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Confront and Remedy the Black Community’s COVID-19 Vaccine Skepticism

Decades of exploitation, abuse, and racism in medicine have cost many Black Americans their lives during the pandemic. Now the government can act to prevent further harm.

Illustration by Elizabeth Brown. Photo by Getty Images.h

After months of anticipation, the first rounds of the COVID-19 vaccine were dispensed this week. Some of the conversation about this historic event has centered on who should be given the vaccine first. But we must also discuss who may not want it at all: the Black community. 

Despite being one of the most affected and at-risk groups for COVID-19, Black communities remain largely skeptical about the vaccine. Rejection of this life-saving measure constitutes a huge risk to the Black community and the entire country, which requires an intensive national effort to confront and remedy it. 

But what are we remedying? 

Data bears out the personal frustration and pain Black people experience in seeking and receiving medical care, even before the pandemic. Black patients are less likely to have their pain acknowledged and treated by doctors. Black maternal mortality was 3.2 times higher than that of white women between 2007 and 2016. Black infant mortality was 2.3 times higher than that of white babies in 2018. Additionally, a disturbingly large fraction of medical trainees believe racist myths about Black bodies.

These disparities persist regardless of class: Even tennis star Serena Williams, with her wealth and status, faced a life-threatening ordeal when a nurse initially dismissed her medical concerns following the birth of her daughter in 2017.

Beyond the everyday mistreatment of the Black community, there is a disturbing history of medical exploitation and abuse. Modern gynecology, for example, was developed through experimentation on enslaved Black women. During the Tuskegee syphilis experiments, the U.S. government studied Black men without getting informed consent or providing any treatment, resulting in decades of community spread of the disease, and suffering for these men and their families. As recently as 1996, Pfizer conducted an experimental drug trial on 200 children in Nigeria during a meningitis epidemic there. The study lacked basic ethical standards and resulted in the deaths of 11 children and permanent injury of many more

But what truly stands in the way of the Black community’s trust in the COVID-19 vaccine today is a complete lack of faith in the government’s desire or will to protect Black people in this pandemic. Systemic racism has pervaded our country’s COVID-19 response (or lack thereof), resulting in increased risk for Black communities in particular. Black people are disproportionately employed as essential workers, meaning that many are unable to shelter at home and socially distance themselves. This harm has been compounded by the fact that most essential jobs do not provide paid sick leave and many predominantly Black neighborhoods lack hospitals. Even if Black people leave their neighborhoods for hospital care, they are often turned away or released without receiving necessary treatment. Instead of addressing these issues, government officials have blamed Black people for racial inequities in COVID-19 infections and deaths, using unsubstantiated claims of biological, genetic, or cultural differences. 

As a result, Black people are 2.8 times more likely to die and 3.7 times more likely to be hospitalized from COVID compared to white people. The numbers are even worse for Black children

The history of exploitation and the continued disregard for Black lives is perpetuated by the government, which appears to be more focused on getting Black people vaccinated than on making sure that they have access to adequate employment protections, housing, food, and healthcare. This translates into a deep-seated and justified skepticism as well as caution when it comes to government-backed medical efforts, with only 42 percent of Black adults saying they would “definitely” or “probably” get the COVID vaccine if it were available today, compared to 61 percent of white adults. 

It’s not all hopeless. If the government acts quickly enough, there are many things that can be done to increase vaccination rates and protect Black communities from further harm during this pandemic. If the federal government and drug companies demonstrate to the Black community’s satisfaction why their vaccines are trustworthy, we can avoid some of the deaths from undervaccination. 

But we must do more. The government must inform and reassure the Black community that the vaccine is safe as well as value the health of Black communities beyond vaccine metrics. If the government releases the vaccine responsibly, prioritizes distribution in vulnerable Black communities, and packages it with the resources desperately needed in those communities—such as food, clean water, access to housing, and legal services to avoid eviction—we will get higher vaccination rates and actually holistically promote the health of Black people, ultimately avoiding more unnecessary deaths. 

And it doesn’t stop with the vaccine. If our government implements thoughtful, equity-focused public health measures, like protecting essential workers, releasing incarcerated people, suspending rent payments, and providing additional economic relief checks, we can avoid the deaths caused by our government’s neglect of the health and safety of Black people during the pandemic. 

We cannot accept any criticism that blames the Black community for low rates of vaccination or the resulting negative impacts on public health. Media, public officials, and academics all need to place blame where it belongs—with the government and medical industry. To address Black skepticism of the vaccine, the government must invest heavily in public outreach efforts that are culturally appropriate, come from the right messengers, and acknowledge the very real institutional harm the Black community has endured. Medical experts, including the director of the Tuskegee University National Center for Bioethics, suggest that the government needs to create an Operation Warp Speed-like task force to invest in solutions. This task force needs to partner with and pay Black community leaders, grassroots organizers, and religious leaders to deliver this message, not just Black doctors or celebrities. By investing in the Black community and existing efforts like the Black Coalition Against COVID-19, the government can demonstrate that it actually values Black health and Black lives.

This is just one step in the long process of building trust and reckoning with racism in healthcare. To make sure we break this monstrous cycle of abusing and neglecting Black bodies, we must invest in Black communities and make serious commitments to transform the medical industry and public health policy to honor Black lives. 

Ruqaiijah Yearby, JD, MPH, is a professor at the Saint Louis University School of Law and the executive director and co-founder of the Institute for Healing Justice and Equity.