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Vaccine, Massachusetts, Community Progressive Rep. Ayanna Pressley Warns against “vaccine red-lining”

It really is a painfully uh, perfect storm of hurt, and so again we did know early on. You know anecdotally. We saw that with h1n1 and we’ve, seen that with everything, as the old adage goes, when everyone else gets a cold black folks get pneumonia so um that is as literal as it is metaphorical. So you know we could predict how this would play out and that’s. Why, within weeks of the pandemic, myself and senator warren introduced legislation, the equitable data collection act, because we believe that which gets measured gets done and the initial data collection was just age and gender. It did not include racial demographic data and we wanted that data, and so of course, once we had that data being collected disaggregated and reported in real time, it confirmed our worst assumptions and then we were able to use that data to uh prioritize the coordination, the Marshaling of resources in those uh marginalized communities – um, you know african americans, um and and people of color and immigrant communities, and so in keeping up with that. More recently, i’ve been advocating for the collection of anonymized demographic, racial data, around vaccine recipients um because again that which gets measured gets done, and so, as i said in my opener, you know we’ve already seen this sort of vaccine redlining. If you will – and this is another reason why we’ve been asking for um the data – we submitted a letter to the department of health and human services – myself senator warren and senator murphy around that.

But you know you use the word confidence a number of times uh. You know in your opener there, and so i want to pick up on that. You know dr gibbons. Getting a vaccine is an important personal health decision and as a medical professional, but also as a black man. What helped you make the decision uh to get vaccinated. Well, just to be uh accurate in full disclosure. I have not yet gotten vaccinated okay in in part um, because i do not rank uh with the highest risk groups at the current time in the locale, where i am and uh it’s my feeling that i should wait. My turn that those who need the vaccine most should get it first and as you’re aware there are policy guidelines that relate to those on the front lines, particularly health care workers. Those involved in the essential service work that we described earlier that have borne the greatest brunt and risk related to the um pandemic should get it first and then it will proceed uh down in priority order, uh, and so we anticipated. So when it is your turn. Will you get the vaccine absolutely okay and so what’s informing that decision and i’m telling you some people might say? Why am i even asking you this question because you’ve already queued us up with you know that you believe in science right um, you believe in the efficacy of the vaccine, which you’ll speak more to uh in a moment, but i actually have been confronted with many Health care workers um, who have that fear and that skepticism about getting it and they’re in the prioritized group, um and they’re waiting so um.

I make no presumptions here, because you are a believer in science um. So could you just speak a little bit to that return? Will you get the vaccine and why yeah no it’s a great point and uh as you’re you’re, pointing out clearly a very uh data, guided leader that that’s, what the studies are bearing out to date, that there has been that sense of what’s called vaccine hesitancy in Which a number of americans are are even, if asked if a safe and effective virus was available today, would you get it? The proportions have been uh relatively low, and what we’re encouraged by, however, is that the curves of recent uh polling and surveys is on an upward trend. I think uh one of the concerns that the nih and seal had this community engaged in alliance against covet 19 disparities was that there was a lot of misinformation out there related to the vaccine. There were thoughts about um, you know things that could happen and have adverse effects that, quite frankly, were inaccurate, and so an important aspect of our our efforts have been providing authentic, authoritative, uh information, that’s science based and more most importantly, i think the critical part is That we’ve collaborated with trusted messengers who have roots and representation of the communities of color that most adversely affected, and we found that those trusted messengers given trustworthy information and conveying to communities of color, i think, have contributed to a rise in that sense of confidence that, Indeed, this is a process that, despite misinformation, to the contrary, was not rushed and that it was expedited based on uh technology advances that have happened over the last decade.

As you pointed out, this isn’t the first time that the the enterprise been faced with a novel coronavirus. It happened around 2001 happened again 2011., so this latest version, uh we’ve learned from previous ones and technology, has enabled scientists to develop a vaccine and develop it in record time. It then has gone through all the rigorous checks and balances of any therapeutic agent to ensure that it’s, safe and effective, we were monitoring all those trials, as they’ve played out over the last year involved. The nih, indeed with the nih director, tony fauci and others we’ve, been surveying all those trials all along to ensure uh that number one for this audience, that they’re inclusive that indeed they that the participants reflected america – and i might say that, if left spontaneously, uh that The hope that those trials would be inclusive uh, they would not have been that took a lot of leaning in efforts like yours to to really make the case demand what you were doing publicly. We were doing uh privately and working with all the study trials. Some of which we fund to ensure that the participants in these trials uh included black and brown folks and for the most part, most of the vaccine trials hovered around 20 25 percent of latino and african american, and so that was successful. I think that’s critical to the confidence, because if, if i was your doctor, congresswoman presley and i write you a prescription any prescription, i want to be able to look you in the eye and say i know this will be effective in you because it was tested In individuals who were just like you and it was shown to be safe and effective, i believe we can say that related to the vaccine trials.

Similarly, you should be aware of that. Those trials were done and assessed by independent review boards data safety monitoring boards, whose job it is to look solely at safety as well as efficacy, and i may also say that that’s part of the job of the food and drug administration to oversee that. As your audience know – and i know you know, and it should be noted that there was representation on those advisory boards. I a good colleague friend of mine, dr hildreth uh, is a member of that advisory panel they’re, the ones who make the independent judgment, they’re nonpartisan non political. They go with the science and they confirmed um, and he confirmed as an african american clinician scientist that the data uh was compelling safe and effective and inclusive of communities of color that’s. What gives me confidence that’s? What gives me uh joy that actually, my sister who lives in boston and who is at risk, has been vaccinated, uh and that’s? What i would encourage all of us to do the data is now quite clear. There have been tens of millions of americans now vaccinated and again it is validated that this is safe and effective. Thank you doctor for speaking to the efficacy and and how it was developed and uh and and just speaking, to the power of representation um that when we have people in these positions, such as yourself um, and that they are uh sounding you know the alarm.

If you will about you know what will happen if we do not do this um, you know it has an impact. It makes a difference and so um, because you made sure that there was a diverse representation in those trials and then also we’re speaking early on about the need for there to be an investment in uh education and um awareness, and that we invest in um and Partner with those trusted community voices um, so it is not or it’s, and it is not just about access. It is also about uh cultural competency and language access and information justice. It is also about uh trusted messengers, um, and so to that end i would just say that um from the beginning, i’ve been fighting for once a vaccine was developed and made available that it be equitably distributed and that we prioritize um incarcerated men and women because In the same way that we are prioritizing um nursing homes, because these are a congregant facilities, um, where it is uh very, very challenging to uh to socially distance, they are sensibly petri dishes for a virus like this to thrive, and sadly, we have seen that happen. Behind the wall, so i was pushing you know early on for those uh behind the wall and nursing homes and and our elderly and our essential workers, and that includes everyone from uh custodians and hospitals to health care workers to grocery store clerks to postal workers and Letter carriers um, you know to to our educators, um now uh, one group that i had not considered in that and so i’ll be fully transparent.

As a black woman who does have a two pre existing conditions, uh was myself. I certainly had not considered myself a priority um in this. What happened for members is that we were confronted about the need for continuity of government that we were all going to have to come together to keep the government going uh not remotely, but in person. Of course, this was days before the the insurrection um in order to elect a new speaker of the house and to vote on vote on the rules package, which meant that 400, and you know 36 of us uh would be in the house chamber uh at a At a minimum um to do the business of the people and, of course, we’ve seen 10 percent of members who have tested positive. We are high risk because we travel we’re on airplanes, frequently um and then in order for us to do our work. Although we’ve tried as much as possible to operate in a way that is hybrid or entirely remote, um that there is a greater risk, and so i would advise everyone to one make sure you’re getting the most accurate information because, dr gibbons, you know your right to Point out the misinformation that has been you know: circulating um online, so talk to those trusted, um advisors and for me that begins with the medical professionals in your life. And so i had a conversation um with my primary care, physician, um and again, because i do have two pre existing conditions, um and because of the nature of the work that i do, i made the decision that i would get the vaccine.

So i was struggling with a lot in terms of whether or not i was worthy of getting it, but also i i did admittedly have my own fear and skepticism because of a history of medical, apartheid, um and um, the violation of trust um by the medical Community, you know on to the black community and so i’m not exempt from that, even though i work hard to combat it for others um. So i had to you know, get over that myself, but when i had the opportunity to be vaccinated and with the advice and counsel of my uh primary doctor and the house attending physician a conversation uh with my family, i decided the best thing for me to Do to protect myself, my family and all those that i am in proximity uh to and my community uh was to get vaccinated so um, you know that’s my own situation now dr gibbons um as the director of the national heart, lung and blood institute, you’re well Acquainted with the health disparities that black and brown communities have faced long before covet, including in the massachusetts seven congressional district, which i represent, we’ve seen very stark disparities. They certainly been exacerbated in the last four years, uh compounded by the last year in particular, but they’ve existed for a long time in a three mile radius in my district from cambridge to roxbury, life expectancy drops by 30 years. So, unfortunately, it’s really no surprise that this pandemic has disproportionately impacted communities of color.

So, dr gibbons, you spoke about a little a little bit to this um in some of your previous comments. But could you speak more pointedly to the comorbidities and underlying health disparities that have exacerbated the colbit 19 crisis in communities of color? You know you make several great points. There um, as you uh indicated this. This concept that you described as quite eloquently about redlining is that we actually have funded research that has been able to track individuals over time decades in our longitudinal. What called cohort studies like the jackson, heart studies, the largest cardiovascular epidemiologic study in the country it’s? Actually, in jackson, mississippi uh, all african americans uh in in the boston area, framingham heart study, many people are familiar with since 1948 – has helped us understand the trajectory of cardiovascular disease. One of the elements that may surprise your audience is that there was a study that showed that those who lived in racially segregated neighborhoods uh during their uh childhood uh and adolescence and young adulthood. If they remained in a racially segregated neighborhood. They were more likely to have a higher blood pressure than those who started in a racially segregated neighborhood, but then moved to an integrated, uh, neighborhood, afterward uh. And so there are things that uh are the antecedents of heart disease and strokes, that people think of in elderly or or middle aged adults. It starts very early and it relates to the exposures and your access to a healthy lifestyle.

And so we know that if you eat a diet rich in fresh fruits and vegetables, literally your blood pressure low will be lower. We actually uh did a study called the dash diet that demonstrate that you’re very well aware that access to fresh fruits and vegetables is not the same in every neighborhood. Just as an anecdote i used to to live in rochester dorchester areas. Many years ago, when i was a medical student – and i still remember that i would always shop at the supermarket near the medical school before i went home to rochester to roxbury dorchester area, because they didn’t have supermarkets with as much uh produce access and variety. In those neighborhoods now, hopefully, things have changed over the last 20 years, but those are the realities and those relate to historical structural differences in these neighborhoods that, if you then compound to that diminished, access to health care and other quality elements of life that promote a Long and healthy life, you see the the causes of these health inequities begin earlier and have these social determinants and structural factors that also uh drive them. This is important not only in understanding things beyond covid, but even we look at the response to covet. We have to be really mindful that, when we think about vaccines or or access to any benefit that we should be sure that we don’t get caught up in those same structural barriers that have hindered uh, very good health up until covent 19.

. So that’s, really where there may be an opportunity and we’d love your support to say what can we learn from this pandemic and our response to it that will really address the underlying health inequities and build the resilience of those communities such that the next time? There’S.

What do you think?

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