As COVID-19 vaccination ramps up across the U.S., many people are eager for their turn to get vaccinated so they can safely reclaim some normalcy in their lives. Yet in parallel with this anticipation, an understandable level of hesitance coexists among communities of color. Though this reluctance may be focused presently on the COVID-19 vaccine, its roots run deeper.
Fortunately, health care providers — physicians, advanced practice providers, nurses, social workers and others — can successfully address the primary reasons patients of color might be hesitant to get the vaccine. They are uniquely positioned to advocate for patients of color, and they partner with their patients to provide evidence-based care in key ways:
Providers can use their institutional influence by leaning on their administrative leadership to ensure vaccine campaigns are equitably designed and proactive community outreach affirmatively engages high-risk populations. Providers also can demand that their administrators begin to address a lack of diversity among care providers, assuring that clinicians look like and speak the languages of the communities they serve.
Providers can leverage the trust they’ve built with their patients. Perhaps even more impactful is the work that can be done in the exam room. The respect and trust providers can build with their patients affords them an opportunity to intimately listen to patient stories and understand the social determinants of health that drive inequities.
Here are three distinct ways providers can take on these challenges and help encourage their patients — and communities of color at large — to get vaccinated.
1. Recognize the distrust that can be caused by a lack of diversity.
While many people do have a trusting relationship with their physician, we must acknowledge this isn’t the case for every patient or patient-provider relationship. For many patients, the distrust is both historical and ongoing. They may have had previous negative experiences with the health care system and the systemic racism embedded within it. They may also distrust providers who don’t look like them or speak their language, and the lack of diversity in health care overall must be called out.
These barriers can be addressed at a systemic and institutional level by building diverse teams to better connect with patients, elevate their concerns and encourage them to get vaccinated. CommonSpirit Health leaders like Alisahah Cole, MD, System Vice President for Innovation and Policy Population Health; Marijka Grey, MD, System Director for Transformation Implementation, Physician Enterprise; and Brisa Hernandez, PhD, System Director for Population Health Engagement and Partnerships, are proactively working on these efforts within our system. And as women of color, they are drawing attention to the unique needs of their community and elevating the shared experiences of many communities of color. But for individual providers, the work can begin by acknowledging the disparities in the exam room and taking steps to address it where possible within their own teams and practices.
2. Seek training in trauma-informed care.
Many communities of color are distrustful of vaccines because they’ve historically been victims or subjects of research but not beneficiaries of its value. And people of color continue to be traumatized by their experiences of pervasive systemic racism in health care. Seeking training in trauma-informed care makes it easier to recognize how historical trauma and systemic racism affect the way that some patients interact with and experience the health care system, so that providers can be more empathetic in the ways they engage with patients experiencing this trauma and tailor their approach to the unique needs of this population.
CommonSpirit Health has trauma-informed care resources, including the Dignity Health-developed PEARR tool, that can provide a starting point and help inform providers on ways to better engage with these vulnerable patients.
3. Address social determinants of health.
The importance of social determinants of health screening during the clinical encounter cannot be overstated. It can help break down potential barriers to patients getting the vaccine. Providers and their staff should take the extra step of inquiring which social determinants may serve as a barrier to a patient getting a vaccine. For example, can they get the time off from work to get their shot? Do they have transportation in place to make it to their vaccine appointment? Do patients have a safe place to rest if they feel unwell after receiving the vaccine? Asking these and similar screening questions allow providers to identify potential barriers to vaccination and help connect them to resources.
By taking these steps to address vaccine hesitance and related barriers head on, providers can take a lead role in the vaccine rollout that ultimately will help us both overcome this pandemic and begin to tackle health inequities in our communities and across the nation.