Public health officials want to vaccinate as many people as possible against SARS-CoV-2, the virus that causes COVID-19. Unfortunately, vaccine acceptance rates have been particularly low in communities of color. Almost three months after it was first approved, many people, particularly people of color, still don’t trust that COVID-19 vaccines are safe.

Only 40 percent of Latin Americans and 18 percent of Black Americans think a COVID-19 vaccine will be effective, and even fewer think it will be safe. This vaccine hesitancy is driven by their lack of trust in the healthcare system and has meant, according to the Pew Research Center, that fewer than half of Black Americans plan to get the vaccine.

Mistrust in the healthcare system is not exclusive to concerns about COVID-19 vaccines.

To reduce the significant burden of COVID-19 among people of color, their concerns about the vaccine must be laid to rest. In a recent commentary published in Annals of Internal Medicine, researchers from the University of Washington, the University of Chicago and the University of California at San Francisco suggest strategies doctors can use to address patients' uncertainty about the vaccine.

“COVID-19 vaccines are not routine vaccines, nor are these routine circumstances,” the authors write. “This past year has laid bare harsh health disparities and structural injustice in the United States, activating and exacerbating mistrust among people of color. Clinicians need to address this mistrust to help patients at highest risk for COVID-19 gain the benefits of COVID-19 vaccines. Prioritizing these discussions now in routine clinic visits, even over other health maintenance or stable chronic disease management issues, may help increase the acceptance of COVID-19 vaccinations and improve health outcomes among persons of color.”

Mistrust in the healthcare system is not exclusive to concerns about COVID-19 vaccines. It is rooted in history: unethical experiments involving enslaved people and prisoners; and Black Americans denied the chance to give their consent.

The researchers suggest doctors might begin to address mistrust by listening to patients’ concerns about the vaccines, and then asking patients what they think. If patients don’t want to take the vaccine or still are not sure about it, doctors could ask for permission to make a recommendation and, if given permission, say something like, “In my view, the benefits of the vaccine outweigh the risks. I am strongly recommending it to my patients.”

Some patients may have questions about the approval process for COVID-19 vaccines. Others may think the vaccines were approved too quickly. These are areas where doctors can inform their patients and explain that COVID-19 vaccines were approved after careful review of the data by the FDA.

And finally, the researchers recommend, doctors should respect and acknowledge any uncertainty patients have about COVID-19 vaccines. “Acknowledging uncertainty builds transparency, and transparency is key to facilitating trust during public health emergencies.”