As the Delta variant courses through New York City, many young Black New Yorkers remain distrustful of the vaccine.

A construction site safety manager in Queens said that as a Black man, he was more worried about the prospect of being stopped by the police than he was about getting Covid-19.

A graduate student in the Bronx who had not gotten vaccinated said her worst fears seemed confirmed when a vaccine that the government was directing to Black and poorer neighborhoods was briefly suspended over a small number of dangerous blood clots.

And a civil rights activist in the Bronx said he grew suspicious when he heard last year that politicians were prioritizing minority neighborhoods for coronavirus vaccinations.

“Since when does America give anything good to Black people first?” said the activist, Hawk Newsome, a 44-year-old Black Lives Matter leader who is unvaccinated.

All three situations reflect a trend that has become a major concern to public health experts: Young Black New Yorkers are especially reluctant to get vaccinated, even as the Delta variant is rapidly spreading among their ranks. City data shows that only 27 percent of Black New Yorkers ages 18 to 44 years are fully vaccinated, compared with 48 percent of Latino residents and 52 percent of white residents in that age group.

This vaccination gap is emerging as the latest stark racial disparity in an epidemic full of them. Epidemiologists say they expect this third wave will hit Black New Yorkers especially hard.

“This is a major public health failure,” said Dr. Dustin Duncan, an epidemiologist and Columbia University professor.

In interviews, dozens of Black New Yorkers across the city — an aspiring dancer in Brownsville, a young mother of five in Far Rockaway, a teacher in Canarsie, a Black Lives Matter activist in the Bronx, and many others — gave a long list of reasons for not getting vaccinated, many rooted in a fear that during these uncertain times they could not trust the government with their health.

The fact that the virus hit Black neighborhoods disproportionately during the first wave made

many extra wary of getting vaccinated: They feel that they have survived the worst and that the health authorities had failed to help them then.

But ultimately, many also said they would get vaccinated if forced to do so.

“If it’s going to be mandatory to work, I’ll have no choice,” said Kaleshia Sostre, a 27-year-old from Red Hook, Brooklyn, who teaches parenting classes to young mothers.

In Canarsie, Brooklyn, a 21-year-old college student, Justin Mercado, said Mayor Bill de Blasio’s recent announcement that dining in a restaurant would require proof of vaccination got his attention. He is now likely to get vaccinated.

“I want to go on a date sometime and enjoy life as much as I can before this strain shuts us back down,” Mr. Mercado said.

For months, the city had focused its vaccination campaign on older residents who are at higher risk of hospitalization and death.

But lately the city has begun to reach out more to young New Yorkers, offering $100 payments for first doses, urging students to get vaccinated before school starts and nudging employers to pressure their employees to get vaccinated.

“We’re not done yet,” said Dr. Torian Easterling, the chief equity officer of the New York City Health Department. “We’re continuing to announce more interventions and more strategies to support New Yorkers getting vaccinated.”

In interviews, Black men and women said that much of their distrust of the coronavirus vaccine was shaped by their own experiences with discrimination or their identity as Black Americans.

“I’m supposed to worry about getting sick when I go outside, versus getting killed by a cop or something like that?” said Jayson Clemons, 41, the construction site safety manager from Queens. After years of trying to be careful not to give the police a reason to stop him — avoiding cars with window tint or rims, and making sure when commuting that his attire clearly marked him as a construction worker — he said he refused to be preoccupied by Covid-19.

He said he would rather put his trust in masks and hand sanitizer — which he credits with keeping him healthy as he worked at construction sites throughout the pandemic — than a new vaccine that the government is pushing people to take. “They came out with one so fast for Covid, and now they want to pay you to take it,” he said. “It seems fishy.”

Some Black women described the need they felt to conduct their own research — and ask around — before deciding if the coronavirus vaccine was safe.

“It takes a little bit of hyper-vigilance when you’re a woman of color,” said Jazmine Shavuo-Goodwin, 31, who believes she encountered medical racism when doctors were dismissive of her severe stomach problems. “There’s a lot of homework you have to do, because your doctors may not truly listen to you, to your full complaint, before they’ve already diagnosed you.”

Ms. Shavuo-Goodwin helps manage dental clinics for Medicaid patients and is studying to be a clinical therapist. Both her job and school require her to be vaccinated against coronavirus, but she has yet to get a shot.

“I’m out of compliance,” said Ms. Shavuo-Goodwin, who is Black and lives in the South Bronx. “I have done heaps of research looking for things that would make me confident and comfortable getting the vaccine, but honestly I haven’t.”

All three vaccines being used in the United States have received an emergency authorization from the Federal Drug Administration. At least one of the vaccines is expected to get full approval by the fall.

When the vaccination campaign began last year, Mr. de Blasio said he intended to prioritize the same Black and Latino neighborhoods that were hardest hit during the devastating initial wave.

12 Aug 2021

Racism Makes Me Question Everything. I Got the Vaccine Anyway.

Surviving in an anti-Black society requires some personal negotiations. This was one of them.

Last summer, when Covid-19 vaccines were in development, friends on text threads and Zoom calls asked if I’d get one. My response was always the same: Sure, I’ll be right in line — after 100 million of y’all go first. I told them I’d seen too many zombie movies. But my hesitancy was actually grounded in a less cinematic reality: I just don’t trust America enough.

This mistrust comes from an awareness of the ubiquity of American anti-Blackness — a dynamic that can, um, modify your sense of reality. That’s what happened, for instance, with the persistent myth of Tommy Hilfiger’s racist comments.

In 1996, owning a Tommy Hilfiger shirt was everything to 17-year-old me. But a year later, I’d completely extracted Hilfiger fits from my rotation. Word had spread that Tommy Hilfiger, in an interview with Oprah Winfrey, had complained about Black people wearing his clothes. The shirts, windbreakers and parka I owned were immediately relegated to the deepest parts of my closet.

Mr. Hilfiger never actually made those racist comments. In fact, he hadn’t even been a guest on “The Oprah Winfrey Show” when the rumors started. But the myth wouldn’t die because it felt so true that to question it felt like gaslighting your own Blackness. Of course this white man with aggressively preppy oxfords and an American flag aesthetic would believe that people like me sullied his brand. It just fit.

The same way, a story about Dorothy Dandridge and a pool just fits: As the urban legend goes, the movie star was visiting a hotel in Las Vegas in the 1950s, and she dipped a single toe into the all-white swimming pool. This so disgusted the hotel’s management that they drained the entire thing. This story, which was also depicted in the HBO biopic about her life, has never actually been confirmed. But to anyone familiar with the history of America’s relationship with its Black citizens, the anecdote is believable. Maybe it ain’t true, but it also ain’t exactly a lie.

To question whether this bottomless skepticism is justified is like asking whether a cow has cause to be wary of butchers. From redlining and gerrymandering to the Tuskegee experiment and Cointelpro, the proven conspiracies against Black Americans are so devious, so deep and so absurd that they blast open pathways for true-sounding non-truths to enter, too.

The terrible spoken word poems I wrote in college (“We’ll never get justice, because justice for just-us just-aint-for-us”) habitually referenced the so-called Willie Lynch letter — an instruction manual for controlling Black slaves that I, along with many others, believed was written by a slave owner in 1712 and contained deep insights into modern race relations. The truth: Willie Lynch never existed and the document was forged. I believed that the government conspired to track my thoughts and movements — as if my flaccid stanzas and banded collar Wilsons Leather biker jackets were a threat to the state. I even once allowed myself to entertain an argument that the natural color of milk is not white, but brown. (Don’t ask.)

The term “hotep” has become a catchall among Black people to describe other Black people who still believe some of these easily debunked stories — but the reality is that most of us have some hotep in us. And not because we don’t know how America really works, but because we know too much. The lack of trust in our nation’s systems and structures is a force field; a bulwark shielding us from the lie of the American dream. And nowhere is this skepticism more justified than with the institution of medicine.

I don’t trust doctors, nurses, physician assistants, hospitals, emergency rooms, waiting rooms, surgeries, prescriptions, X-rays, MRIs, medical bills, insurance companies or even the food from hospital cafeterias. My awareness of the pronounced racial disparities in our health care system strips me of any confidence I would have otherwise had in it. As critics of a recent Saturday Night Live skit suggesting that Black people are illogically set against getting vaccinated pointed out, the vaccine hesitancy isn’t due to some uniquely Black pathology. It’s a direct response to centuries of anecdote, experience and data. (Also, the demographic among the least likely to get a vaccine? White evangelicals.)

Despite all this, in March, I stood in a long line to receive my first dose of a vaccine to prevent me from becoming seriously ill from a virus that I had no idea even existed 14 months ago.

My journey from “I don’t even eat hospital pizza” to “voluntary Pfizer guinea pig” is complicated, but not singular. Existing in America while Black requires a ceaseless assemblage of negotiations and compromises. Even while recognizing the anti-Blackness embedded in society, participation is still necessary to survive.

For instance, I am dubious that American schools are able to sufficiently nurture and prepare Black children for 21st-century life. But my interest in home-schooling my kids is the same as my interest in letting them attend school on Neptune. So my compromise is to allow them to attend school, but then to also fortify them with as many academic, social, and political supplements as possible.

Sometimes the negotiation is just the choice to participate: My parents were two of the tens of thousands of Black victims in the subprime lending crisis. I watched them be evicted from their home after loan terms they just couldn’t meet kept multiplying. But when I was ready to buy a house, the gateway to homeownership was through those same banks.

The trust still isn’t there. Will never be there. But the negotiation that placed me in that vaccination line last month required me to weigh that distrust against all that I miss. I miss the year we just lost. I miss playing basketball. I miss watching it with my dad. I miss barbecues. Malls. Movie theaters. Restaurants. Cities other than Pittsburgh. I miss only needing to be hypervigilant about racism and gluten, and not whether the air inside of a Giant Eagle supermarket might kill me too. And I know other people miss their years and their hobbies and their dads and their homies. With the disproportionate havoc this plague has wreaked on Black and brown people, my desire to return to some semblance of normalcy and prevent more death is a force greater than my cynicism.

I’ve already begun to fantasize about the cookout I’ll host after I get my second shot, and each of my equally-suspicious-about-America family members and homies get their shots, and enough time has passed to feel safe gathering. Maybe we’ll laugh about how us seeing each other was only possible because we trusted an institution that has been pathologically untrustworthy. Or maybe we won’t. Because that’s not actually funny.

9 Apr 2021

Johnson & Johnson’s Covid-19 Vaccine Emerges as Preferred Shot for Homeless

CHICAGO—Johnson & Johnson’s Covid-19 vaccine has found a niche among organizations that work with the homeless, who say the one-dose shot is better-suited for a population that can be difficult to reach twice. The U.S. homeless population has soared during the pandemic. Shelters have become a source of spread as experts puzzle over how to stem stubbornly high infection rates despite an aggressive national vaccine rollout.

In Chicago, the Night Ministry, a group that serves the homeless, has increasingly used the J&J vaccine since it was approved by U.S. regulators in late February. Before that the group had only the Moderna Inc. vaccine, which requires two shots. But the often-transient population can be tough to find a second time, said Stephan Koruba, a nurse practitioner with the Night Ministry, especially those sleeping on the Chicago Transit Authority train system. Now, the group offers both. Many of the group’s beneficiaries are living on the streets. Others in tent encampments. Or, for those able to pay a few hundred dollars a month to escape Chicago’s frigid winter, in transient hotels.

“When we’re out on the CTA, we’re never going to see these people again,” Mr. Koruba said. “We’ve specifically held to J&J doses for them.”

4 Apr 2021

Covid-19 vaccine side effects, explained

What’s now clear: an injection with either vaccine, both of which use mRNA technology, can feel more intense than other routine vaccinations (such as the flu shot) — with side effects for some recipients such as pain, headache, and fatigue. And this may be especially true for Moderna’s vaccine: About 16 percent of people who got the shot in clinical trials experienced a “severe” adverse reaction, a classification the FDA uses to refer to side effects that require medical attention and prevent people from going about their daily activities.
“We should anticipate that if you got vaccinated that day, you may not want to go to work,” Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College, said of the vaccines. That’s why health systems are being warned to stagger immunizing their workforces, to avoid “potential clustering of worker absenteeism,” as the vaccine expert group advising the Centers for Disease Control and Prevention (CDC) put it.
These side effects are known as reactogenicity, and vaccine developers and regulators allow for some level of reactogenicity in all approved vaccines. They can be a sign of the body’s immune response kicking into gear, said Saad Omer, director of the Yale Institute for Global Health.

After months of waiting, we finally have detailed information on the safety and efficacy of the first Covid-19 vaccines that will be distributed in America.
On Thursday, a committee that advises the Food and Drug Administration will meet to determine whether the Moderna vaccine should get an emergency use authorization. Ahead of the decision, the agency shared the most comprehensive data to date on what we know about the shot. The same process happened last week with the Pfizer/BioNTech vaccine, which is now being rolled out across America following an EUA Friday night.
While both vaccines had already been shown to be highly effective, the new data provides a much more granular picture of their side effects and safety profiles.

“Think about [reactogenicity] as mouth wash — it’s hurting while it’s working,” Omer said. “The key is to prepare people to know this will happen — this may hurt a little, give you a bit of fever — but these are short-term, known side effects that you need to be aware of.”
The stakes for clearly communicating information about each vaccine’s risks and benefits are high: More than a quarter of Americans reported that they would probably or definitely refuse to take a Covid-19 vaccine, according to a late-summer survey by the Kaiser Family Foundation, even if it were freely available and deemed safe by regulators. And with the pandemic spreading further and faster in America than just about anywhere else in the world, it’s critical that people don’t feel caught off guard by the side effects or spread misinformation about the vaccine.
To achieve that, transparency is key, said Brendan Nyhan, a Dartmouth professor of political science who has been thinking about how to build trust in the Covid-19 vaccines. “Millions of people are going to get this vaccine and we know huge numbers of people are going to have normal side effects, which are often indicating that the vaccine is working. We want to build trust with people so there are no surprises when that happens.”
In that spirit, here’s what we know about the side effects of these two shots and how to think about them.
What mild and moderate side effects really mean
Before we get into the weeds, it’s helpful to understand how these companies classify side effects in the first place. In general, vaccine developers seeking approval in the US market use the FDA’s “toxicity assessment scale” to grade side effects and other adverse events from 1 to 4, from mild and moderate to severe and life-threatening.
Grade 1 “mild” side effects are generally easily tolerated and don’t interfere with a person’s regular activities. Grade 2 “moderate” effects may interfere with regular activities, grade 3 “severe” effects are incapacitating and need medical attention, and grade 4 are “potentially life-threatening,” usually requiring an emergency room visit or hospitalization. Let’s use the example of headache following vaccination. Here’s how the FDA would classify it:
Mild: “No interference with activity”

Moderate: “Repeated use of nonnarcotic pain reliever > 24 hours or some interference with activity”
Severe: “Any use of narcotic pain reliever or prevents daily activity”
Potentially life-threatening: “ER visit or hospitalization”
So a mild side effect is one you’d notice but doesn’t require any special care or keep you from living your life; a moderate side effect can keep you home from work but doesn’t warrant medical intervention; severe adverse events require medical care and definitely interfere with your normal life; and potentially life-threatening is just what it sounds like and usually involves a visit to or stay in the hospital.
In vaccine studies, these events are broken down into “local” reactions (meaning they’re specific to one part of the body, like pain or tenderness where the vaccine is injected) and “systemic,” whole-body reactions (like fever or fatigue).

For a vaccine to win FDA approval, any reactions people have during clinical trials have to be mostly mild and moderate. And that’s because the safety bar for vaccines is really high, even compared to medicines.

Vaccines “are given to healthy people who have in many cases absolutely nothing wrong with them. And we are talking about [giving them] to literally billions of people. Even rare side effects if they’re serious matter enormously,” said Charles Weijer, a professor of medicine and an ethicist at Western University in Alberta, Canada. “We’re more willing to accept adverse effects [with drugs], provided those are counterbalanced by benefits to the patient.”
Mostly mild and moderate side effects: that’s the safety profiles of both the Moderna and Pfizer/BioNTech vaccines — and that’s why the FDA in the US, and drug regulators in other countries around the world, are rushing to bring them to market. But there are important differences between the two vaccines.
What we know about Moderna and Pfizer/BioNTech side effects
Now, let’s look at the best data we’ve got on the vaccines. It comes from the FDA’s analyses of phase 2 and 3 clinical trials ahead of their emergency use authorization meetings on December 10 for Pfizer/BioNTech and December 17 for Moderna. (The companies also released their own data but we focused on the agency’s independent reviews here.)
The reviews show the vaccines are both safe and that they’re wildly successful at preventing Covid-19 infections (with about a 95 percent efficacy rate). That’s important at a time when more than 3,000 Americans are dying from Covid-19 each day on average.
They also give a sense of what side effects we might expect when these are rolled out. The Pfizer/BioNTech vaccine caused mild or moderate reactions in most people, but severe reactions were rare. Moderna didn’t share the details of its vaccine trial’s mild and moderate side effects, but the FDA said mild and moderate is how they’d characterize the bulk of them. A key difference with the Moderna vaccine, however, is that we know severe reactions were more common in the trials.
Let’s get into what this means, but with a couple of caveats first. Because we have no head-to-head study of the two vaccines and the companies haven’t reported side effect data in the same way, doing apples-to-apples comparisons is tricky, said Hilda Bastian, an expert in reading medical evidence who has been analyzing the coronavirus vaccine data. The vaccines also come in different doses: 30µg in the case of Pfizer/BioNTech and 100µg with Moderna. While they’re supposed to be delivered in two shots per person, the time intervals are different: the Pfizer/BioNTech shots are three weeks apart and Moderna’s are four weeks.
Pfizer/BioNTech and Moderna also tested their products on different populations. “Some of the differences affect risks and so could be affecting outcomes,” said Bastian. For example, there were more people of Hispanic/Latino background and with chronic lung disease in the Pfizer/BioNTech trial than the Moderna trial, she added. And in the real world, when the vaccines roll out to millions, the side effects may again look different.
With all that in mind, here’s what we know about each shot. For Pfizer/BioNTech the most common side effects overall, according to the FDA’s analysis of the data, were local reactions at the site of injection (including pain, redness, swelling), fatigue, headache, muscle pain, chills, joint pain, and fever. Again, these were mostly classified as mild or moderate. Severe reactions, meanwhile, were rare — occurring in 0 to 4.6 percent of participants, depending on the specific side effect. (There were no severe fevers reported, for example, but 4.6 percent of the age 18-55 study participants experienced severe fatigue after the second dose of the vaccine.)
In general, side effects popped up more after the second dose than the first. They also happened less frequently in people 55 and younger, the FDA said. You can see the breakdown of adverse events data in younger adults (18-55) in the chart below following dose 1, and if you click through, following dose 2. (Note: Pfizer/BioNTech found no potentially life-threatening (grade 4) adverse reactions linked to the vaccine in the population they analyzed for safety.) READ MORE: https://apple.news/AZvmcYrtKQWObJ00qk6feuw

24 Jan 2021