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Brian Lehrer: It's the Brian Lehrer Show on WNYC. Good morning again, everyone. Here are some COVID headlines. You heard some of those in the news just now, some not. New

Jersey will require its 600 school districts to have their kids wear masks in the classroom this fall. Governor Cuomo, in a politically weakened state, will not set a statewide masking policy for public schools in New York. He'll leave it up to local school districts.

Yelp says it's introducing a feature where you can search for businesses that say all their staff are vaccinated. United has just become the first major airline to announce it will require all its workers, including in the cabin, to be vaccinated. It's amazing, isn't it, to think that someone who flies on airplanes every day in an enclosed cabin with all those people would have found it a bigger risk to get vaccinated, but that requirement is now announced by United.

A survey of unvaccinated Americans finds most of them think the vaccine is a bigger risk to their health than COVID is. 60% of Americans 18 and up are fully vaccinated, 80% of Americans over 65 are fully vaccinated, but in New York City, it's around 75% fully vaccinated among people in their 60s but only around 55% fully vaccinated among New York City residents 85 and up, according to official city data.

According to The New York Times COVID tracker, the US just crossed the 100,000 new COVID cases a day threshold for the first time since last winter. The US passed 400 deaths a day yesterday. Daily deaths are up more than 70% in the last two weeks. In New York State, more than 1,000 people a day in the last week were hospitalized with COVID, a 40% increase from the previous week.

An average of nine people per day died from COVID in New York State last week. I'd say that's an encouragingly low number compared to the rest of the country, at least so far, nine deaths per day, despite the surge in cases and hospitalizations. In New Jersey, new hospitalizations went up 50% to over 500 a day and about 7 deaths per day compared to last week.

Public employee unions continue to walk the line of resisting vaccine mandates for in-person work but encouraging their members to get vaccinated. NBC News reports COVID is rising again in nursing homes amid staff resistance to the vaccine. California has just become the first state to mandate nursing home staff vaccination. CNN reports The Food and Drug Administration is eyeing an early September rollout of a national vaccine booster strategy, quoting a Biden administration official, they say it could come even before September for especially vulnerable people.

By demographic group, the City of New York reports 70% of Asian Americans in the city are fully vaccinated. Just 46% of whites, 42% of Latinos, and 35% of Black New Yorkers are fully vaccinated. Let's talk about some of these stories and more with Dr. Uché Blackstock, emergency medicine physician, founder of the group Advancing Health Equity, an MSNBC medical contributor, and now writing a book called Legacy: A Black Doctor Reckons With Racism in Medicine. Dr. Blackstock, it's always great to have you on. Welcome back to WNYC.

Dr. Uché Blackstock: Hi, Brian, thank you so much for having me back. I always love to be in conversation with you.

Brian Lehrer: As a health equity person, let me ask you to comment on that last stat that I gave first, 70% of Asian Americans in the city are fully vaccinated. Just 46% of whites, 42% of Latinos, 35% of Black New Yorkers fully vaccinated. Why just 35% to 45% vaccinated among Black, Latino, and white New Yorkers? Do you think the reasons vary by group?

Dr. Uché Blackstock: Brian, I do think they vary by group. We think about this term vaccine hesitancy. It's a very general term, it's not always that accurate, but I think that there are varying reasons given the racial or ethnic demographic. I think because of that, we need to identify strategies that are not one-size-fits-all but rather that are customized and tailored to those particular communities.

I'm not surprised that especially among Black New Yorkers, that we have the lowest vaccination rates. It's an uphill battle, essentially working against the trauma caused by systemic racism. Not just the trauma of being a Black person and living and working within a racist society but lack of access to healthcare, not being able to trust healthcare institutions, and what we're seeing now in these numbers is, again, the legacy of that, and also ongoing discrimination that Black New Yorkers may face.

This is not surprising, but again, this is why we really need to continue those vaccine outreach efforts to reach these communities, and we need to do it again in a way that is culturally responsive so that we're meeting people where they are.

Brian Lehrer: On meeting people where they are, what do you think of those TV commercials that are on constantly now showing Black and brown physicians and public health officials and regular non-medical people touting the vaccine?

Dr. Uché Blackstock: I think we have to use many different strategies. I think for some people in the public, they may respond to those sorts of commercials, seeing Black healthcare professionals, seeing average New Yorkers on television talking about the vaccine, but what I will say is one thing that I have recognized during this pandemic is how for some Black people, they think that Black healthcare professionals are part of the system understandably so, because we have been educated and trained within a healthcare system that hasn't been embedded with racism.

Even if I say these vaccines are safe or if Dr. Kizzy Corbett says these vaccines are safe, I think that there are some people who will listen to us and say, "If you're saying this, I believe you." I think that there are other Black folks who have been so traumatized, and our healthcare systems, as I said before, have not been trustworthy. We've caused significant harm, even Black healthcare professionals.

I think for some people, it doesn't matter who's saying that vaccines are safe and effective, they won't listen. I think that is the bitter pill that I've had to swallow. I don't want to make this about me, no, it's about the public and trying to really be in conversation with people and find out what their concerns are, but the realization that as a Black healthcare professional, I can be perceived as a surrogate of a racist healthcare system.

Brian Lehrer: Let me get your take on some of the vaccine mandates coming out now or being debated from a health equity standpoint. We have vaccine mandates, we have no negative testing option for New York State healthcare workers, we have vaccine mandate with an alternative of showing weekly negative COVID test for other public employees, we have vaccine mandates for participating in indoor dining and live performances and gyms. Is there a health equity take on this trend?

Dr. Uché Blackstock: Absolutely. I know it's easy to look at these mandates as just black or white. I do feel strongly, though, that in certain settings, healthcare settings, schools, other congregate settings, that we really need the strictest vaccine mandates. I think that, although we need to think about equity, we need to think about whether we're engaging communities who will benefit or be burdened by these policies, and because we know that vaccine uptake among people of color in the city has been lower, we know that these policies will probably impact them more.

I think that the conversation really has to be a nuanced one. I think weekly testing is not sufficient. If someone is saying that they don't want to be vaccinated, that we need at least twice or three times a week of testing, but I do think we need to think about the harm caused to these communities and how coercive vaccine mandates can potentially be. Think about whether there's any flexibility but with a goal of keeping everyone as safe as possible.

Brian Lehrer: I understand, I think, the nuance is there. Ultimately then, do you come down yes or no on the mandates?

Dr. Uché Blackstock: I come down yes, I do, Brian [laughs]. I come down yes. It's a yes after a lot of consideration. It's yes because we need to create safe public environments for people, but I think at the same time, and I said this at the mayor's press conference when he announced the mandate for city workers, we still need to make sure that we are engaging with these communities, that we are giving people the information they need, that we are still performing outreach, that we're answering questions about these vaccines, that we keep having conversations.

I will say, even on a personal level, I've had a number of people in my life who were very concerned about taking the vaccine and for months did not want to take the vaccine, but we had multiple conversations. I think, even some of the survey polling and Kaiser Family Foundation has done a really wonderful job with some of their polling data. We see that among the wait and see, it's a lot of people of color. Among the definitely nos, it's mostly white rural conservative.

I think the wait and see people, we can work with that group. That group can be moved, but we need to consider the harm caused to these communities and the work and resources that need to be invested in these communities really to ensure that we are not being coercive. That we are not re-traumatizing people, but I will say, yes, the vaccine mandates, I am a yes for them, but I want to make sure that we're still using an equity lens in thinking about how these policies are developed and implemented.

Brian Lehrer: Listeners, we can take some phone calls, especially about equity when it comes to COVID and COVID vaccines and COVID mandates for Dr. Uché Blackstock, founder of Advancing Health Equity, 646-435-7280. Personal stories welcome. Your individual stories always help us report the overall story. Your comments welcome, questions welcome, 646-435-7280, especially on equity when it comes to COVID and COVID vaccines and COVID vaccine mandates for Dr. Blackstock, 646-435-7280, or tweet at @BrianLehrer.

We're going to take a break and then continue. I want to ask you about another COVID prevention policy that's controversial in the news right now with New York and New Jersey going different ways. I know from your Twitter that the first way you identify yourself on Twitter is a proud mom of your two kids.

Dr. Uché Blackstock: [laughs] Yes.

Brian Lehrer: I'm going to ask you when we continue what you think of mask mandates for schools this fall. Stay with us. Brian Lehrer on WNYC.

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Brian Lehrer on WNYC with Dr. Uché Blackstock, emergency physician and founder of Advancing Health Equity. That question that I teased before the break for you as a proud mom raising two kids, the mask mandates for schools this fall, New Jersey is imposing one statewide, New York State is leaving it up to local school districts, Florida leaves it up to parents. What do you think is best?

Dr. Uché Blackstock: I think right now, there should be both mask and vaccine mandates for schools. I feel very confidently about that. Given that children under 12 are not eligible for vaccines and we've already seen outbreaks in places like Mississippi, where masks are optional, leading to spread and school closures. I'm very much a proponent of both mask and vaccine mandates for schools. I actually, I'm surprised, I saw Randi Weingarten on MSNBC the other day, and she was asked about-- [crosstalk] Sorry.

Brian Lehrer: Just so people know, the teachers union leader. Go ahead.

Dr. Uché Blackstock: Right. I was really surprised at her response about vaccine mandates. She was sort of, it was more like a non-response, but I can't think of any other group outside of health care workers that really should be mandated to receive vaccines, especially given our current environment, given that we have a highly transmissible variant, given that majority of children still remain unvaccinated and given that students are returning for the most part throughout the country for full in-person learning. We have even more crowded classrooms than we had this past year.

Brian Lehrer: David on Staten Island. You're on WNYC with Dr. Uché Blackstock. Hi, David.

David: Hey, how are you?

Brian Lehrer: Good.

David: I just wanted to say, I think that there's an issue maybe with digging too deep into the reason between different races or groups with their vaccine hesitancy. I think it just all comes down to more or less the same thing. It's misinformation. It's like YouTube videos. One group might have a different video that they're watching [unintelligible 00:14:46] people might have a video that they're watching. It's just misinformation. I think approaching it from that point of view might be more helpful than some deep race reason. It's just misinformation.

Brian Lehrer: Dr. Blackstock.

Dr. Blackstock: Actually, I agree with you that misinformation is part of it, but I do think that we need to really consider the context of how our society functions and how people given their race experience life in the city and in this country. For example, I was recently at a street festival, the African Art Street Festival in Brooklyn. I saw someone giving out some flyers and it said medical racism on it. I looked closer. It was actually anti-vaccine propaganda from RFK Junior's Children's Health Defense Organization.

This is an organization that is not just anti-COVID vaccine but all vaccines. I saw that they were trying to attract the attention of Black attendees by using this medical racism bit, which was very deceptive, but trying to frame COVID vaccines as sort of not being good for Black people and potentially being racist towards Black communities or this effort to get the Black communities vaccinated.

I think it's a combination of both, and I think we need to make sure that we understand the context in which people are living and working, playing. Then also, yes, this information definitely I think it's convincing a lot of people not to get vaccinated, but the way that the misinformation is tailored I think does vary sometimes by racial group.

Brian Lehrer: Sharon in Queens, you're on WNYC. Hi, Sharon.

Sharon: Hi, I have two comments. As working in a nursing home with 500 beds, I just retired, I'm 70 years old. [crosstalk]

Brian Lehrer: Congratulations, by the way.

Sharon: Thank you. The hospitals were so full, they were discharging patients with COVID into the nursing homes, and it was a mix-- They actually put them on floors with people that did not have COVID, and I cannot see how you can require CNAs and nurses to take a flu vaccine but you don't make them take a COVID vaccine. A lot of that was due to Cuomo and his misinformation on numbers because he's in cahoots with nursing home owners.

The second comment I have is that I didn't want to take the vaccine myself because I don't want to even take flu vaccines, but I had to have. I changed my primary care physician. I trusted her, I got as much information because I live in a mixed house with my daughter who's a principal, who told me what was going on in the schools. I have a four-year-old granddaughter, and as for me, in my house, I've been just telling people I was hesitant, but I took it because it's not about me. It's about my family, and I don't go out a lot. I distance myself.

I mask up because I remember the Harvard, my next door neighbor died of COVID. You know what? I have a good memory. We must not forget what we've been through for the last 15 months and also live the best life we can for those who lost family members. I just get very upset, and I turn the TV off. That's another factor. I don't need to listen to anybody telling me what to do in my house. Thank you.

Brian Lehrer: Thank you. Wow, Dr. Blackstock, wow.

Dr. Uché Blackstock: Well, I want to thank her for her service and congratulate her on her retirement. Yes, two things. I think people need to understand how diverse the healthcare worker demographic is. Nursing aides compared to physicians compared to nurses, it's an incredibly diverse group with different educational, socioeconomic backgrounds. I think that's part of why we are seeing that really range in terms of almost all physicians being vaccinated versus 40% of nursing aides being vaccinated. I think that there is an opportunity for actually peer-to-peer outreach with nursing aides.

I think that you can find a group of nursing aides that have actually been vaccinated, have them talk to their colleagues about why they decided to take the vaccine. As the caller even talked about, it was having a trusted primary care physician. It was about having a four-year-old granddaughter. We need to figure out what are people's whys and why nots for being vaccinated and help them to answer those questions. I do really, again, feel strongly, schools, nursing homes, prisons and jails congregate settings, everyone needs to be vaccinated. I think that is really non-negotiable at this point.

Brian Lehrer: One more call, Pam in Union County. You're on WNYC with Dr. Blackstock. Hi, Pam.

Pam: Hi. Good morning, Brian. Good morning, Dr. Blackstock. I just had a question regarding the rumor, misinformation about fertility issues. I'd heard that months ago from two different people in healthcare who were hesitant to receive a vaccine, a pharmacist and a nurse. I'm vaccinated. I believe in vaccines. I just don't understand where this came from and what can be said to those individuals to dispel that myth, because I don't even know how they would have the data to support that kind of issue this early on. That's all. I'll listen to my answer off-air. Thank you so much for your efforts.

Brian Lehrer: Thank you. That not even having the information early on cuts both ways, Dr. Blackstock, as I'm sure you know. People say the vaccine is so new, how do I know it's not going to affect my fertility?

Dr. Uché Blackstock: Right. The caller has such a great question. What we're seeing in a lot of the polling is that people who are unvaccinated have significant concerns about fertility.

I think a lot of the concerns stem from misinformation on social media and other platforms, but as recently as this past week I believe, the American College of Obstetrics and Gynecology came out in full support of people who plan to get pregnant as well as people who are pregnant to be vaccinated because vaccines, the evidence that we have so far is that there have not been any untoward side effects of the vaccines, that they do not cause fertility and that there's been no reported evidence in the adverse effects system really showing otherwise.

It's unfortunate that this misinformation keeps on being perpetuated. There are misconceptions that antibodies developed after COVID-19 vaccination will attack a protein in the placenta, which is not true. There are actually a lot of really wonderful OB/GYNs on social media, obstetricians, gynecologists on social media who are working to dispel some of this misinformation, especially about fertility, that I would recommend people to follow because the fertility issue I think is an issue that it's coming up a lot.

We're actually seeing it even in parents who are concerned about vaccinating their children. We know that the next stage of the rollout are children under 12 years old and some of the concerns that parents have are fertility issues that the children may have later on in life if they are vaccinated.

Brian Lehrer: You know what? I'm going to sneak in one more caller, because I think he has got a really interesting question. Sam, in Kew Gardens. Sam, you're on WNYC, but we've only got 30 seconds for you. Go for it.

Sam: Okay. Good morning. Long time, first time. I'm calling because I don't buy the notion that African Americans have good reason to be suspicious of the medical establishment and traumatized by it. As a person who grew up in the South in the '60s and '70s, I became aware of the Tuskegee experiments the same time everyone else did, and I can't say that because of that I'm traumatized because it was history. I just don't see the point or basis for thinking that African Americans have good reasons to be suspicious of the medical establishment.

Brian Lehrer: Dr. Blackstock, 30 seconds for you.

Dr. Uché Blackstock: Oh, I wish I had more than 30 seconds.

Brian Lehrer: Sam, we'll give you more time when you call in again. Thanks for being a first time caller. Dr. Blackstock, go ahead.

Dr. Uché Blackstock: Essentially, I would say that we have a lot of data. We even have data as recently as 2016 showing that medical students and residents have different ideas about pain in Black people versus white people. We know that pain is routinely undertreated in Black patients. We know that Black patients are less likely to be believed when they go seek help in healthcare settings.

They're less likely to be listened to, we have data for this. Yes, Tuskegee is part of our history, but there was ongoing discrimination that Black patients face when they interface with healthcare settings, but also it's the everyday racism that they face fights social institutions. These institutions, as I've mentioned before, had not been proven trustworthy.

If these institutions are then saying, "Here, take this vaccine," of course people are going to have doubts, but I also want to just emphasize that multiple truths can exist. Yes, our social institutions can be racist and discriminatory, but these vaccines are also safe and effective and are essentially miracles of science. That's why I encourage as many people as possible to get vaccinated.

Brian Lehrer: Dr. Uché Blackstock, emergency medicine physician, founder of the group Advancing Health Equity, an MSNBC medical contributor, and now writing a book called Legacy: A Black Doctor Reckons With Racism in Medicine. Obviously you're invited back when your book comes out. I think we'll talk before then, too. Thanks so much for today.

Dr. Uché Blackstock: Thank you, Brian, for having me.

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