The New York Times
A hospital encounters vaccination hesitation: ‘I’m not in a hurry’
NEW YORK – When it was Rev. Al Sharpton’s turn to get vaccinated against COVID-19 last month, he did it on camera at NYC Health + Hospitals / Harlem – a city institution known for providing healthcare to the black community. Sharpton was trying to send a message to his community: the vaccine is safe and effective. But that message was also addressed to the hospital staff. At a certain point, the unit’s team had the lowest vaccination rate among hospitals in the city. Even after steady improvement, as of mid-March, the hospital still had a rate well below the average for hospitals in the state. Subscribe to the New York Times newsletter The Morning. In the state of New York, African Americans represent about 17% of the adult population, but received only 10% of the injections. This is because of difficulties in accessing the injections, but also because of a persistent reluctance – and this rang true at Harlem Hospital, where the majority of the team is black, administrators said. The situation at Harlem Hospital underscores how ingrained this mistrust may be: even employees at a hospital where the vaccine is readily available are afraid of being inoculated. But it also shows how it is possible to move forward in changing attitudes towards vaccines, albeit slowly. At Harlem Hospital and nationally, confidence in vaccines has increased among black Americans. Recent research shows that black Americans, while initially more skeptical, are now just as likely to want to be vaccinated as white Americans, and that politics, not race, is emerging as a larger divide. Republicans are now the group with the highest degree of skepticism: in a CBS News poll in late February, 34% of Republicans said they would not be vaccinated against COVID-19, compared with 10% of Democrats. Brasil Rice, 54, who has worked at Harlem Hospital for 21 years in cleaning and maintenance, was one of those who said they would wait. “It has not been properly tested in the field,” he said. “It usually takes years to test a vaccine in the field.” He emphasized that his distrust had nothing to do with the hospital, which made vaccination “quite convenient”. “I have every intention of doing it; I’m not in a hurry, ”he said. And when the runners are quiet on the night shift, he keeps an eye on the friend who was vaccinated and so far is fine, he said. Harlem Hospital’s low vaccination rate did not surprise its leaders. Research at the institution in late 2020, before vaccines were approved, showed that only 30% of workers were willing to be vaccinated, said Eboné Carrington, the hospital’s executive director. Black workers cited concerns rooted in the legacy of medical injustices such as the Tuskegee experiment, a United States government study that suspended syphilis treatment for black men, and general skepticism about a vaccine developed rapidly under presidential administration. that they didn’t trust. “The team reflects a population of people who traditionally are reluctant to vaccinate, and not only hesitate, but are afraid of being wronged,” she said. The hospital is known as a historic training ground for black medical staff and for saving the life of Rev. Dr. Martin Luther King Jr. after a woman suddenly stabbed him in the chest in 1958 in a Harlem department store. Attracted by its prominence, local celebrities are being vaccinated there. Neil deGrasse Tyson, the astrophysicist, posted on Twitter about his recent inoculation at the hospital. “If we can inspire people, as we have countless times, to protest against certain social ills, I hope that we can inspire them to do whatever is necessary to have a healthy environment in our community,” Sharpton said in an interview about his vaccination. Keisha Wisdom, head of nursing at Harlem Hospital who spent time in an intensive care unit in 2020 after contracting the coronavirus, also released her injection. “I think the history of medical experimentation on black people plays a role in some of the decision-making,” said Wisdom of why about half of his nursing staff remained unvaccinated. “It is real and it is something we have to talk about. And then find a way to continue that dialogue. ”The first weeks of the vaccine’s launch saw widespread hesitation among hospital staff across the country and in the state of New York, with less than half of eligible workers vaccinated in early January. In public hospitals in the city, the number was even lower, 31%. This drew the ire of Governor Andrew Cuomo. “This is a management issue for hospitals,” he said at a news conference on January 4. Although vaccination rates at other hospitals have improved, Harlem Hospital was among those left behind. In late January, Cuomo repeatedly highlighted the institution in press conferences for having the lowest rate in the city, 37%. The approach angered Carrington, who felt she was being punished for having a black and brown team, whose concerns she was trying to resolve. Her mother called to express concern when she heard the governor’s harsh words. “Mom, I don’t care,” Carrington said that she told her. Harlem Hospital has been trying to increase the fee with a “publicity campaign” that includes advertising, city halls and individual conversations. His current vaccination rate among employees, 51%, puts him in the “middle” of 11 public hospitals in the city, the city said, but still well below the average vaccination rate of almost 80% for hospitals in the state of Nova. York as a whole. Some nurses told their supervisors that they did not feel an urgent need to get the vaccine because they already had COVID-19, Wisdom said. The hospital was hit hard by the virus, with about 200 patient deaths from March to September. The lethality rate was 36.6%, one of the highest in the city, according to hospital data released to the state. There is now no shortage of personal protective equipment, so some employees said they felt safer. “Employees are saying, ‘I almost died on the first wave, I’m fine,'” said Carrington. “There is this invincibility that it is difficult for me to make up for.” Dr. Mitchell Katz, executive director of the city’s public hospital system, said last month that about 40% of nurses in the city’s public hospitals have not been vaccinated. But instead of expressing alarm, he said he was willing to be patient in the coming months and focus on personal reach, like individual conversations, to increase the rate. Extra resources did not flood Harlem Hospital after Cuomo’s criticism, nor did Katz attempt to scold Carrington. Katz said he was not tracking hospital vaccination rates because he believed the rate was not a management issue, but related to the percentage of black and brown employees in each institution. “For me, there are very understandable reasons why people might not want to be vaccinated yet,” he said, citing the lack of long-term studies on COVID vaccines and the negative experiences that many black and brown New Yorkers have had with doctors. “I find it surprising that so many people are surprised.” Jasmine Travers, an assistant professor at Rory Meyers College of Nursing at New York University, who studies vaccine hesitation, said empathizing with the team’s reluctance was a good start, but not enough. The goal, she said, should be 70% to 80% adherence and a determined effort by the leadership to get there. “We must not simply attribute a refusal to that person’s wishes; we also need to examine ourselves and understand how we’re addressing this, ”she said. “We can’t get around the issue on tiptoes. It is one thing to want to be respectful, but we have to ask people about how we can better support them. What work needs to be done? ”Warren Davis, 54, a carrier at Harlem Hospital, was among those who overcame his concerns and made an appointment for a vaccine in late February. Davis believes he had the coronavirus in May, but it was never tested. He said he is concerned about the vaccine’s short and long-term side effects. He also heard a variety of conspiracy theories, including that the vaccine was designed to injure blacks, and for a time, he said, he was caught by them. So he reconsidered. “Many people are receptive to the bullshit they are hearing, the rhetoric that people are telling them,” he said. Sharpton said he had heard this conspiracy theory and many others. He advises leaders to take up such ideas directly, he said, because the vaccine is necessary to keep people safe. “When you see all these white people lining up to get the vaccine, do you really think they are sacrificing all these people just to kill some of us?” he said. “When are we the ones who don’t have access?” This article was originally published in The New York Times. © 2021 The New York Times Company