“Yes [the vaccine] he came out today, I wouldn’t take it, “said Lonzo Bullie, a 26-year-old retired school principal who called in Tuskegee, Alabama,” I’m still reluctant … because I don’t have enough information. “
The two FDA-authorized COVID-19 vaccines are more than 95% effective in preventing symptomatic disease and the reported side effects are minor. Trials, which included more than 30,000 volunteers each, showed that vaccines work just as well among people of all races and ethnicities.
But Bullie, who is also president of the NAACP’s Tuskegee-Macon County branch, said skepticism about the vaccine within the African-American community stems from the “history of the U.S. government he experienced about people. black ”and years of“ mistreatment ”.
Tuskegee, where Bullie resides, is the zero point for the infamous study of syphilis in the 1930s. The U.S. public health study at the Tuskegee Institute, which recruited 600 black men, aimed to record natural progression. of syphilis infection, but the researchers did not inform participants or request their consent. The study lasted 40 years and left an indelible mark on the black community.
Residents in rural communities of color not only have widespread distrust of vaccines and the health care system, but face multiple barriers as vaccine distribution begins, including lack of accessibility to medical facilities.
Nearly one in four Alabama residents (24.1%) is black or Latino, according to the 2018 American Community Survey.
Mona Fouad, director of the University of Alabama at the Birmingham Health and Minority Health Research Center (Birmingham).
“Tuskegee came back again and again, to all the groups we were talking about,” Fouad told ABC News. “People started remembering Tuskegee.”
He said that before the pandemic, outreach groups were gaining strength with the “overcoming” of distrust of the health system of communities of color, but now COVID-19 “put the nerve back on Tuskegee.”
“We learned that distrust stems from a lack of information and transparency,” Fouad said.
In a statement provided to ABC News, the Alabama Department of Public Health said, “ADPH has addressed access to testing in rural and color communities by working with partners such as historically black colleges and universities, communities of faith and housing authorities “. in an effort to combat discomfort from a COVID-19 vaccine.
However, advocates and local leaders said more inclusion and transparency will be needed to increase the participation of communities of color.
“As we see more people taking it, people of color, in particular, taking the vaccine, people will be more fit to [taking it]said Benard Simelton, president of the NAACP Alabama State Conference.
He also added that explaining the “technical aspects” and providing a clearer public message about the vaccine will help people living in rural communities understand it better. In addition, diverse messaging is needed to ensure that all communities understand the information.
According to Ana Espino, executive director of the Alabama Coalition for Immigrant Justice, language also presents a huge barrier to accessing COVID tests, because people “don’t have the information distributed in any language other than be English “.
It is important to involve local community leaders in rural Alabama to ensure the safety of the vaccine and explain it in a way that people can relate to.
“The key is to develop this factor of trust in the community,” he added.
Distrust is not the only challenge of providing vaccines to rural communities
In some areas of rural America, vaccine delivery will encounter unique health barriers, including understaffed clinics, lack of refrigerated storage units for vaccines, and hard-to-reach residents living miles from major hospitals. , experts say. State public health systems, which are already over-extended due to the pandemic, will be responsible for ensuring daily delivery and accessibility for rural residents.
Geographic isolation and labor shortages in hospitals in rural America add to the burden of providing vaccination.
According to a 2018 Pew Research Center survey, rural Americans live an average of 16 miles from the nearest hospital and among a quarter of rural Americans who travel the longest to reach a care center sharp, the average travel time is 34 minutes by car.
“Access to hospitals is difficult, because you have people who don’t have transportation or don’t have reliable transportation, distance is definitely a barrier,” Espino said. “In rural Alabama, blacks and browns will really struggle with accessibility.”
According to the Health Services and Resources Administration, 64.6% of rural Alabama counties are considered “areas of shortage of health professionals,” who do not have enough primary care, health, and mental health providers to serve residents. In addition, 55.7% of Alabama’s rural population does not have adequate health care services, HRSA said.
When the vaccine is available to the general public, people living in rural communities will have to travel long distances to access larger hospitals in cities where doses can be properly stored in refrigerated units, Simelton said.
“There’s an important part of the community that won’t be able to get the vaccine they want,” Simelton said. “We have to make it available in large enough quantities for everyone in the community to take.”
And in places like rural Alabama, the burden of providing vaccines in the midst of a pandemic is already taking its toll.
At a Dec. 16 briefing, Army General Gustave Perna, the COO of Operation Warp Speed, the Trump administration’s program to accelerate the deployment of the vaccine, described minor setbacks with the delivery. in Alabama, even when the vaccine shipments arrived, but they had been stored at the wrong temperature.
Since the impact of storing the vaccine at the wrong temperature is unclear, the vials were not used and sent back to Pfizer.
“When COVID came along, I felt we had been pushed for two more decades,” Fouad said.[COVID] it impacted much more than anyone on our rural and poor communities in our cities. “
Addressing vaccine access disparities for rural communities, the Alabama Department of Public Health “works with rural health clinics, federally qualified health care centers, county health departments and other providers to provide access to statewide COVID-19 vaccines “. according to a statement provided by the chief medical officer, Mary G. McIntyre.
Fouad said the lessons learned from state oversight during COVID with limited access to evidence and few quarantine options for underserved rural communities served as a “continuum” to inform decision-making by leaders. of public health on the deployment of vaccines.
“Now that the vaccine is over, we don’t want to make the same mistakes,” he added.
Mark Nichols of ABC News contributed to this report.