High levels of distrust toward the federal government—as well as a knowledge of historic medical abuses in the Black community—can hamper efforts to get Black Americans to take a free coronavirus vaccine, should one be available, finds a new study.
While several studies have come out in recent months gauging potential public responses to a COVID-19 vaccine, the survey released Monday is among the largest and most rigorous to date, focusing exclusively on attitudes Black and Latinx Americans have toward a potential vaccine, reports the Washington Post. Similar research has shown reticence about a vaccine among communities of color, but this latest study stands out because it polled respondents on why they feel the way they do.
The study found just 14 percent of Black people trust that a vaccine will be safe, and 18 percent trust that it could effectively protect them from the coronavirus. This was substantially lower than Latinx respondents, of whom 1 in 3 respondents said they trusted the safety of a vaccine, and 40 percent believed in its efficacy.
Respondents’ answers suggest the distrust of a vaccine hinges on a general lack of trust in government and government institutions and not a lack of familiarity with the disease. More than half of Black people said they know someone diagnosed with COVID-19, with slightly less than half saying they knew someone who was hospitalized or died from the disease (these rates were higher among Latinx respondents).
Two out of every three Black respondents, however, said the government can never or could only rarely be trusted to look after their interests. Those who did report some trust in the government were, not surprisingly, much more likely to say they would get a COVID-19 vaccine than those who did not.
Historical knowledge of medical trauma also played a major part in discouraging Black Americans from putting their trust in a vaccine—specifically, knowledge of the infamous Tuskegee syphilis study, in which African American men were unknowingly studied for the venereal disease—and denied treatment for it. More than a hundred African American men ended up dying from syphilis and its related complications and spread it to their spouses and children. The study also found trust in a vaccine lowest among those respondents with a strong connection to their Black identity.
Understanding the roots of Black Americans’ distrust in vaccinations is necessary to understand how to effectively promote treatments in a community that has seen disproportionate damage from the disease. As the Post reports, the success of a vaccine is contingent on having enough Americans (a strong majority) take it to establish herd immunity.
“It’s not having a vaccine that saves lives, it’s people actually getting vaccinated,” Michelle A. Williams, dean of the Harvard T.H. Chan School of Public Health and co-founder of the COVID Collaborative, which commissioned the study, told the Post. “For that to happen, we need to understand why so many are hesitant and help overcome that.”
It’s also important to establish how the attitudes of Black Americans and other historically marginalized groups, like Latinx and Native Americans, all of whom have been hospitalized at much higher rates for COVID-19 than white Americans, are historically and socially different than those of anti-vaccination movements.
“On one hand in this country, you have the anti-vaxxers and the unfounded disinformation they push,” Alexandre White, a professor at Johns Hopkins University who studies the sociology and history of medicine told the Post. “But what you see from minorities is a hesitancy that is quite rooted in historical reality.”
The survey also points to a path forward for building the necessary trust with Black communities. Notably, more than 50 percent of Black Americans said they trusted Dr. Anthony Fauci, the country’s foremost expert on infectious diseases, while trust in the FDA, pharmacies and clinics, drug companies and the Trump administration didn’t crack more than 30 percent. Putting a personal face on the COVID-19 messaging, then, may be key. Respondents also reported that they were twice as likely to trust information coming from a Black person than a white one.
The survey also found that appealing to Black folks’ responsibility to their communities, as well as reinforcing the idea that people around them would also get the vaccine, could effectively boost participation rates.
This, of course, is just quantifying what some public health experts and elected officials have been saying for months: that if the government hopes to stop the spread of the virus, it needs direct engagement with marginalized communities and their leaders. This was the thinking behind a recent letter from Black doctors encouraging families to take the COVID-19 when a safe option is available, as well as cautioning against large Thanksgiving gatherings.
Howard University President Wayne A.I. Frederick, himself a physician, told the Post it was essential that Black healthcare providers relay the importance of vaccinations, as well as addressing patients’ concerns directly.
“The average African American cannot give you details of Tuskegee,” Frederick noted. “Their mistrust is of institutions, of government institutions, of law enforcement, and that mistrust spreads across our community.”