknowns on the risks of contracting the coronavirus – the death, a prolonged hospital stay or, and perhaps for me the most convincing, the increasingly documented, long-lasting complications of Covid-19 itself: brain fog, difficulty breathing, extreme fatigue , depression.
The choice became clear. I will get the vaccine.
I did not feel well for three days after my second Covid-19 shot. I had fever, body aches and headaches for 24 hours; then fatigue. Motrin and Tylenol helped with my symptoms, which was a small inconvenience of getting the freedom to finally be able to work in the emergency department without fear.
Let us normalize the reluctance to take a new vaccine. Shaming people who have questions will not encourage their use. Skepticism is particularly striking for black people, for whom centuries of abuse and damage by systems meant to serve and protect have caused distrust.
Health systems and public health institutions that are rapidly trying to address vaccine vaccination among black people must first recognize their own role in creating and perpetuating mistrust. The aim should then be, in partnership with black people, to create forums for conversations and opportunities to answer questions that are not judicious by trusted messengers.
I am concerned that the under-representation of black people among those who have received the vaccine so far will lead to a further widening of racial differences in Covid-19 infection and mortality rates. And so I share my journey from “no” to “yes”, my own #BlackWhysMatter, whoever listens, to allay fears and open doors for conversations. I want to help people make informed decisions.
And if you’re wondering, yeah, my father-in-law just signed up for his vaccine.