Skip to Main Content

The presidents of two historically Black universities in New Orleans thought they were doing a public service by enrolling in a Covid-19 vaccine clinical trial back in August, so much so they urged their campus communities to consider doing the same.

“I said we should inform our communities because I think there’s something about teaching by example,” said Reynold Verret, a biochemist who leads Xavier University of Louisiana. “We’re two Black men who rolled up their sleeves.”

So Verret and Walter Kimbrough of Dillard University were stunned by the fierce backlash that followed their joint letter to faculty, staff, students, and alumni. Hundreds of outraged commenters flooded their schools’ Instagram, Twitter, and Facebook accounts.

advertisement

“Our children are not lab rats for drug companies,” said one post. “I can’t believe a HBCU would do this to our people,” said another reply. “Tuskegee, Tuskegee. … Me and mine aren’t first in line,” said another response.

Dillard University in New Orleans, La.
Dillard University in New Orleans. Emily Kask for STAT

The episode illustrates the challenges historically Black colleges and universities face as they seek to leverage their legacies of trust within African American communities to bolster lagging Black enrollment in Covid-19 vaccine clinical trials. Their recruitment efforts will need to overcome the deep-seated suspicions many Black Americans hold toward medical researchers, pharmaceutical companies, and the government that stem from long-standing racial injustices perpetrated by those institutions.

advertisement

Now, as the four HBCU medical colleges prepare to host Covid-19 vaccine trials on their campuses, there’s hope their efforts will have more success.

“We’ve engendered a level of trust with communities of color that other organizations, quite frankly, just don’t have,” said James Hildreth, an immunologist and president of Meharry College of Medicine in Nashville. “It’s imperative for us as HBCUs to rise to this occasion because people need us.”

Meharry College plans to begin a trial of a vaccine made by Novavax within the next two weeks, with Hildreth as its first participant. The goal is to enroll 300 at the site, but Hildreth thinks they can enroll 600 people, mostly African Americans. The other HBCU medical schools, Howard University College of Medicine in Washington D.C., Morehouse School of Medicine in Atlanta, and Charles R. Drew University of Medicine and Science in Los Angeles, are planning to start their trials in the coming weeks.

“By engaging with the four Black medical schools,” Hildreth said, “they will have individuals who look like them, sitting across the table, having these conversations, and we think that’s going to make a huge difference.”

As the death toll passes 210,000, the Covid-19 pandemic has laid bare inequalities within the U.S. health care system and labor force, with a large portion of Black workers employed in essential jobs that put them at risk of infection. Black Americans are three times as likely as white Americans to contract the disease, five times as likely to end up in the hospital, and twice as likely to die from it, according to the CDC. Had Black Americans died at the same rate as white Americans, some 20,800 Black people would still be alive.

Yet, clinical trials for vaccines are struggling to recruit from their communities. Moderna, one of the drug companies testing a shot, slowed down its trial after failing to enroll enough people of color among its 30,000 participants — though as of last week it said one-third of volunteers were from “diverse communities.” Pfizer and BioNTech reported that 9% of their U.S. clinical trial enrollees are Black and 13% are Latino, while some 72% are white.

“Watching all throughout the summer, you kept seeing stories that say there aren’t enough African Americans in these trials,” said Kimbrough. “You had people like Tony Fauci saying that’s going to be a problem if we create this vaccine and it doesn’t work for Black folks.”

Though people are all nearly identical genetically,  people of color might respond differently than white people to a vaccine, especially for a respiratory disease, due to social differences such as exposure to air pollution that disproportionately affects Black and brown communities, or higher rates of chronic diseases such as diabetes or sickle cell.

“How we live and where we live impacts how medicine affects us,” said Kimbrough. “I think that’s a powerful conversation that we need to be having.”

He enrolled in a Phase 3 trial of the Pfizer and BioNTech vaccine after Verret mentioned in a phone call that he’d done the same, through New Orleans’ Ochsner Health system. The study is double-blinded, so neither the participants nor the researchers know whether they received the vaccination or a placebo until the trial is over. (Because the vaccine doesn’t contain any live virus, the participant has no risk of developing Covid-19 from the injection.)

In their letter, Kimbrough and Verret addressed the pain caused by the Tuskegee syphilis study — in which Black patients were told they would be treated for the disease but weren’t — and how it eroded trust between the Black community and health care providers.

“We understand they’re scared, we understand the history,” Kimbrough said, “but we’re not just telling them this, we’re saying, ‘Look, we’re doing this.’”

Xavier University in New Orleans, La. 01
Xavier University in New Orleans. Emily Kask for STAT

Outrage poured in nonetheless, fueled in part by a ProPublica story published a day before the presidents’ letter that found Ochsner had sent Black patients infected with coronavirus home to die despite the threat they could spread the disease to other people.

To Tevon Blair, a 2018 Dillard graduate, part of what made the letter unpalatable was the absence of predominantly white local universities such as Loyola and Tulane.

“The red flag in this vaccine trial … is that it is not a city-wide partnership with other colleges,” Blair tweeted.

Myles Bartholomew, 22, a 2020 Xavier graduate who is pursuing his doctoral degree at Brown University in molecular biology, cellular biology and biochemistry, said that from a researcher’s point of view, he understood the importance of encouraging Black people to take part in clinical trials and said the presidents were acting unselfishly.

“And then from a student’s perspective, there’s a lot of panic and trepidation about anything related to Covid right now,” Bartholomew said. He said he would not enroll in a clinical trial for a Covid-19 vaccine and he understands why other Black people wouldn’t either due to distrust of medical research.

“Those horror stories are something that is part of our history as African Americans, so we’d be completely naive to ignore the precedents that have been set,” he said.

The presidents responded to the social media criticism.

“There was some misinformation that was being exaggerated,” said Verret. “The suggestion that there was money being paid to me or Dr. Kimbrough? No. That there was money paid to Xavier. No. That Xavier was requiring that all students be in the trial. No.” He added that any of the standard clinical trial compensation he received — participants are paid a nominal sum for their time — he would donate to his parish.

The presidents’ letter may have helped make some headway in aiding recruitment, said Julia Garcia-Diaz, the principal investigator of the clinical trial at Ochsner. After it went out, she received an email from a woman in her late 60s who said she read the presidents’ note and wanted to sign up.

“Not only was she elderly and African American, but she was a female also,” said Garcia-Diaz. “She ticked all sorts of boxes because women are also underrepresented in clinical trials.”

Kimbrough said if he were to rewrite the letter, he would have addressed it to the general public rather than just his and Xavier’s campus communities.

“That’s a good lesson in terms of messaging,” he said.

The HBCU medical schools have been working to make sure they get the messaging right as they address people’s skepticism. Their outreach includes interacting with faith-based organizations and participating in virtual town halls, like one hosted in September by Howard University’s radio station and The Black Coalition Against Covid-19.

“The major concern that people are expressing is the question, ‘Am I being experimented upon?’” David Carlisle, the president of Drew and an internist, said during the town hall. “I can assure individuals that this vaccine when you are taking it to fight Covid-19 is not an experiment that is being directed against the African American community.”

He added that anyone considering enrolling should first ask their doctor if they should take this vaccine, why, and is this vaccine safe for them?

At Morehouse, Valerie Montgomery Rice, the president and an OB-GYN, is no stranger to recruiting diverse populations into clinical trials. When she helped run a clinical trial for a birth control pill at the University of Kansas in the 1990s, her site was commended for recruiting the highest percentage of minority women in the country. She said she is confident 60% to 70% of the people enrolled in the vaccine trial on her campus will be people of color, because Morehouse has long cared for the community.

“The benefit that is with an HBCU medical college is that we deal with these issues everyday with our community. We are more culturally sensitive and more culturally aware,” said Montgomery Rice. “We have the trust of the community and we’ve earned that trust.”

Nicholas St. Fleur is a University of Michigan Knight-Wallace reporting fellow.

  • Okay. I have a question. Is a vaccine not needed for COVID-19? On 60 minutes, two physicians were asked, separately, whether they would like a vaccine or treatment and more masks or vaccine. Treatment and masks were preferred over vaccine. Are the two physicians here and on 60 minutes mistaken, or is the strategy for opening up the country using a vaccine flawed?

  • The negative backlash is a thoughtless over-impulsive reaction to quality attempts to positive change. I commend the University presidents on their pro-active endeavour. Because if a minority truly wants to come out of its (self-) labelled realm, participation in solidly universal events that are somehow still perceived as “white dominated” should certainly be embraced. That is what breaks old moulds.

  • If we can accept that systemic racism and historical discrimination are real, then we can understand the suspicion and reluctance of Black communities to volunteer. However if the trials were clearly designed and communicated as multiracial with the need for valid sample sizes, the concerns may have been averted.

  • Irrational beliefs, such as oposition to vaccines, can be rooted in past experience, but in the end they are harmful. Do any of these critics of black university leaders and black scientists seriously believe that black volunteers will be given a different COVID-19 vaccine from the one given to volunteers of all other races? Do any believe that a black boycott of the search for a vaccine that’s effective for people of all races will protect the health of black Americans, who have been harder hit by the pandemic than most other demographics? More broadly, do any of them seriously believe that the cause of black equality is furthered by an opposition to science? One would hope that reason is not seen as an enemy of equality and justice. The Enlightenment gave society to tools to expose and oppose racism. It would be a tragedy if politically correct activists embrace irrationalism as an antidote to racism. It is one thing to understand the distrust of black Americans toward medical institutions. It is another thing to actively sabotage scientific research that might bring much needed relief to black Americans.

  • Why pick only HBCUS because it’s a quicker way to kill us off? Why are no white colleges being used a test sites? Using blacks as test rats has always been the way and I can’t believe these presidents agreed. Smh if I were a student at any of these schools I wouldn’t do it for any reason what so ever

    • First of all…I am not aware of what a white college is. But to your comment about why “white” colleges arent being asked to enroll..both of my kids are enrolled in major mainstream universities and both are recruiting heavily for vaccines trials. So too, are universities that their friends are attending

    • I totally agree with Rachel Sisson. The mistrust and skepticism are definitely real and justifiably acceptable to me. I have a 19 year old son and after listening to him, he would NEVER EVER volunteer for this because he doesn’t know if genocide is the end results. In my opinion, I don’t want my people to be lab rats.

  • I wish I could have the emotional distance of not being amoung the group whose relatives were tricked by people they trusted into taking something they knew was harmful. Then I could make all the “y’all” comments I see below and try to guilt people out of their well earned suspicions. Suspicions which are not based on history alone but on the fact that in current day medicine minorities are still known to be provided unfounded sub par treatment thereby leading to more sever outcomes than their White counterparts. This is well documented. If you are a compassionate non minority then you are probably attempting to better understand the suspicions and how to remedy the root cause. You are unlikely to be attempting to shame others into actions. If you are a non minority who is not compassionate then your thoughts and suggestions are self serving and of no use to anyone outside of you.
    Those who feel comfortable with taking the vaccine should take it, those who do not (minority or otherwise) should refrain. Individuals speaking here will not be next to you if you suffer any consequence.

  • Minorities can’t have it both ways: A vaccine trial is, in fact, an experiment. If a population subgroup isn’t willing to be “experimented on”, then they forfeit the right to complain that the medical science in question is insufficiently focused on them.

  • I’m a white guinea pig for the Moderna covid vaccine clinical trial. I’m also a statistical analyst for clinical trials and other bioscience. What will happen with lack of representation by non-white people in the trials is insufficient knowledge gain about people of color. As in more bigoted times. That would a sad outcome indeed if it turns out there are immunological differences. Let’s hope there are not. Hope is all we’ll have without volunteers.

  • Dr. David Sack and I enrolled in the Johns Hopkins COVID-19 Phase 3 vaccine trial in August – as a vaccine expert and public health research librarian in our mid 70s, we felt elders should enroll, so why not us? We became aware of the stigma against vaccine trial enrollment and tried to encourage our friends of color and of hispanic origins to also enlist. We could not convince anyone. This is NOT A GAME! Vaccines are life-saving for our neighbors and politics should not be a part of a well-run Phase 3 trial! I am so glad you quoted Myles Bartholomew, 22, a 2020 Xavier graduate who is pursuing his doctoral degree at Brown University in molecular biology, cellular biology and biochemistry, said that from a researcher’s point of view, he understood the importance of encouraging Black people to take part in clinical trials and said the presidents were acting unselfishly.

  • Seems like these communities of color have a lot more insight into being guinea pigs for Big Pharma than most of the other sheep in communities at large. Good for them. Vaccine is unproven, highly likely to be unnecessary, and basically just another game being played –– creating unnecessary fear and then a magic cure. Hopefully America is waking up.

    • Dr. Foley,
      I’m interested in your rationale for why a vaccine may not be necessary.

      No one should be guinea pigs but pharma has conducted clinical trials with strict rules for decades. Is your concern that these rules have been relaxed?

      We’ve complained for years that drugs have been tested primarily on white men below age 65, encouraging greater inclusion of women, minorities and older people in early trials. Seems trust is the big issue here, not medical efficacy.

    • Given the heterogeneity of coronaviruses, probably best to focus on prophylaxis and therapies. Lifestyle is a huge factor as you know; contrary to the media’s spin, exercise, vitamin D, and NAC are effective at reducing symptoms/symptom duration and morbidity. But, alas, sheep will be sheep..

Comments are closed.