In an effort to overcome hesitancy, U of T physicians lead Black Health Vaccine Initiative

The COVID-19 pandemic has had a disproportionate impact on racialized groups, with Black communities among the hardest hit.

To address this inequity, the Black Physicians’ Association of Ontario (BPAO) is leading the Black Health Vaccine Initiative, which includes family doctors from the University of Toronto’s department of family and community medicine (DFCM) in the Temerty Faculty of Medicine.

The initiative aims to support advocacy, education and vaccination efforts in Ontario’s Black communities.

“Black people are over-represented in front-line roles – in factories, as personal support workers and other essential services,” says Onye Nnorom, BPAO president and the department of family and community medicine’s equity, diversity and inclusion lead.

“Many don’t have the luxury of working from home, or the housing conditions to isolate when needed.”

The BPAO recently shared City of Toronto data from December 2020 that showed COVID-19 rates and hospitalizations were three times higher for Black people who live in Toronto, compared with white people.

A Statistics Canada report from March 2021, meanwhile, indicates that 49 per cent of Canadians say they are not likely to get a vaccine. For Black Canadians, the figure rises to 77 per cent.

Systemic health gaps and social inequities have put Black Canadians at higher risk of contracting COVID-19 and underpin education, employment and income disparities, Nnorom says.

She adds that a distrust of the COVID-19 vaccine – and public services in general – stems from centuries of anti-Black racism that has resulted in a systemic inequity of power, resources and opportunities that discriminates against people of African descent.

A key component of the Black Health Vaccine Initiative is the Network of Black Vaccinators (NBV): Black and BIPOC physicians working closely with community partners to build vaccine confidence and increase vaccine uptake in Black communities.

Duate Adegbite has been performing vaccinations at TAIBU Community Health Centre, as part of a clinic that officially launched in April with support from Scarborough Health Network and U of T’s department of family and community medicine. The clinic serves primarily Black, Indigenous and francophone communities, as well as the local Malvern community.

“The clinic has been a culturally safe space for people to get vaccinated,” says Adegbite, a lecturer in the department of family and community medicine and physician NBV lead at TAIBU.

“We’ve had many patients come in and say they’ve never seen so many Black doctors. This creates a level of comfort because people see themselves reflected in who’s providing their care – from administrative staff, to doctors and nurses,” says Adegbite, who is also a family doctor with Toronto Western Family Health Team.

Dominick Shelton, an assistant professor in the department of family and community medicine and co-lead for the Black Vaccinators Network, says the response to vaccinations at TAIBU has been overwhelming.

“Black and other racialized physicians are helping to overcome vaccine hesitancy in Black communities,” says Shelton, an emergency physician at Sunnybrook Health Sciences Centre. “We are having important conversations with people and our mere presence as a vaccinator is sending a message of confidence in the COVID vaccine.”

The Black Health Vaccine Initiative is currently focused on pop-up clinics in hot-spot neighbourhoods. The first of these pop-ups will be hosted with the Jamaican Canadian Association on May 8 and 9 in partnership with Black Creek Community Health Centre. Future pop-ups are planned across the city, in Peel Region and beyond.

To reach and vaccinate those that are hardest hit, community partnerships are key, say those involved in the project.

“Community health centres already have established relationships and are trusted by the communities they serve,” says Adegbite, who has been a BPAO member since being in the U of T MD program over 10 years ago.

“Getting information from someone who you trust helps to dispel vaccine hesitancy. Working at community centres, we have more time to sit and talk with people who have questions.”

David Esho, an assistant professor in the department of family and community medicine, is leading the mobile and pop-up vaccine clinics in Toronto as part of the Black Health Vaccine Initiative.

“We are very aware of vaccine distrust and hesitancy in Black communities, so we’re working to recruit Black health professionals to act as vaccinators and educators,” says Esho, who is also a family physician with the Toronto Western Family Health Team.

“I am very proud of the work we are doing at BPAO. We have focused on the importance of relationship building in our vaccination efforts and utilized our links with community agencies, DFCM and our hospital partners to bring vaccines to members of our community who may not otherwise have been able to access them.”