COVID-19 Vaccine and African Americans
By Cindy George
For the last six years, vaccine scientist Dr. Kizzmekia Corbett has been working on the best and safest immune response for coronaviruses as part of a pandemic demonstration project at the National Institutes of Health (NIH).
Corbett’s work was based on the “what if” scenario of a real outbreak. Then, in late 2019, the “if” happened.
Corbett’s work was foundational to the development of one of two vaccines now approved for emergency use in the United States for SARS-CoV-2, the novel coronavirus that causes COVID-19 illness.
Corbett explained her work and the science behind the first vaccines available in the United States last month during a national NAACP call with other public health experts and policymakers. The conversation was moderated by journalist and veteran White House correspondent April Ryan, who is newly affiliated with TheGrio.TV. The call was part of this year’s UNMASKED: A COVID-19 Virtual Town Hall series of discussions focused on how the coronavirus pandemic is impacting African Americans.
“This moment is very different when you compare it to historical moments when vaccines have been developed,” said Corbett, a viral immunologist at the Vaccine Research Center. “The circumstances are extremely dire right now.”
The Vaccine Research Center is part of the NIH’s National Institute of Allergy and Infectious Diseases – the agency led by Dr. Anthony Fauci.
So far, two COVID-19 vaccines have been approved for emergency use in the United States. One vaccine was developed by Pfizer pharmaceutical corporation in partnership with German biotechnology company BioNTech. It received clearance for distribution in the United States on Dec. 11, 2020, from the U.S. Food and Drug Administration. The other vaccine was manufactured by Moderna, a U.S. biotech firm, in collaboration with Corbett and the NIH. It received emergency use authorization on Dec. 18.
Both vaccines use mRNA or messenger RNA technology, which is genetic material. According to the FDA, each vaccine contains a small piece of mRNA from the SARS-CoV-2 virus that instructs cells in the body to make the distinctive “spike” protein from the virus. That allows the body to produce copies of the spike protein, which doesn’t cause disease but triggers the immune system to react defensively and produce an immune response and a memory muscle against SARS-CoV-2.
“These vaccines teach your body how to respond if and when you were to encounter the real virus. They make sure that you’re ready,” said Dr. Patrice Harris, the immediate past president of the American Medical Association and the first Black woman physician to lead the organization.
Harris emphasized the value of people from “minoritized and marginalized communities” hearing “information and data and science” from Black experts.
Corbett, who has a Ph.D. in microbiology and immunology, also emphasized that the rapid or “warp speed” of the vaccine development process doesn’t mean scientists cut corners. They followed the same checkpoints to ensure a safe and effective result, she said.
The medical professionals focused on safety and access, the historical medical mistreatment of African Americans and the trustworthiness of health institutions in caring for Black people.
A full course of each vaccine is two doses, a priming dose followed by a booster shot. The Modern interval is 28 days between shots, while the interval is 21 days for the Pfizer vaccine.
The Pfizer vaccine is authorized for people 16 and older, while Moderna’s can be used for those 18 and older. Both vaccines have shown at least 94 percent efficacy in preventing COVID-19 infection at seven days after the second dose is administered.
It’s currently unknown how long the protection provided by these vaccines will last.
Sandra Lindsay, a Black critical care nurse in New York City, became the first person in the United States to receive a COVID-19 vaccine on Dec. 14. Inoculations have started nationwide for frontline health care workers including physicians, nurses, respiratory therapists, pharmacists, and custodians.
Fauci, the nation’s top infectious disease expert, has predicted that COVID-19 vaccines will be widely available to the public by April 2021 and that “herd immunity” or a critical mass of those who have received the two-dose regimen could be achieved in communities by mid-year.
Dr. Donald Alcendor, a medical virologist and associate professor at Meharry Medical College, said some people who have had COVID-19 illness will make neutralizing antibodies that can fight the novel coronavirus and some won’t – and it’s unknown how long these antibodies last.
“Getting the vaccine is likely to boost your immune response further and offer you protection that you did not have or had waned during the natural infection process,” Alcendor said.
Early on, the Moderna-NIH Phase 1 clinical trial only had 4 percent African Americans, which “was actually the only embarrassing thing that has happened for this vaccine effort, from my standpoint,” Corbett said. “At that point, it became clear that if we were going to be able to sit on panels like this and tell people of color that the vaccine is safe and effective for them, that we needed to increase the representation of those people of color and people with co-morbidities, etc. in the Phase 3 clinical trials.”
Moderna slowed down enrollment in Phase 3 clinical trials to increase Black representation, which ended up at 10 percent.
“Could it be better? Yes. It could match the population of this country at about 14 percent,” Corbett said. “We are at least trying.”
AstraZeneca and Johnson & Johnson vaccine candidates, which are the likely to be the next to receive emergency use authorization, replace the “guts” of an adenovirus or common cold virus with the SARS-CoV-2 spike protein. The immune system goes on alert when the familiar shell of the cold virus shows up and learns to fight the virus that causes COVID-19 in the process.
Dr. Jehan (Gigi) El-Bayoumi, professor of medicine at the George Washington University School of Medicine and Health Sciences, is a member of the Black Coalition Against COVID, which convenes the nation’s four historically Black medical schools and other stakeholders to address distrust among African Americans concerning the novel coronavirus. She referred people to the coalition’s website at blackcoalitionagainstCOVID.org for more scientific and clinical information.
El-Bayoumi, the physician, hopes that information sessions and educational forums targeted to communities of color will bring an acceptance of taking COVID-19 vaccines when they become available to the wider public.
“To see that Black people and people of color are involved and are keeping an eye on exactly what’s happened is super important and should really bring trust,” El-Bayoumi said.
U.S. Sen. Cory Booker (D-New Jersey) agreed.
“This COVID virus is laying bare the deeper structural inequalities in our country that have to be addressed,” said Booker, who is advocating for more robust funding for health care workers as the vaccine rolls out in low-income as well as Black and brown communities.
In June, with Rep. Robin Kelly (D-Illinois), Booker co-authored the Community Solutions for COVID-19 Act which would help grassroots organizations eliminate inequities in health care outcomes related to the coronavirus. (The bill is stalled in House and Senate committees.)
Dr. Marcella Nunez-Smith, a physician and a Yale School of Medicine professor who is co-chair of President-elect Joe Biden’s transition advisory board on coronavirus – which is guiding the incoming administration’s response to the pandemic – said she balances this moment of great optimism and hope with the grim milestones.
More than 389,000 reported COVID-19-related deaths in the United States since late January, according to data tracking by The New York Times, with the number of deceased exceeding 3,000 in one day for the first time in early December. So far, more than 23.4 million cases of illness have been reported.
Vaccines are “one important tool in the toolbox” but not a cure, Nunez-Smith said. So continued mask-wearing over the nose and mouth, frequent handwashing, and physical distancing remain essential.
“There is a commitment to equitable and efficient distribution of the vaccine, but we’re also keeping our eye on things like testing and things like treatment,” she added. “We have to ensure equity in those domains as well.”
WHAT YOU SHOULD DO NOW
“The thing that you should be watching as you are deciding whether you want to get the vaccine when it becomes available to the general public is how the efficacy data continues to stand, remembering that the Phase 3 clinical trials are actually continuing to monitor people both from a safety perspective and also from the efficacy perspective,” Corbett said. “If you know a health care worker – someone on the frontline who is getting the vaccine – … ask those honest questions that people have been asking me, such as: What are the side effects? How did you feel after you got the vaccine? How did other people around you feel when they got the vaccine? Have you seen anyone become severely ill?”
And while awaiting access to a COVID-19 vaccine, don’t forget to get an influenza inoculation for protection against that virus this season.
NAACP President and CEO Derrick Johnson emphasized prevention against COVID-19 that’s within our personal power as well as fair distribution of vaccines in Black communities to keep families safe and healthy.
“Vaccinations need to be equitable,” Johnson said. “Wear a mask – that’s the kindest thing you can do in the midst of this.”
Cindy George is a freelance writer in Houston.