Challenges Of Ensuring Diversity In Coronavirus Vaccine Trials
SACHA PFEIFFER, HOST:
Black and Latino people in the U.S. have been disproportionately affected by COVID-19. That's a big reason pharmaceutical companies want and need to include minority volunteers in clinical trials for their coronavirus vaccines. Recruitment efforts are happening, but that often means overcoming deep-seated and well-founded mistrust of the medical system. And as Blake Farmer of WPLN in Nashville found, that's not something that can necessarily be done at warp speed.
BLAKE FARMER, BYLINE: Half a dozen patients snack on turkey sandwiches and potato chips around a conference table. They're visiting with their doctor, Vladimir Berthaud, at Meharry Medical College.
VLADIMIR BERTHAUD: So what's the best hope to get rid of this virus?
UNIDENTIFIED PERSON #1: Vaccination.
BERTHAUD: Vaccination. So raise your hand if you would like to take the vaccine.
FARMER: He senses some hesitation. All of these patients are Black.
LANETTE HAYES: I ain't going to be the first one, now.
FARMER: That's Lanette Hayes. Katrina Thompson says she does want to get a shot for protection against the coronavirus. People in her apartment building aren't doing the basics of covering their coughs.
KATRINA THOMPSON: The word vaccination don't scare me. The word trial do.
FARMER: Black Americans have reason to be suspicious. Beyond the well-known Tuskegee experiments, where syphilis patients were misled for decades, they've also faced an ongoing exclusion and mistreatment by medical providers. But Dr. Berthaud, who is Black and from Haiti, appeals to a sense of duty. Plus, he's recruiting in Nashville and wants more than 300 people of color.
BERTHAUD: If you don't have enough people like you in those vaccine trials, you will not know if it works for you. You will not know.
FARMER: For most of the COVID vaccine trials, recruitment is happening online, which often results in mostly white people enrolling. But Meharry, which is a historically Black school, is one of the few places in the country where Black patients are being wooed with a personal invitation to take part. And this trial doesn't even start until October. Meanwhile, other pharmaceutical companies are nearly done recruiting. Moderna is publicizing its demographic statistics. They're somewhat better than the typical clinical trial but still not a good representation of the diversity in the U.S. And the National Institutes of Health has suggested minorities should be overrepresented in testing the COVID vaccine.
DOMINIC MACK: We say we want everybody to be included.
FARMER: Dr. Dominic Mack of Morehouse School of Medicine in Atlanta is working with the NIH to make sure people of color are included in COVID research.
MACK: Really, the effort for the vaccinations, in a sense, are started the same way they always been.
FARMER: Mack says there are no shortcuts if medical research is to reflect the diversity of the U.S. It takes time to build trust and meaningful relationships with people who've been excluded.
MACK: Now, that being said, the only thing we can do is what we're doing.
FARMER: The primary effort taps into existing trial networks that were designed for HIV research and convincing patients of color to help with COVID. Reverend Ed Sanders of the Metropolitan Interdenominational Church in Nashville has helped educate Black clergy about HIV. But he says it's not his job to preach trial participation from the pulpit.
EDWIN SANDERS: I am not going to do anything more than make sure people are able to make an informed choice.
FARMER: And there's a danger that lunging for big diversity goals could result in less-than-willing participation. Professor Rachel Hardeman studies health equity at the University of Minnesota.
RACHEL HARDEMAN: I think there's a lot of potential for more harm because of the quick timeline if we don't have the - again, the right people.
FARMER: Historically Black medical institutions in the country are uniquely positioned to do this work. While they haven't been on the leading edge of the vaccine trial recruitment, they mean to play an important role. The president of Meharry Medical College is himself an infectious disease researcher. But instead of working on the vaccine trials being hosted on his campus, Dr. James Hildreth plans to participate as a patient.
JAMES HILDRETH: I think my role is more important in advocating for people to be involved in the vaccine studies than to be one of the leaders of the study.
FARMER: Back in that cramped conference room, Dr. Berthaud won over the holdouts.
ROBERT SMITH: Oh, yeah. Where's the line? Where do we sign?
UNIDENTIFIED PERSON #2: You don't have to yet. Wait until...
FARMER: That's Robert Smith with his young grandson in tow. And Smith says he'll participate for no other reason than he trusts his longtime physician.
SMITH: He's not only my doctor, he's proven to me that he cares about me.
FARMER: Convincing hundreds of thousands to sign up will be difficult. But even for those who don't participate, researchers hope their outreach efforts will at least result in more minorities ultimately taking the vaccine when it's available. For NPR News, I'm Blake Farmer in Nashville.
PFEIFFER: This story comes from NPR's partnership with Kaiser Health News and Nashville Public Radio.
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