Vaccine Hesitancy: Is Healthcare Listening? is the second episode in the six-part At the Core of Care Vaccine Confidence podcast and blog series.
In this episode, Dr. Deborah Washington, the Director of Diversity for Nursing and Patient Care Services at Massachusetts General Hospital, speaks to the importance of community engagement in the vaccine rollout and the unique role nursing can play in advocating for systemic change in the healthcare system.
Dr. Washington discusses issues of hesitancy about the vaccine in the Black community early in the rollout, but one of her chief concerns now is community access to the vaccine. From distance to sites, internet access, language barriers, and more, access remains far from equitable. Despite increased confidence in the vaccine, justified hesitancy still exists. To address it, Dr. Washington recommends a peer approach:
“It’s important to bring more diversity to nursing and to the workforce. And we need to think about the whole concept of racialized medicine, and how we need to be careful and mindful of how we use our science when race is part of the demographic of the people who are participating in our studies. It makes a difference if Black people are talking to Black people, compared to a mixed-race conversation.”
She is heartened that in this instance, communities have come together to assess their own need and demand systems change, rather than allowing the healthcare system to hold all the power in decision-making.
While communities have made huge efforts in self-advocacy, Dr. Washington sees opportunity for nursing to better define its role in driving change. “We have work to do,” she says, “in terms of seeing nursing as a driver of things, as a voice that can sit at a legislative table, or an organizational strategy table and have impact. That is a conversation that needs to be included in this current awakening around inequities around what's inadequate and insufficient… The whole notion of nursing as a partner and a co-creator of change is very much on the mind of community activists and community organizers.”
Dr. Washington stresses the importance of maintaining and building community trust in the nursing profession, and in using the language of the community to talk about vaccines. In her own vaccine decision-making, she decided to get the vaccine to be a “shield” for elders and children in her family, a message she knows can resonate with many members of her community.
Overall, her recommendation is for systemic changes within healthcare to respond to community needs. “The most practical thing we can do these days is to stop treating health disparities and inequities as sort of a crisis intervention, address this issue for the moment and then let's all go back and do what we were doing. But to take the interventions that we're applying now, find ways to measure them for outcomes and effectiveness, and then package them for incorporation into the system as it exists now.”
This project was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number NU50CK000580). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The contents of this resource center do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.