Fauci calls for racial and ethnic diversity in coronavirus vaccine trials

National Institute of Allergy and Infectious Diseases Director Anthony Fauci on Wednesday said coronavirus vaccine trials need to be conducted on a diverse population to make sure any potential vaccines are safe and effective for everyone. 

“We need to get a diverse representation of the population in the clinical trials,” Fauci told a panel of Congressional Hispanic Caucus (CHC) members.

“So when they are proven to be safe and effective, we can say they are safe and effective in everyone, not only in whites,” added Fauci. 

Fauci was speaking to the members at a CHC-organized panel on the effects of coronavirus on Latinos.

The Hispanic community has been disproportionately affected by the pandemic, due to a combination of higher rates of pre-existing comorbidities, reduced access to health care, workplace exposure and multi-generational households.

Fauci relayed striking numbers to the CHC: COVID-19 hospitalization rates among Hispanics as of Sept. 19 are 359 per 100,000, compared to 78 per 100,000 in whites, and the death rate is 61 per 100,000 among Hispanics, compared to 40 per 100,000 in whites. 

Young Hispanics are also getting hard hit by the disease. Fauci said 45 percent of coronavirus patients under 21 years of age who died of the disease were Hispanic. 

Fauci added that once the pandemic is over, the health care priority for the Hispanic community will be to create a long-term plan to address the social determinants of health care that made Latinos so vulnerable.

“When it’s all over and it will end we need to look at what we can do now for this to be an enduring lesson for the Latinx community,” said Fauci. 

Peter Jay Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, told the CHC members he is excited about Operation Warp Speed — the race to produce a working vaccine — but painted a stark picture of the disease’s effects on the U.S. Hispanic community.

Hotez said he was shocked when reviewing the prevalence of Hispanic victims among Houston COVID-19 death statistics. 

“It occurred to me that what we’re seeing is a historic decimation of Hispanics by this virus,” said Hotez.

Hotez said conditions in Texas, both in the larger cities and along the U.S.-Mexico border — as well as in Latin American countries to the south — have not been adequately addressed by policymakers and the press.

“We need to do better to highlight the decimation that’s happened among the Hispanic families in America,” said Hotez. 

A third doctor, University of California San Francisco Professor of Emergency Medicine Robert Rodríguez, also blamed the lack of doctors in coronavirus hotspots for the higher death rates.

“Without overdramatization, my volunteer time in the hospital where I was born was the most difficult experience of my career,” said Rodríguez, who was born in Brownsville, Texas.

“To be clear, as compared to well resourced Bay Area hospitals … one tenth the number of physicians were caring for 10 times the number of patients,” added Rodríguez.

And Kenia Peregrino, an emergency relief organizer for the United Farm Workers Foundation, said some of the most vulnerable Hispanic essential workers will need assurances that seeking care, testing or vaccines won’t threaten their livelihoods. 

“Out of economic necessity, farm workers will toil to the very limit of their endurance,” she said, explaining that farm workers are often forced to work through illness to make ends meet.

All those factors have played a part in making the pandemic disproportionately deadly for Hispanics, and will also provide obstacles when a vaccine is made available, the medical experts told the CHC.

“Many Latinos and other marginalized groups get their care through the emergency department. You’re going to have to set up a system that includes the emergency department for the distribution of vaccines,” said Rodríguez. 

Fauci vowed to raise a series of issues related to Hispanic vulnerability with the White House Coronavirus Task Force, including in conversations about prioritization of vaccine distribution and trials and the potential for cross-border vaccine coordination with Mexico.

Still, Hotez said one of the major challenges for any vaccination program will be communicating its benefits, given the incessant disinformation produced by the anti-vaccination movement. 

And while the pandemic perdures, said Hotez, the Hispanic community is likely to bear the brunt.

“We never really brought this virus down to containment level,” he said. “My prediction is we’re going to be in for a very difficult fall and winter.”

“We know from what we’ve seen so far that the Hispanic community will take it the worst,” added Hotez.