RACIAL DISPARITIES IN COVID-19 VACCINE TRIALS

by Chloe Yang

Due to systemic inequities in the healthcare system, racial and ethnic minorities have historically been at a disproportionately higher risk for a multitude of health problems. According to the CDC, many factors influence an individual’s access to equitable healthcare, such as economic instability or lack of transportation, quality healthcare facilities, and clean air, water, food, or shelter. According to a paper published by the Medicare and Medicaid Research Review, minorities have less access to healthcare and often have higher rates of morbidity and mortality when compared to white individuals. These issues have only been exacerbated due to the COVID-19 pandemic, with the disease disproportionately impacting minorities. Researchers at the Rollins School of Public Health have been closely monitoring the impact of COVID-19 on people of color and have noticed a disturbing trend of racial disparities in ongoing COVID-19 clinical trials.  

Dr. K.M. Venkat Narayan and Dr. Kamlesh Khunti, researchers from Emory University, published a paper in the Lancet, calling for representation of  Black, Asian, and minority ethnic (BAME) groups in COVID-19 clinical trials. Citing research from the Intensive Care National Audit and Research Centre, Narayan and Khunti highlight the disparate impact of COVID-19 on BAME groups, particularly Black communities. Despite representing 13.4% of the United States population, Treweek et al declare that “Black people comprise between 2% and 70.5% of deaths from COVID-19 depending on the state.” Even with this disproportionate burden that BAME communities have been bearing during the pandemic, Narayan and Khunti report that these groups are under-represented in ongoing clinical research to prevent and cure COVID-19. In fact, Treweek et al mention that of 1,518 registered COVID-19 clinical trials, only six are collecting data on ethnicity. If this is the case, the generalizability of collected data is compromised, potentially resulting in future therapeutics lacking efficacy against certain populations. 

According to Narayan and Khunti, racial and ethnic disparities in clinical trials can be attributed to a multitude of social and systemic reasons, such as a mistrust of researchers among ethnic communities, a lack of engagement from researchers, and inaccessibility to research trials in remote areas. These issues will not be easily resolved, but researchers must strive to expand the scope of their research in order to include underrepresented groups, such that “thinking about participants’ ethnicities … [becomes] as routine as thinking about their age and sex.” Only then can the scientific community ensure that they are designing treatments and vaccines for the whole population, rather than a small portion of it.  

Equitable and representative clinical trials benefit everyone. Several factors can influence how an individual reacts to drugs and vaccines, including age, sex, and other biological factors. By limiting clinical trials to a certain population, researchers are not able to understand the full scope of a drug’s efficacy and cannot achieve fully generalizable results. Representation in clinical trials will provide a necessary step forward in ensuring health as a human right in the United States and protecting our most vulnerable populations against future diseases.  


References: 

Community, Work, and School. (2020, February 11). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html

Treweek, S., Forouhi, N. G., Narayan, K. M. V., & Khunti, K. (2020). COVID-19 and ethnicity: who will research results apply to? The Lancet, 395(10242), 1955–1957. https://doi.org/10.1016/s0140-6736(20)31380-5

Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health care. Health care financing review, 21(4), 75–90.