Equity in vaccine development needs to be at the forefront

I agree with the arguments made by hepatitis C editor Andrew Reynolds in his guest editor’s note, “Lessons Learned: Viral hepatitis in the COVID-19 pandemic” published in the July+August 2022 issue. I think it is essential, however, when highlighting problems of equity and health disparities to do it in a way that is systematically integrated into each point discussed instead of mentioning it at the end.

There is a lot to learn from the response to COVID-19, specifically in the domestic and global mobilization to develop a vaccine. The early and continuous public health guidelines and activities were impactful in containing the pandemic’s spread. Yet, even with the addition of the vaccine, the U.S. surpassed more than one million deaths from COVID-19. Equal access to the vaccine was and continues to be a problem. The availability of the vaccine was a problem early on, as well as medical mistrust by some populations, dysfunctional health systems, and the stigma that resulted from the COVID-19 pandemic.

We might also have plenty to learn from COVID-19 around science and public health, but not in helping the HIV community overcome medical mistrust, stigma and access to functional healthcare systems. These critical issues affect access; it is not enough to educate and make the vaccine accessible. Some communities need to gain trust in a medical system that has constantly failed them and continues to do so. As the editor says, “The social determinants of health—including racism, poverty and access to healthcare and other services—had a dramatic impact on our COVID-19 outcomes.” The same is said about HCV; we continue to see health disparities that, instead of being overcome, get exacerbated. It is good that we acknowledge it, but I believe it is time to give these issues the priority they need. Community mobilization and meaningful involvement must be front and center when confronting any epidemic or infectious disease. It needs to happen from the beginning of government and industry planning and implementation of responses. I believe the lessons learned from COVID-19 could influence our efforts to develop a vaccine for HCV, but I doubt that those lessons would help eradicate HCV.

—Moisés Agosto-Rosario NMAC, Washington, D.C.

On a cool autumn morning, I wish I was snuggled on the couch with my furballs drinking a large mug of coffee while reading. Last Friday, I visited a handful of locally located Little Free Libraries in Oak Park [Illinois]. I snagged some copies of Positively Aware to learn more about sexual health and mental health awareness. I recognize that I need more information and language to meet my clients where they are and to better inform myself with these communities.                  —Dominique Rodriguez via Instagram

Associate Editor Enid Vázquez responds: Ironically, I go to three Little Free Libraries near Positively Aware each week, and I thought people wouldn’t be interested in an HIV publication. You have inspired me to contribute copies.

Where do you find Positively Aware?

Post a picture of where you find us and tag @posaware.