The coronavirus pandemic has raged for more than a year now. But the battle to save lives has entered a new phase. The push to vaccinate as many Americans as possible received welcome news on Thursday with the announcement that the U.S. will have enough doses to vaccinate 300 million people by the end of July. But the campaign still must outrun new variants, skepticism in the science, and costly misinformation before then. With the threat of pandemic fatigue looming, our moral and political will to marshal the resources to the hardest-hit communities must not wane. A major component of that will be solving the “wait and see” conundrum among members of those groups.
In a poll last month from the Kaiser Family Foundation, conducted before President Joe Biden’s inauguration, 47 percent of respondents expressed willingness to be vaccinated as soon as possible or said they had been vaccinated already. This is a sharp increase from December, but the most important details are among those who find themselves in the wait-and-see category.
Forty-three percent of Black adults were in this camp, along with 37 percent of Latino adults. That’s in comparison to only 26 percent of white adults. Likewise, young adults ages 18 to 29 and those in urban areas both said in high numbers that they would rather hold off until later. Participants who identified as Republican or independent only slightly trailed those groups, at 33 percent.
We can take away some key insights from those numbers: First, knowing someone who has been vaccinated tracks with vaccination enthusiasm. Among those who are the most eager to get vaccinated in the survey, just over half say they know someone who has been vaccinated — a group that is largely white and higher-income — compared to only 40 percent of the wait-and-see category who know someone who has already been vaccinated.
Second, the latter group has critical information needs that must be addressed. They’re concerned about any unknown long-term effects of the vaccines, the potential for serious side effects, the efficacy of the vaccines and whether they’ll contract the coronavirus from them. These needs are also high among lower-income adults and those who have completed fewer years of education. Luckily, we have conclusive data now about at least three of these points. But the information must be communicated by trusted messengers in easy-to-understand language and repeated across multiple engagement scenarios.
The sting of disproportionately lower vaccination rates among Blacks and Latino groups isn’t just immoral; it is untenable — it perpetuates a vicious cycle that further delays the nation’s reaching full vaccination.
Third, vaccination status is also correlated with the likelihood to believe myths and misinformation about the coronavirus vaccines. Forty-one percent of the wait-and-see group either believe the vaccines contain live virus or that they cause infertility or that vaccination is not free. Fifty-three percent of those who say they definitely will not be vaccinated are more likely to believe the same.
And fourth, we know what messages register most strongly with people of color and young adults. They include: “vaccines have been shown to be highly effective in preventing illness from Covid-19,” “the vaccine will help protect you from getting sick from Covid-19” and “the quickest way for life to return to normal is for most people to get vaccinated.”
What do we do with this information? The answer is to invest in equitable distribution and access to vaccines, especially in Black and brown communities, including poor and elderly subpopulations. This is where federal action is most critical, in partnership with state and local governments and across various business or social sectors, like local pharmacies, grocery stores, community health centers and faith-based settings.
If someone has ready access to vaccinations in their neighborhoods, and if transportation, literacy and convenience barriers are removed, then people are more likely to be vaccinated. If you know people in your family or community circle who have been vaccinated and you can “verify” that the vaccines are safe and effective, your time spent weighing the options will likely shorten, allowing people to move forward in their decision journeys. This is why the sting of disproportionately lower vaccination rates among Blacks and Latino groups isn’t just immoral; it’s untenable — it perpetuates a vicious cycle that further delays the nation’s reaching full vaccination.
We must elevate and mainstream stories that matter to the groups who have been disproportionately devastated by the pandemic — specifically within their social and cultural circles, as well as across the broader public discourse. Everyone must see and hear public narratives that resonate with their lived experiences and perceive themselves as the intended audience. The message must be consistent, especially now, in this next four to six weeks, when we have our best chance to get ahead of rapidly disseminating variants by vaccinating as many people as possible. This gives us an opportunity to reduce morbidity and mortality associated with more transmissible variants. We must understand that the race we’re running is both a marathon and a sprint. The baton keeps passing from person to person and from group to group. The objective is to get safe and then stay safe. And that happens only when herd immunity is achieved. And this is a goal we can attain only through equity, not in its absence. Just the other day, someone left a comment on one of my social media posts labeling me a sellout to my community. This person claimed I was enriching myself and had been bought out by corrupt interests to persuade Black people to get vaccinated. I can’t know the person’s motivations for sure, but I know that voice isn’t the majority. So we must persist. The odds are stark. The science is clear. And the history is blunt. But there is cause for vigilant hope.
Dr. Chris T. Pernell
Dr. Chris T. Pernell, MD, MPH, FACPM, is a public health physician and health equity champion. She is a fellow of the American College of Preventive Medicine, the daughter of a father lost to the coronavirus pandemic and the sister of a Covid-19 long hauler. 
