Building Trust in COVID-19 Vaccines and Beyond Through Authentic Community Investment

• Published in: American journal of public health (1971) Vol. 111; no. 3; pp. 366 - 368
• Main Authors: Ojikutu, Bisola O, Stephenson, Kathyrn E, Mayer, Kenneth H, Emmons, Karen M
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01.03.2021
• Subjects: 21st century; Beliefs; Candidates; Clinical trials; Community; Community Health; Community involvement; Community participation; Community planning; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 vaccines; COVID-19 Vaccines - administration & dosage; Cultural change; Cultural Diversity; Cultural groups; Cultural values; Discrimination; Drug Development - organization & administration; Drug Development - standards; Editorials; Enrollments; Ethnicity; Experimentation; Experiments; Government industry relations; Group norms; Health behavior; Health Communication - methods; Health risks; Humans; Immunization; Immunization/Vaccines; Indigenous peoples; Intervention; Language attitudes; Medical research; Medicine; mRNA; Multiculturalism & pluralism; Norms; Opinions, Ideas, & Practice; Other Race/Ethnicity; Ownership; Pandemics; Political campaigns; Prevention; Public health; Racism; Recruitment; Research methodology; Research methods; SARS-CoV-2; Sustainability; Systemic racism; Trust; Vaccine development; Vaccines; United States > US
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2020.306087

COVID-19 vaccine development has advanced at lighting speed. Research that would normally require years has been completed in months. As a result of this unprecedented effort, two vaccine candidates, mRNA-1273 (Moderna, Cambridge, MA) and BNT162b2 (Pfizer, New York, NY), have been found to be safe and more than 90% effective in preventing symptomatic COVID-19 shortly after vaccination. These vaccines are extremely promising and will eventually be distributed widely. Unfortunately, as the science of vaccine development has swiftly progressed, the equally important science of community engagement, which should guide the establishment of mutually beneficial partnerships and promote eventual vaccine uptake, has lagged behind. Research methods focused on the development of effective public health interventions place communities- groups with shared culture, norms, beliefs, or language-at their core and emphasize the primacy of community ownership as essential for uptake and sustainability.1 Yet, communities of color (i.e., Black, Latinx, and Indigenous communities), who remain at highest risk for infection, have been peripheral, not central actors in the pursuit of COVID-19 vaccines. Instead, the tripartite relationship between industry, government, and academia has dominated the research enterprise related to COVID-19.The peripheral position of community has been evident since early in vaccine development. Notably, initial trial recruitment consisted of short-term community outreach, and more detailed plans for longer-term community engagement to support enrollment and eventual vaccine uptake commenced late in phase III trials. Such a critical oversight may be the Achilles' heel of this unprecedented effort. Deeply rooted mistrust bred by centuries of well-documented, abusive medical experimentation and ongoing structural racism impedes racially and ethnically diverse individuals' participation in clinical trials and threatens the uptake of future COVID-19 vaccines, particularly among Black individuals.