As the COVID-19 pandemic disproportionately impacts diverse communities, the need for greater diversity in vaccine trials is very evident. Black and Latinx people have been three times as likely as white people to be infected with the virus, and twice as likely to die, but they have historically made up disproportionately small percentages of medical trial groups. Because medical test subjects participate in trials on a volunteer basis, increasing diversity in upcoming COVID-19 vaccine trials has been a challenge.
In addition to Black and Latinx people facing the challenges of COVID-19 at higher rates than white people, Asian Americans and the elderly also face disparities. According to data, 8 out of 10 of those who die from COVID-19 are elderly, and Asian Americans account for fewer cases in the U.S. but have higher death rates.
The National Institutes of Health (NIH) has guidelines on including elderly people, women and people of color in trials, and advocates have been pushing to diversity these studies. However, according to research, Black people make up 13% of the U.S. population and 5% of trial participants. Hispanic and Latinx people make up 18% of the population and 1% of trial participants.
Kaiser Health News reports that research shows people of different races may respond differently to certain medical treatments. The reasons for these discrepancies are not well-understood, but nonetheless point toward the importance of diversity in trials for treatments of various illnesses. Additionally, the medical community knows that immune response decreases with age. There are higher-dose flu shots for seniors for this reason.
Although diversity in the upcoming COVID-19 vaccine trials is important, so is making injections immediately available. Drugmakers are accelerating the development of the vaccine, but recruiting people from various communities to take part in these studies takes time. Guidance from the Food and Drug Administration (FDA) “strongly encourages” diverse test subjects, but as the government is fast-tracking the development of these vaccines, companies are not required to disclose their demographic goals.
Attracting ethnically and age-diverse candidates requires agility. Unequal access to health care for people of color due to systemic poverty and culturally incompetent treatment alienates many underrepresented populations from trials. Older people with limited mobility, hearing and vision may require extra help to understand and follow protocols.
Additionally, cultural perceptions of medicine may also get in the way. Black people report higher distrust of the medical profession — a reality rooted in the racist history of medical trials such as the Tuskegee Study and invasive reproductive testing on Black women exploiting Black bodies for medical gain. Fear of being treated like guinea pigs is a real obstacle.