The coronavirus pandemic has hit disproportionately hard in Black and Hispanic communities, where infection rates and death rates have reached staggering levels.
But as scientists race to develop vaccines against the SARS-CoV-2 virus and treatments for the COVID-19 disease it causes, many trials are struggling to enroll people from those very communities.
Government and private sector scientists trying to enroll tens of thousands of Americans in a handful of studies of potential coronavirus vaccines are working overtime to reach out to underrepresented communities. But they have reported running up against rumors and misinformation in minority communities in places like Seattle and New York City, where mistrust remains deeply rooted.
That mistrust comes from America’s long history of discrimination against minority groups, some of whom have been used as human guinea pigs for sadistic experiments.
The U.S. Public Health Service denied treatment to 600 Black men who had syphilis, even after penicillin became a widely available treatment, in the gruesome Tuskegee experiments. Native Americans were forced to undergo sterilization procedures, and some were used to test dangerous new pharmaceuticals.
To many, that history is all too recent. Surveys conducted by the Pew Research Center and the Robert Wood Johnson Foundation in recent years have found both Black Americans and Native Americans are less trusting of medical doctors than are whites.
“There are countless examples that all get pushed into a general well-founded feeling that when people are coming to do experiments or trials in Black communities, maybe there’s an ulterior motive,” said Prabhjot Singh, a health systems expert at the Arnold Institute of Global Health.
Enrolling a diverse set of patients and volunteers in trials is both a scientific and cultural imperative, said some of those involved in designing trials today.
On the scientific side, so little is known about the way the coronavirus attacks the body and the way COVID-19 manifests that diversity — in age groups, ethnic groups and even socioeconomic status — is necessary to learn who is at risk of serious or severe symptoms.
Some diseases strike certain ethnic groups more than others. People of African descent, Hispanic descent and Middle Eastern descent are more likely to be impacted by sickle cell disease. Some cardiovascular drugs are less effective in people of Asian descent than in those of European origin.
Studies that include a diverse range of people can identify whether a vaccine would have different safety and efficacy profiles among different racial or ethnic groups. The goal, scientists said, is to develop treatments that work for everyone, even if that means different groups respond better to one treatment over another.
“Having a clear representation of different minorities in these trials, you can ensure a vaccine is working across populations,” said Alejandro Cané, head of Vaccines Medical and Scientific Affairs at Pfizer.
On the cultural side, enrolling a diverse range of people during the trial phase can lead to a broader acceptance once a vaccine or treatment is approved and becomes widely used.
“There is an element