Baltimore’s University of Maryland School of Medicine understands the importance of working with diverse cultures in a research setting. Baltimore, a city seeking a renaissance has struggled as the key mid-Atlantic port and trading center at one point had nearly 1 million residents back in 1950. A lot has changed in 70 years. From deindustrialization and the transition to a knowledge economy—spurred by globalization and the technology revolution—such a new economic reality drives up incomes for some fortunate groups, and down for many others. Situated strategically between Washington DC and Philadelphia, Baltimore, along with parts of Maryland, have emerged as an important biomedical research cluster with the university, Johns Hopkins and various federal labs nearby. But mounting challenges, driven by socio-economics, ethnic and racial bias and associated social and economic factors mentioned previously, transformed Baltimore from a predominantly middle class city to one with a majority African American population (now about 63%) and unacceptable deep pockets of dire poverty. In the meantime, the metropolitan area has transformed fields and forest, driven in part by so called “White Flight,” leading to a growing population of nearly 2.4 million. Looked at in combination with Washington DC, this bustling urban complex totals nearly 10 million people, representing one of the most vibrant and dynamic economies in America. With the onset of pandemic and disproportionate impact in the urban core, such as Baltimore, came the need for the expertise, the institutional connectivity and cultural competency to identify, recruit and treat at risk populations; in Baltimore, that includes African Americans, a demographic that traditionally has viewed medical research with suspicion and in the context of Baltimore strives for a better tomorrow. The recent Moderna COVID-19 vaccine study successfully included a diverse participant base thanks to the ongoing work of this dynamic academic medical center in the urban core.
COVID-19 in Baltimore
The city’s population steadily decline to about 594,000 today. With 6.046 million population statewide, Baltimore recorded 508 deaths associated with the coronavirus thus far, as compared to 4,172 statewide. Meaning: although the city represents about 9% of the population yet recorded, 12% of the deaths associated with the new virus. In fact, statewide Blacks have substantially higher death rates than whites and Latinos.
The social determinants of health matter and are in fact a fundamental predictor of good health, or not. Baltimore’ Behavioral Health System is intimately familiar with the challenges faced by the city: a place struggling with a poverty rate of nearly 25% as compared to a statewide figure of 10%. Enter University of Maryland School of Medicine and its approach to Diversity and Inclusion.
Diversity and Inclusion
At the University of Maryland School of Medicine, diversity and inclusion matters greatly. With a Diversity Advisory Committee (DAC), the academic medical center seeks to ensure that institutional-level initiatives align with goals and objectives involving diversity and commitment to an inclusive multicultural institution embracing all people in the city and beyond.
This kind of track record helps when a pandemic comes along and hits Blacks nearly twice as hard as the Anglo and other white ethnic populations. With traditional tensions between at least some demographic cohorts and biomedical research, a track record of a commitment to not only diversity and inclusion but also equity makes a difference when enrolling participants for studies.
The mRNA-1273 Study and Successful Volunteer Recruitment
As reported recently by Fox 45 in Baltimore, the university’s investigators were able to enroll hundreds of participants for the Moderna mRNA-1273 COVID-19 vaccine study, including many African Americans. With a hope that the vaccine will actually work as 2020 comes near an end, the recent Fox News highlights study participant: Anthony Oles, a retired firefighter paramedic and one of the 400 who participated in the Baltimore clinical trial.
Dynamics of a Clinical Trial
One of the key investigators in this study, Dr. Matthew Laurens with the university’s Center for Vaccine Development and Global Health, shared with the local audience that of the 30,000 participated in this study. Part of the national public-private partnership initiated by POTUS called Operation Warp Speed (OWS), Dr. Laurens shared, “This study has involved folks from many different backgrounds and many walks of life. This will help us to develop a vaccine that hopefully will protect everyone.” He continued, “We are including elderly individuals as well as any other adults. We are including those who are having high risk conditions, so individuals with heart disease, diabetes, chronic lung disease, they’re all included as well.”
Reminding all the importance of patient safety as the number one priority, Dr. Laurens commented to the local press, “This is something we’re accelerating very quickly, but at the same time we’re not skipping the steps that are required for safety. We’re still following the sequence of phase one, phase two, phase three trials. It’s just a significant financial support that we’re getting from the US government and individual donors and private partnerships that are allowing us to advance so quickly.”
Matthew B. Laurens, MD, MPH, Associate Professor, Center for Vaccine Development and Global Health
Call to Action: Sponsors when considering selecting trial sites consider the capabilities and track record of University of Maryland, School of Medicine in Baltimore. The university’s research covers wide tracks. Joni Prasad, PhD leads the Office of Research Affairs.