A letter to Black America for those who do not want the COVID-19 vaccine [PODCAST]

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“As a Black physician, I urge you to consider taking the COVID-19 vaccine when it becomes available to you. Vaccines save lives. Preventing poor outcomes, as in death, is an exciting effect of this vaccine.  I will be first in line when it is offered to me, and I hope to see you in line next to me. Masked up, of course.”

Erkeda DeRouen is a family physician and can be reached at her self-titled site, Dr Erkeda DeRouen.

She shares her story and discusses her KevinMD article, “A letter to Black America for those who do not want to take the COVID-19 vaccine.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Erkeda DeRouen. She is a family physician. Erkeda, welcome to the show.

Erkeda DeRouen: Thank you so much for having me.

Kevin Pho: We’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?

Erkeda DeRouen: Sure. So as you mentioned, I’m board-certified in family medicine and also certified in lifestyle medicine. I’m originally from the D.C. area, and I currently live there now. I’m currently working as an associate medical director for a telehealth organization called 98point6, and I just love empowering women in tech as well as mentoring medical students.

I also host a podcast, called The Prospective Doctor, but it’s more geared toward medical students and talks about the admissions process and hot topics in medicine. I also engage in a little public speaking. So I’m super excited to be here.

Kevin Pho: Excellent. The past year has been tremendously difficult for medical students, obviously. They have to take a lot of virtual classes, and they’re taken away from their clinical rotations. Now, through your podcast and through your work with medical students, what do you feel are some of their biggest challenges, and what kind of advice and tips do you give to them?

Erkeda DeRouen: I think a lot of their biggest challenges are that we’re living in uncharted territory, where they’re not able to do their audition rotations or have the camaraderie of studying with their cohorts and things like we’ve had before. So they’re having to figure out ways, like through my podcast and other ones, of figuring out the admissions process. It’s kind of on a rolling basis, where we’re having different program directors and different people come and talk about the new world, as well as figuring out ways to innovate things. So students have started to do virtual shadowing and things like that. So it’s very interesting, when people are under certain constraints, how innovation comes about.

Kevin Pho: Wonderful. So let’s go ahead and talk about your KevinMD article. It’s titled “A letter to Black America for those who do not want to take the COVID-19 vaccine.” Now, for those who didn’t read the article, can you just walk my audience through it and share the story of why you decided to write it?

Erkeda DeRouen: COVID-19 has impacted each and every one of our lives to at least some extent. So I was feeling quite excited when the Moderna and the Pfizer vaccines were released, but I noticed some apprehension on social media and in other conversations, just in the Black community, about them not wanting to take it ever, if at all. So I was actually inspired to write the article after participating in an extended family group chat where there were quite a few people just saying how much they just distrusted the vaccine and how they didn’t want to take it.

So I felt like there needed to be some more education out there. I realized that, of course, there is some normal apprehension, just given America’s historical relationship with people of color and medicine, but we need to think through things in a systematic manner and think about the scientific process. So I just wanted to start this necessary discussion, not only with patients but also among our providers who may be caring for Black patients, and just let them acknowledge the distrust and figure out mechanisms in order to educate, meet patients where they are, and support them.

Kevin Pho: Now, tell me some of the reasons why Black patients are hesitant to take the COVID vaccine.

Erkeda DeRouen: From what I’ve been reading and hearing about and having in discussions, a lot of it is because it feels rushed. It’s called Operation Warp Speed, and they feel like there isn’t enough information out there. Some people feel like they may be experimented on, because some of the earlier conversations talked about how they wanted to try to get the vaccine out to the minority populations first instead of the traditional everybody’s population. Things have changed now with the different tiers, but to them, it feels like it may be more experimentation.

Kevin Pho: So when they say something like that to you in the exam room, what is your response, and what are some tips that you could share to help overcome some of those fears?

Erkeda DeRouen: I think that, firstly, acknowledging the apprehension is one thing that you can do, and not putting a blanket assumption on why people may not want to take the vaccine. Meet patients where they are and ask why. It may be because they are having similar thoughts to what we just discussed, but it may be because they’re afraid of needles, or they had a reaction to the flu vaccine or something. So see why there’s apprehension.

But if it’s more in line with what we discussed, think about how to talk to patients in a way where, yes, it does seem rapid, but SARS and COVID and things like that are not new. So these are things that have been brewing and being researched for over a decade. It’s just that sometimes, when there is more attention and more finances put into something, things move a little more quickly.

Also, talk about the evidence and the data and how it has been studied. At this point in time, it’s been over a year for these two particular vaccines. So there’s not longitudinal data, but there is some data that people aren’t having severe side effects where they are passing away from taking the vaccine, and a lot of people are protected and it’s not giving them severe disease.

So do all the education, and then also just give them space to think about it, especially when you’re engaging with the patient. They don’t have to make the decision right now. You can give them the information and maybe check in with them in the next month, or check in with them on your next visit to see where they are. And don’t give up on them, because as more data comes in, you can give them more education.

Kevin Pho: I understand there’s some historical context in terms of the apprehension Black patients may have against vaccines. Has that ever come up in your discussions with Black patients when you talk about the vaccine?

Erkeda DeRouen: Absolutely. I think that the most famous is the Tuskegee studies and reports, where things were going like that. Especially in my area, there’s the long history with Johns Hopkins and all of the things that they did with Henrietta Lacks. So there’s a lot of information out there and a lot of things that are passed through historically.

But even now, as we look in 2020, in the news, there are a lot of health care disparities. Black people are dying, I think, 2.8 times more than the general population from COVID itself, and there are other things, where Black women are dying in childbirth and things. So there is some valid distrust there.

But it’s about figuring out how to educate patients and support them, and how to not let them block themselves off from the things that are available to them just because they are afraid. A lot of it’s due to fear, and mistrust is underlying. So figuring out how to build that trust is important, especially as a partner, as their health care provider, where you are involved with some of their most intimate choices.

Kevin Pho: Now, can you comment on the role of social media? I know that there’s a lot of misinformation on social media, specifically on Facebook. I’m seeing a lot of patients who come to me saying that they read this on Facebook: “Is it true?” Now, when you talk to patients, tell me about your experiences in terms of the information they’re getting on social media, and what are some ways that you can combat that?

Erkeda DeRouen: I think social media in this age is really important. I think when we were in training, things were a little newer, and we wouldn’t necessarily encourage our patients to look on apps, or even have our physicians engage or have social media channels. But right now it’s kind of a must-have, because we think of education in the traditional route, I guess, in the medical community, where you give them an after-visit summary or you tell them to go and look at a journal or something like that. But patients aren’t looking there. Their everyday lives are kind of incorporated on social media, so things like Instagram, things like YouTube, things like TikTok and stuff like that. So that is what our patients are using.

So we need to figure out how to spread information that is accurate and easy to digest, because if we don’t, as we’ve seen, there are communities out there who are discussing things, and they may not be as accurate. So we need people with the certain educational background and knowledge to counter that and spread the message in ways that will actually get to the patients, and they’ll actually look at it.

So there’s a lot of engagement with different health care providers who are getting on those platforms and educating and spreading things. And it brings your patients, and they’ll say, “Oh, I saw this thing on Instagram. Is that true?” Then you can show an easy diagram or a quick YouTube video, and it’s helping them learn in different modalities.

Kevin Pho: We’re speaking with Erkeda DeRouen. She is a family physician, and she wrote the KevinMD article “A letter to Black America for those who do not want to take the COVID-19 vaccine.” Erkeda, the vaccines have been out for three to four months now, and we’ve had time to do plenty of messaging, both in mainstream media and through what you’re doing in the exam room. Do you think the needle has moved since the introduction of the vaccines? Do you find that more of your patients are more accepting of the vaccines?

Erkeda DeRouen: Yes, I can definitely see, from when the vaccines came out in about December and even when I wrote this article, that there is a lot of engagement and people wanting to learn more. I think that with the different rollouts, we’re seeing that there are waiting lists and people just waiting to see and get the vaccine.

Of course, there are still people who are still unsure, and I think now we’ll have to continue those conversations, especially as new vaccines come out and evolve that may work a little differently. So we have our work cut out for us, but I think that as long as we continue to engage, educate, and inform, more people will get on board, especially as time goes on.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Erkeda DeRouen: My take-home message is that being a part of the medical community comes with great responsibility. So we have to educate our patients and our community, especially about the pandemic, as there is a lot of conflicting information out there. Also, figure out ways to mentor those who come after you, as those will be the future leaders of health care. And it’s OK, especially with me being in technology and kind of a nontraditional medical pathway, to create the life you want. It’s OK to pivot into someone else.

And I guess, for those who are listening, I just want to appreciate you for taking the time to listen. If you haven’t checked out my article, definitely go on the KevinMD website and blog and look at it, and feel free to reach out to me at drerkeda.com, D-R-E-R-K-E-D-A dot com, if you want to chat more about this or any other opportunities in the future.

Kevin Pho: Well, thank you so much for sharing your time and insight, and thanks again for being on the show.

Erkeda DeRouen: Thank you so much for having me.

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