Trust and transportation may be keeping some Gulf coast residents from a COVID shot

Mar 4, 2021

An APR news feature

Trust and transportation keeping some Gulf coast residents from a COVID-19 shot COVID-19 rates are falling in Alabama and across the country. Still, state health officials are looking at statistics that show only 13 percent of Alabamians have been vaccinated. Healthcare providers remain worried about apparent reluctance to get a coronavirus shot.

Crowds line up at most vaccination clinics on the Gulf Coast. For all the people waiting in cars or auditorium seats, thousands more eligible recipients appear toi be staying away. Police, firefighters and members of minority communities have low vaccination rates in many communities in the Mobile Bay area. Some police departments report rates as low as one in five getting a shot.

“Law enforcement has had low uptake of vaccine, minority groups and people who live in rural areas, we don’t have a lot of vaccine right now and it requires people driving to a location to get it and so transportation is a barrier,” said Dr. Rendi Murphree, an epidemiologist with the Mobile County Health Department.

Dr. Rendi Murphree
Credit Mobile County Department of Health

“This is an extremely challenging time on all fronts,” Murphree said. “We’re just coming off historic high numbers of cases and hospitalizations. People are tired of COVID. They’re ready for things to get back to normal. There is reluctance among some groups. Even health care workers sometimes are reluctant to receive a new vaccine even though they are at greatest risk of contracting COVID because of the work that they do. There are known health disparities with people of color and low income and rural areas. These are only amplified during a pandemic. It’s certainly an issue for all health related issues like I said, not just COVID.”

Dr. Errol Crook is chairman of the Department of Internal Medicine at the USA Health College of Medicine. He’s also one of the authors of a study in the effects of COVID-19 on the area’s minority community.

“I think there are lots of individuals both locally as well as nationally and quite frankly internationally who have some frustrations around the vaccine and those are the people who want the vaccine right away,” Crook said. “And then there are others and I think in large part in the communities on which we focused where there are concerns about the vaccine. Their concerns are multiple. I think could be summed up best by saying about really issues around trust. Trust in the safety of the vaccine. Trust in something now that’s really had a government backing and support. Many of the individuals don’t have the trust in that government to do well on their behalf. So trust in whether or not that’s something that’s been developed that’s going to be in their best interests. Trust in whether or there’s a health care system that’s going to distribute it equitably to them. Trust in whether or not the public health services we have will be able to prioritize those individuals equally with others.”

Dr. Erroll Crook
Credit University of South Alabama

“When we spoke to people, they told us of very practical problems,” said Dr. Martha Arrieta, Director of Research, Center for Healthy Communities, University of South Alabama, was another author of the study.

“They told us there is financial issues,” Arrieta said. “There are food problems. There is this lack of technology that affects us all and then the social network is so disrupted.”

Arrieta said COVID has hit lower income communities hard. Residents have been cut off from support networks while losing income. Many also have to educate and care for children at home as schools close. Arrieta says another big issue is transportation.

“Even when with testing, there were actually walk-in places within the community that were set up by our federally qualified health centers, they explained to us that some people may, even if they are in the community, still, they are not able to walk in. For them, they are too are away,” Arrietta said.

Dr. Martha Arrieta
Credit University of South Alabama

“I think that’s one of the things that we need to strive for, to actually bring vaccination very deep into the community,” she said. “We may not realize how much of a limit our limitation of transportation is for people. And so that’s one thing that I think we could also strive for in our vaccine efforts.”

Trust is a major challenge to convincing people to take a vaccine.

“There is always the issue of trust and so what’s going to take to escalate that wall, that trust, that mistrust between the healthcare system and the community,” Arrieta said. “I believe there is no simple answer to that.”

When it comes to medical research and minority communities, some residents bring up examples like the Tuskegee Experiment. From 1932 to 1972, close to four hundred Black men with syphilis were not treated. Researchers wanted to study how the disease progressed.

“I was a student at Tuskegee when the ramifications of the Tuskegee came about in the middle 80s,” Sandra Conley-Edwards said.

The impact of the Tuskegee experiment is no theory to Conley-Edwards. She understands the reluctance.

“I’m also a former occupational therapist in addition to being a person of color and a person with a disability, so all of those things made me understand that it was important that people of color be included in any sorts of research in terms of diseases and that sort of thing,” she said.

Credit Pixabay

Conley-Edwards tells people how medical research helped her deal with her orthopedic disabilities. She volunteered to take part in COVID-19 research early in 2020.

“I’m starting to hear about COVID. In the meantime, after that I actually became a part of a clinical study on purpose on COVID, I initially had the placebo, but again, because of my background, I understood the importance of medical research and including all types of groups and so that’s part of why I became a part of it,” Conley-Edwards said.

She said personal communication is one key to convincing people of the importance of trusting the medical community.

“I hear a lot in terms of people being uncomfortable with medical experimentation, particularly in communities of people of color,” Conley-Edwards said. “So the question is how can I trust now when there’s been this history of distrust and I think what it’s really going to come down to is people being willing to tell their story. And so, that’s one of the things that I tell them when people talk about the Tuskegee Experiment, I bring my own experience into it in addition to letting them know that I’m part of the current clinical trial for COVID.”

Health officials are also working to build trust, including Dr. Rendi Murphree.

“We are working with faith-based leaders to reduce stigma and improve understanding. We’re trying to work with people of color, leaders in minority groups to help us educate and inform and try to improve vaccine uptake in populations that are largely minority,” Murphree said.

She said protection, whether through vaccines or other precautions, is vital for everyone.

“This is an unprecedented event in our lifetime, the COVID 19 pandemic and we need to be using very tool in our arsenal to try to prevent infection and those tools are covering your mouth and nose, staying at home if you’re sick, distancing yourself from others, getting tested and getting vaccine as soon as you can get it. Please, we just need everyone to do their part and help us protect our community, because it’s going to take all of us doing the right things together,” Murphree said.