The Promise of Community Collaboration
The pandemic has exposed racial and ethnic disparities, but has also demonstrated how community level partnership, access to quality information and good communication can quickly bolster vaccine rates.
African descendants in Latin America have been disproportionately affected by the pandemic, due to factors such as limited access to quality health care and related co-morbidities, on the job exposure, and living in dense urban areas. The relationship between Afro-descendants and the medical system is complex. This complexity must be considered when thinking about COVID-19 and the vaccination process.
What does the data tell us?
Initial reports demonstrated a troubling COVID-19 incidence rate gap, with African descendants overrepresented in mortality and hospitalization rates. Over time that gap has been illusive to track as reporting by race remains inconsistent and low. Even in the U.S. only 60% of current cases of COVID include reporting on race and/or ethnicity, the racial reporting rate in Brazil is similar and racial data collection remains a challenge for health care systems throughout Latin America.
Sometimes this lack of reporting is a conscious choice. African descendants are less likely to self-report their race if it is seen as a disadvantage that may lead to lower quality health care due to racial or ethnic discrimination. Targeting geographical communities with high African descendant populations may be a promising approach to better understand the nature of the pandemic and where potential pockets of risk and vaccinee hesitancy persist.
Trust: Doctors and Targeted Messaging
Despite governments outlining differentiated COVID-19 response policies, African descendants have largely accessed only public information campaigns on COVID-19 with limited tailoring or adaptation to specific African descendant communities. In the cases where messages have been targeted, these have been led by local community campaigns, which have been effective.
When community efforts are coupled with direct access to the vaccinee, vaccination rates have increased. When these messages are provided by trusted medical sources, such as black doctors, vaccination rates have increased quickly through these coordinated responses with local communities.
The ability to trust is very important particularly because African descendants are more likely to have health backgrounds which make them vulnerable to the most negative outcomes from COVID-19. They also make them more likely to have side-effects from the vaccines. Access to follow-up care and good medical counsel is important because African descendants may require more intense management of vaccinee side effects and closer monitoring of their symptoms.
Having doctors that listen and serve as role models is a factor for good health outcomes and increases the willingness to vaccinate. Knowing that trusted medical professionals have taken the vaccination has an important impact on the willingness to vaccinate in African descendant communities.
Timing. When can you go? Who can go with you? Which vaccine is being offered when you go?
Timing and when vaccines are made available is key. Are vaccines being administered at convenient times that offer a variety of option for workers and caregivers? Do vaccinees impose a transportation burden, or are they also being offered in local communities?
A recent survey demonstrates that more than half of African Americans expressed concern about missing work to get a vaccine. Are employers providing time off from work, or time off to manage side effects? Having a trusted relative, friend or neighbor go to the vaccination center increases vaccinee acceptance rates. Local community level vaccine centers can provide additional reassurances, however low-income black communities in Latin America have less access to vaccines as a proportion of their share of the population. The reality is that vaccinees are still widely unable to African descendants despite their interest in being vaccinated.
Testing and flagging hot spots
Information on hot spots seems to be a very effective tool for understanding of the status of the virus and vaccine — recent progress in the U.S. to close vaccination gaps has been based on information regarding trends. Knowing where hot spots are and wanting to protect based on real data to assess potential risk is a highly effective tool and encourages vulnerable individuals to get vaccinated.
The African descendent response to COVID-19 vaccines varies but is fundamentally strengthened when communities actively participate. Avoiding community transmission and decreasing hotspots are excellent motivators for community-level coordination on vaccines. However, perhaps one of the most challenging barriers in the region continues to be the lack of access and targeted approaches to information sharing on the availability of vaccinees and health.
Campaigns targeting African descendants are fundamental for making sure that all members of society are protected. The willingness of local communities to contribute to the pandemic response is an important policy advance.
The promotion of equity and inclusion of diversity is a fundamental cornerstone of our 2025 Vision “Reinvest in the Americas” at the IDB. In our mission to improve lives, we strive to have an operational portfolio and knowledge products that include all the diverse populations in the region.
Want to learn more about equity and transparence in vaccine distribution?Follow “The Vaccine and me” series in our blog and: