Racial Inequities
Specific concerns and life experiences more common among some groups may influence minority patients’ perceptions of COVID-19 vaccines and their personal willingness to be vaccinated.
“The old pandemic of social injustice is happening at the same time as the new pandemic of COVID-19. So that is impacting vaccine deliberations and what our patients are thinking about,” said Dr. Manning. It’s important to acknowledge the valid, historical reasons an individual from a minority group may think others may not have their best interests in mind. For example, Dr. Manning referenced the infamous Tuskegee study of syphilis patients in Macon, Ala., in which Black men were not adequately informed about their condition, nor offered effective treatment when penicillin became available in 1943.2
Historical inequities may lead some minority patients to have concerns that they may be unfairly and unsafely being used as test subjects, even today, Dr. Blanco noted. It does not help that rheumatology, like many medical specialties, is not very diverse. “I think, like many medical fields, we have a hard time having those difficult conversations around race, especially when providers are not racially concordant with [their] patients,” she said.
One of most important things a provider without racial concordance can do is to sincerely acknowledge the terrible experiences of minority communities in medical and other settings. From there, a real conversation can begin. “I think it goes wrong when people brush over [the topic] because it is so uncomfortable,” Dr. Manning said.
Physicians can also consider and voice their own differences in background. For example, a white male rheumatologist may verbally acknowledge his own privilege and say that, because of his life experiences, he may have different worries and perceptions from his patient. “That can mean a lot to your patient and really make people feel seen,” said Dr. Manning. From there, providers can let their patients know they are available to provide support and answer their questions about the vaccine.
The ACR has an extensive list of vaccination resources for providers talking to their patients, including a patient-focused infographic.