Dr. David Tom Cooke says his choice to participate in a clinical trial for a coronavirus vaccine is like his grandmother’s decision to leave the Jim Crow South to work in California’s naval shipyards during World War II. She was determined to contribute even though the country didn’t recognize her as worthy of full rights.
Today, it’s Cooke’s sense of duty and experience as a Black man that led him to test out Pfizer’s vaccine in August and make it his mission to allay concerns about its safety among Black friends, family and community members. He’s also driven by an understanding of skepticism toward the medical profession among many Black Americans, rooted in a history of poor health outcomes and abusive research.
“When you look at the scourge of the COVID-19 pandemic, communities of color are disproportionately affected in regards to death,” said Cooke, head of general thoracic surgery at UC Davis Health, the Sacramento area’s major trauma center. “Therefore, it’s imperative that we enroll people of color into these clinical trials enough to show they’re effective in these really at-risk communities.”
Cooke, 48, was concerned when he saw a lack of diversity among participants in Moderna’s clinical trial. So when UC Davis had the opportunity to connect people with a trial by Pfizer, he volunteered. He got the first shot in August and recently learned he’d been given the actual vaccine.
“I felt that in order to increase enrollment in these clinical trials and make a difference in this global pandemic, I needed to walk the walk,” Cooke said.
For him, the understanding of distrust in the Black community is personal — even some of his own family didn’t plan to take the vaccine until they learned he had tried it.
His parents, former principals in Oakland public schools, still feel the need to tell any new doctor or nurse they see that their son is a Harvard-trained surgeon. That’s because they fear they won’t get quality care otherwise, he said.
“Is that warranted? Who knows? It’s hard to say. But is it understandable? Of course it is,” Cooke said.
That distrust comes from Black people being mistreated in the medical system for decades. Among the most infamous: the Tuskegee experiment, where Black men weren’t told they had syphilis or treated for it so doctors could study the disease’s progression, and the story of Henrietta Lacks, whose cells were used in pioneering medical research without her consent or compensation for her family.
A December survey by The Associated Press-NORC Center for Public Affairs Research showed 40% of Black people said they would not get the coronavirus vaccine, a higher percentage than white or Hispanic people.
Distrust over unethical practices of the past also is prevalent in Native American communities, with few signing up to participate in clinical trials. That’s also tied to the quick nature of the studies, which typically may need several layers of approval from tribes.
Black, Hispanic and Native Americans have been hit harder by the virus than white Americans. A Pew Research Center study shows 71% of Black Americans surveyed said they know someone who has been hospitalized or died from the virus, compared with 61% for Latinos and under 50% for white people and Asian Americans.
Cooke’s informal effort to promote the vaccine in the Black community is one piece of a larger effort to increase the number of people who get the shots.
Sandra Lindsay, a critical care nurse at New York’s Long Island Jewish Medical Center, was among the first Americans to receive a vaccine. Lindsay, who is Black, told the New York Times that her goal was to “inspire people who look like me, who are skeptical in general about taking vaccines.”
Covered California, the state’s insurance exchange, held a news conference last month to promote the vaccine to Black residents. Doctors and nurses from historically Black medical universities and associations nationwide recorded a video “love letter,” saying they are working to ensure that respect for Black lives remains a centerpiece of coronavirus conversations.
“It is imperative that we engage with communities to address their concerns so that all of our communities can feel confident that these vaccines are safe and that they are our key to defeating this virus,” said California’s surgeon general, Dr. Nadine Burke Harris, who is Black.
Gov. Gavin Newsom said relying on community messengers, like nonprofit groups, faith leaders and health care providers, will build trust “in a different way than we ever could from Sacramento.”
For Cooke, he’s been active on social media, sharing his experience with the vaccine and photos of other doctors and nurses, many Black, getting the shots. He’s also given local radio and television interviews.
Growing up in Oakland and spending time at the schools where his parents worked shaped Cooke’s worldview. He observed his parents as they interacted with all kinds of people, from students and parents to law enforcement and inner-city residents. He learned empathy and how to understand differing perspectives — lessons he’s brought to patient care.
“It is not the responsibility for our communities of color that have been traditionally disadvantaged to trust us,” Cooke said. “It is the responsibility of care providers, for health care, to establish that trust.”