Beyond Tuskegee — Vaccine Distrust and Everyday Racism Bajaj, Simar Singh; Stanford, Fatima Cody
New England journal of medicine/The New England journal of medicine,
02/2021, Letnik:
384, Številka:
5
Journal Article
Recenzirano
Odprti dostop
When we hyperfocus on a few historical racist atrocities, we ascribe current Black health experiences to past racism, rooting our present in immovable past events and undermining efforts to combat ...mistrust. Everyday racism, by contrast, can be tackled in the present.
COVID-19 outcome disparities are rapidly becoming apparent for people with obesity and multiple black, Asian, and minority ethnic (BAME) groups. Researchers have reported differences in COVID-19 ...hospitalization and mortality rates by race/ethnicity in the United Kingdom (UK) 1, 2 and United States (US) 3, 4. Numerous minority ethnic groups in these countries live with a greater burden of obesity and other chronic diseases. This is particularly significant as obesity has emerged as a risk factor for severe COVID-19, the disease caused by novel coronavirus SARS-CoV-2 3, 5. We synthesize a range of potential biological, socioeconomic, behavioral, and sociological contributors to the disparate outcomes for people with obesity and minority ethnic groups in COVID-19.
•1.5-inch needles are recommended to immunize patients with obesity.•Inappropriate needle length may decrease vaccine efficacy against COVID-19.•Differential vaccine efficacy could widen health ...disparities among high-risk groups.•Strategies should be employed to ensure proper vaccine administration.
Researchers have speculated that vaccines to prevent coronavirus disease 2019 (COVID‐19) may be less effective for individuals with obesity, a major risk factor for mortality and morbidity from ...COVID‐19. Initial results from the Pfizer‐BioNTech and Moderna COVID‐19 vaccine trials, though limited by inadequate power to compare subgroups and incomplete stratification of high‐risk groups, appear to have similar efficacy among individuals with and without obesity. Careful follow‐up in placebo‐controlled studies is required to generate data on long‐term vaccine immunogenicity, particularly in high‐risk groups. Subsequent analyses should stratify safety and efficacy results by each class of obesity. Speculation about variable effectiveness of COVID‐19 vaccines in obesity likely increases vaccine hesitancy among individuals with obesity, who face not only a higher risk of severe outcomes from COVID‐19 but also weight stigma, which reduces health care engagement at baseline. Clinical and public health messaging must be data driven, transparent, and sensitive to these biological and sociological vulnerabilities.
War has catastrophic impacts on human health, but the risks facing those fleeing violence are made all the more dangerous when compounded by racism, say Simar S Bajaj and Fatima Cody Stanford
FatCamera/Getty Images A paucity of Black women in academic leadership and medicine not only limits the role models students can take inspiration from but may also contribute to inadequate care for ...Black patients, particularly given the importance of racial and gender concordance in health care. ...if they do speak up about inequities, advocate for reform, or seek to advance institutional diversity, these physicians can be caricatured as just another angry Black woman and dismissed as being unreasonable and melodramatic. At New York University School of Medicine, Uché Blackstock resigned due to a perceived inhospitable environment for Black trainees seeking professional mentorship and for Black faculty seeking promotion. ...the National Institute of Health's Faculty Institutional Recruitment for Sustainable Transformation programme is a career-development initiative that fosters cultures of inclusive excellence through the hiring and retention of diverse faculty, integrated systems to address bias, and the development of a Data Coordination and Evaluation Center for the evaluation and measurement of systemic cultural change.
...the language of recruitmentology has assumed a scientific posture, with a growing body of studies trying to determine the most efficient means of recruiting marginalised groups to participate in ...the research. ...in clinical studies and census research, Middle Eastern and north African (MENA) communities have traditionally been overlooked as a distinct category from White communities. ...there is little understanding of MENA communities’ unique demographic characteristics, and racial data are skewed in this void. In The Gambia, for instance, a pilot in a malaria treatment trial featured videos and audio narratives in the three major local languages. Since subaltern communities have long been exploited to satisfy demographic checkboxes, continued interrogation and creative revisions to consent processes are prerequisites to producing greater trust and equity in biomedical research.
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