“We Had to Participate”
A Physician Commits to Fighting Vaccine Hesitancy
Back in the summer of 2020 — before the COVID-19 vaccine was a reality — Erica Marsh, M.D., began hearing about vaccine hesitancy, especially among Black Americans. When it came time for her to get the vaccine, she even felt a little trepidation herself.
“The African American in me understood the fear, understood the mistrust that was prevalent in the community,” she says, citing the history of scientific and medical experiments that took advantage of Black people. But “the scientist, researcher, and physician in me knew the importance of diverse populations participating in trials” and ultimately receiving the vaccine. “The granddaughter, sister, niece, and friend in me needed to connect, needed a hug.”
“I want to be more than just a witness. I always want to be part of the solution,” says Marsh, an associate professor of obstetrics and gynecology. “Sometimes being part of the solution is just dropping off a bag of groceries at as many people’s houses as you can.” She did a lot of that at the beginning of the pandemic and helped organize a distribution of hand sanitizer across southeast Michigan, with the help of members of her research team, her department, and the Michigan Institute for Clinical and Health Research.
But in August 2020, she seized an opportunity to help on a larger scale. Marsh heard about a grant from the National Institutes of Health (NIH) to help fund COVID-19 outreach efforts. She reached out to Barbara Israel, Dr.P.H., professor of health behavior and health education at the U-M School of Public Health, to partner with her on an application. “We were both out of town on vacation, but decided it was important enough to try to pull a team together” and meet the fast-approaching grant deadline.
Their application led to a $1.4 million grant. Marsh and Israel partnered with 16 community leaders across four Michigan counties (Wayne, Genesee, Kent, and Washtenaw) to understand drivers of trustworthiness and sources of trusted information for people who were hesitant to get a COVID-19 vaccine. She has since applied for and received two additional grants — a five-year grant of $3.4 million to address interventions to decrease vaccine hesitancy and a one-year grant of $1.4 million to address access to the vaccine, both from NIH.
In addition to her work organizing these large grant operations, Marsh also went out and talked to her own community members. She told them she understood their hesitancy, but “in order to stop the devastating disparities we were seeing with COVID-19, leading to an enormous amount of death in our community, we had to participate,” she says.
While she was waiting in line for her own vaccine, Marsh was able to overcome her initial fear. “My desire to keep my family safe, my community safe, my colleagues safe, my patients safe, and myself safe, won out,” she says. “After I got it, I felt really moved, in a way that I didn’t expect. Because I did feel like, ‘OK, I’ve taken a step to protect people that I care about.’
“That’s fundamentally what [the grants] are about, making sure that people get the right information, that the information is coming from sources they trust, and that they have equitable access to the interventions that we have right now — the leading one being the vaccine — to protect themselves, their families, their communities, and all of us at the end of the day.”
Marsh quotes James Baldwin when she says, “We are our history.” She adds, “We’re certainly not who we were or where we were 400 years ago, in terms of how we practice medicine today or how we live as a society, but we’re still paying a price for the sins that were committed and that haven’t fully been addressed.”
Another thing she’s thought a lot about over this last year is the power of community. “When jobs are lost, when life supplies are low, when access to food is a challenge … community steps up. And it has been such a privilege both to bear witness to that, but also to be able to respond to the call of community members.”
Her hope is that these grants will help the state exceed its goal of having 70% of Michiganders vaccinated. “Success would look like us being able to go back to our normal lives … to not live in fear from this pandemic, and to have it be a thing that we learned from, but a thing in the past.”