Equity Fact: Understanding Vaccine Hesitancy

A brief look at historical malpractice and distrust 

Have you wondered why some people may seem cautious about the COVID19 vaccine, particularly some Black, Indigenous, and People of Color (BIPOC)? Some individual's precautions may be related to the timeline of trials and the nature of approval under emergency use authorization. Some may be related to religious beliefs. Some have distrust of our prominent political, elite and wealthy individuals' relationship to science. But, there are others who have concerns that are more deeply rooted in our country's fabric. 

It is very unfortunate that we live in a nation in which BIPOC have experienced targeted racism as it relates to healthcare. But, if we want create an inclusive society where all individuals feel valued, each of us must accept these shameful realities and cannot live in disbelief or belittle them. To advance inclusiveness here are a few historical events that you should read more about: 

Small Pox and Indigenous People: The first form of bioterrorism that occurred on U.S. land was when European settlers distributed smallpox blankets to Indigenous people, which is estimated to have killed 90% of the country’s original inhabitants. Then, in 1832, the Indian Vaccination Act was used to move Indigenous people off their land. ("How Native Americans were vaccinated against smallpox, then pushed off their land," Washington Post, March 28, 2021) 

Denial of Healthcare for African Americans: In 1863, the Emancipation Proclamation freed African Americans who were enslaved. However, they were given freedom without any necessities for survival, including access to healthcare. Even when provided healthcare, hospitals were segregated until the passage of Medicare in 1965. ("How the bad blood started," New York Times, September 13, 2019) 

The Story of Henrietta Lacks: Henrietta Lacks was an African-American woman who unknowingly donated her cells at John Hopkins in 1951, beginning what was the first and, for many years, the only human cell line able to reproduce indefinitely. Lacks died a few months after her cancer diagnosis, but her cells continue to be used for research, including for COVID-19. They have also become the foundation of a multibillion-dollar industry. There are more than 17,000 patents involving HeLa (‘He’ for Henrietta, ‘La’ for Lacks) cells. At the time no credit was given to Lacks and her family wasn’t even aware of the existence of the cells until 1973 and were never given compensation. ("Henrietta Lacks: science must right a historical wrong," Nature, September 1, 2020) 

Tuskegee Study: In 1932, more than 600 African-Americans were recruited to be a part of a study on syphilis. The men had been misled and had not been given all the facts required to provide informed consent. They were given free medical exams, free meals and burial insurance, but were not given adequate cure treatment, which was the original purpose of the study. (The Tuskegee Timeline)

Sterilizations in the Latinx/Hispanic Community: In the 1978 case of Madrigal v. Quilligan, a doctor leaked information that 10 Mexican and Chicano plaintiffs at the Los Angeles County-University of Southern California Medical Center were sterilized without informed consent. The 10 women lost the case, however it led to exposure of thousands of other similar cases. Additionally, from the 1930s through the 1970s, about one-third of the female population in Puerto Rico was sterilized under population control policies that coerced women into postpartum sterilization after their second child's birth. ("Thousands of Latinos were sterilized in the 20th century. Amid COVID-19 vaccine hesitancy, they remember," USA Today, March 16, 2021)

In addition to these disparaging line of healthcare events, some BIPOC may have a general distrust of systems (law enforcement, criminal justice, banking, housing and others). These historical events and reasons are not intended to create a monolith amongst BIPOC communities, so each person's feelings and beliefs should be treated individually. 

Even currently, according to the CDC, Latinx, Indigenous, and African-Americans are three times more likely to be hospitalized from COVID-19 than Whites (which showcases the inequity in healthcare prior to COVID-19). With the consideration of our nation's unfortunate events and the current crisis of people of color being impacted by the disease, it is clear we have a very complicated and complex issue.

So, in our quest to equip individuals with the most accurate information on the COVID-19 vaccine to help them make the best-informed personal decision, it is critical that each of us continually develop cultural awareness to, at minimum, respect individual feelings toward the vaccine.

This CNN article describes an African-American doctor’s approach to deliberating with patients about the vaccine with cultural awareness and respect.

Eric Reed, Ph.D.
Dean of Student Access, Success, Equity, and Inclusion
Washtenaw Community College