Building trust in vaccines with communities of color

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Vaccines have the power to protect us. For decades life-saving immunizations have eradicated smallpox and almost eliminated measles, meningitis, and polio in this country. We rarely see these diseases in our communities because generations of families have recognized the importance of vaccines and made the decision to vaccinate loved ones. According to the Centers for Disease Control and Prevention, almost four million deaths worldwide are prevented each year because of vaccines. In the last three years, we have taken the success of all vaccines for granted. We cannot nor should we diminish the importance of vaccines. 

Confidence in vaccines, let alone healthcare in general, does not come without historical trauma and mistrust within the Black community. When the COVID vaccine was introduced, generational pain resurfaced from memories of the Tuskegee experiment and the use of Henrietta Lack’s cell lines, without her consent. While the vaccine is highly effective in preventing complications, hospitalizations, and death from infection, historical trauma, misinformation, and inconsistent messaging contributed to the Black communities’ low COVID vaccination rates. In Minnesota, African Americans have lagged behind their white counterparts in getting their first dose of the COVID-19 vaccine and completing the series, even though they are at greater risk for hospitalization and complications from the virus.

Unfortunately, racial disparities in immunizations also exist with basic, essential childhood vaccines such as measles and whooping cough. Recently, world leaders announced the largest sustained decline in childhood vaccinations in over 30 years. Current data shows even lower rates in communities of color. With the increased threat of vaccine-preventable diseases such as measles and polio, we must address the community’s lack of confidence in vaccines because our kids deserve this protection! 

Three years ago, Hennepin Healthcare developed the Pediatric Mobile Health (PMH) community-based outreach program to address these challenges. The program’s goal is to decrease barriers to healthcare, improve immunization rates and help restore trust within the community. Lead nurse practitioner Amy Green notes, “There was a decline in the rate of childhood immunizations during the pandemic. When our patients are not protected, then our community is not protected.” 

The PMH team provides care to families outside their home in a kid-friendly mobile clinic. In addition to providing checkups and immunizations, the team also screens families for food insecurity, housing needs, transportation challenges and financial strains. The team refers families to a medical home facility, specialty care or community resources when needed. The PMH program conducts pop-up clinics at schools and Head Start centers. In addition, the team answer questions and concerns about vaccines at community town halls. The work has been well received and the program continues to grow. 

Last year, PMH interviewed community leaders representing education, human services, media, and public health. The team also surveyed patients and held focus groups in the Black community. Here are some key findings from the community assessment:

• Trust is important to increase vaccine confidence, especially for Black community members residing in Minneapolis and neighboring cities. 
• Vaccine information must come from respected community leaders in partnership with healthcare members, who share similar experiences and speak the same language. Health systems need to engage with community leaders and prioritize culturally appropriate outreach. 
• Healthcare providers must devote time to understanding their patients’ fears and concerns, even if it means sitting in a space of uncertainty. This time spent is a key factor in building trust.

While progress is being made, the challenge remains. We need to protect our children and our communities from diseases as best we can. Many of these diseases can be prevented with a vaccine. If communities do not trust vaccines, we have work to do. This work is ours, both as community members and healthcare providers. The work requires building trust and partnerships so that we can provide culturally sensitive information that builds on what we’ve known for generations. 

Vaccines save lives by preparing our bodies to fight disease. One life lost to vaccine-preventable disease is one life too many. The work has begun—will you please join us?