The Black Case for Vaccinations
We are nearing the twilight of the COVID-19 pandemic. With the announcement of three different vaccines, the reality that our nightmarish existence in deference to our microscopic foe will soon be over sparks a ray of hope for people around the world as they fortify themselves for a brutal winter. Yet lurking in the shadows is the reality that many people have expressed resistance to the idea of receiving the COVID-19 vaccine. This could be the result of misinformation or the culmination of decades of distrust towards the medical community. In particular, I’ve been made aware by my pastor that several black pastors in the Greater Boston area expressed concern about their congregation accepting the vaccine. Later, I heard from my parents about skepticism in their circles regarding the viability and safety of the vaccine. In the corners of black society there are three primary reasons for this: disparate healthcare outcomes, concerns about the vaccines’ unknown side effects, and most notoriously the Tuskegee Experiment. This essay attempts to appeal to those whose skepticism is more centered around logic than emotion. That’s not to say that I will not acknowledge the emotional arguments; refuting emotion is simply not my priority. Ultimately, the black skeptic should take the COVID-19 vaccine because the impact of unknown side effects, disparate healthcare outcomes, and the Tuskegee Experiment may be misunderstood and misapplied significantly enough that the skeptic should revisit his or her current stance.
Unknown Side Effects
Arguably the most common cause for concern in the eyes of many vaccine skeptics is that the side effects of a COVID-19 vaccine are unknown. This is generally true: Because we’re dealing with a novel virus, any vaccine is going to come with unknown side effects. However, this is a concern that should be out of the minds of most of the general populace. The reason being is that by the time the average citizen has access to a vaccine, enough people will have already been vaccinated that we should be aware of any serious issues. For example, Moderna believes that it could have twenty million doses ready by the end of the year. Those twenty million doses could only fully vaccinate ten million people. Those ten million people are likely to be government officials and healthcare workers. I won’t project which subset of people are likely to get vaccinated after that because if this pandemic has taught us anything, it is that the bounds of human selfishness are indeed boundless. There will absolutely be folks who will obtain access to a vaccine far before their risk profile suggests. However, that is a digression. The reality is that it is likely tens of millions, if not hundreds of millions of people will be vaccinated worldwide before you even receive your first dose. The bottom line is this: because we aren’t important enough to get early access to a vaccine, hundreds of millions of people will have access to it before us. As a result, serious side effects, if any, should be known by then.
Healthcare Outcomes
In any systemically racist society, such as America’s, the institutional rot never stays in one place. It eventually seeps into every facet of society, likely calcifying itself through the unconscious bias of the individual. While the target of this particular essay is the black American resident on the fence about getting the COVID-19 vaccine, it is publicly available for anyone to read. Thus, I’d like to pause here and share something with my non-black readers: a lot of black people don’t trust their doctors. There’s a number of reasons for this from general incompetence to being ignored. Nevertheless, black people statistically trust their doctors less to be forthcoming than other ethnicities. This is important to keep in mind as you continue reading [0].
Black healthcare outcomes are one of the common indicators pointed to when discussing America’s systemic racism. Some of these outcomes are correlated with other racist elements in society. For example, elevated obesity rates are one of the outcomes of having food deserts in urban areas [1]. Other outcomes are correlated directly with interactions with our healthcare system itself [2]. A common example would be elevated pregnancy mortality rates. It is these direct interactions that lead black patients to distrust their doctors. They feel unheard or that their doctors aren’t being forthcoming. This distrust becomes relevant when doctors need to convince patients to take their medicine or receive a vaccine for a disease that is inundated with misinformation. There isn’t a lot I can do to ease fears on this particular issue. I hope the demographic information assures you that healthcare outcomes should be equitable. And I hope that doctors and healthcare systems are proactive about reaching out to patients about getting vaccinated. But that’s all I can do against this particular argument. Hope.
Revisiting Tuskegee
I am not a health care provider nor am I a medical historian. Despite my ignorance, it remains unfathomable that there plausibly exists a class of medical ethics violations worse than those that happened in the Tuskegee Experiment. Despite the horrific nature of the experiment, there is still widely believed misinformation about it because the United States of America does not properly educate its citizens on the failures of this country and its connection to the systemic racism we struggle to defeat for a better tomorrow. The Tuskegee experiment began in 1932 in an attempt to understand the long-term effects of syphilis on the human body. The subjects solicited for this experiment were black males who already had syphilis. This is contrary to the popular misconception that the U.S. Public Health Service (PHS) injected these men with syphilis [3]. In order to get these men to participate in the study, the PHS promised free health care to the men, which is a great deal for pretty much any American in the year of our Lord 2020 much less a black man in Jim Crow Alabama. However, because this was still Jim Crow Alabama, they didn’t actually get free health care. Instead, they received placebos as syphilis continued to ravage their bodies.
Now, let me tell you what I know about syphilis: nothing, because that would require me to refuse to wear a condom. Well, that’s not totally accurate. I know you can die from syphilis since almost all of these men did. This gets to the crux of the discrepancy of the perception versus the reality of the experiment. It’s not that the U.S. PHS injected the men with syphilis and let them die. They already had syphilis; they just said they’d give them proper care for syphilis and instead just let the disease run its course. Clearly, that’s the much better outcome. I’ve digressed. I don’t know the proper terminology for the medical science violation the Tuskegee Experiment perpetrated so I’ll come with my own: The Tuskegee Experiment was an example of non-consensual experimentation. This simply means that the subjects of the experiment weren’t aware that they were a part of an experiment or what the nature of that experiment was.
You may already start to see the argument I’m going to attempt to make. The COVID-19 vaccine is not a case of non-consensual experimentation. In my opinion, the biggest element missing from this particular case is the lack of information asymmetry. That’s not to say there is no asymmetry; it’s just that the common person of color has access to the same information as the common white person. Additionally, the pharmaceutical companies have been clear that this is the fastest we’ve released a vaccine in human history. Therefore, while they’ve been able to identify some of the risks involved, they have not discovered all of them. If any asymmetry would exist, it would be between researchers and the common populace. Two of the three vaccine developers have made the results of their studies fully available to be analyzed by the general population in order to assuage fears of opacity [4] [5]. There is no hidden information and if there is, we are all unaware of it. Therefore, the COVID-19 and Tuskegee Experiment are poor contemporaries due to the lack of similarities in ethical failings.
America has failed its black citizens continually throughout its relatively short history. It is understandable, if not unsurprising, that deep skepticism about a vaccine likely to be mandated by the state exists in a community with a troubled history with state intervention in their lives. However, I would ask once more that our people put aside our misgivings and distrust in order to protect those around us, our loved ones, and ourselves from a disease that already has needlessly killed so many people in our country due to selfishness and incompetence.
Author’s Note: I tried to put forth my typical effort on this post. It’s important to me. I wanna play softball next year. But to be honest, I just wanted to be done with it. This pandemic and the rejection of best practices without any research by the skeptic, is exhausting. I didn’t quite get there. I’ll probably make some edits for clarity and proofreading over the next few days but the ideas will stand as is. I’m tired and the fact there existed evidence that I needed to write this was just more disappointment in a disappointing year.
[3] — https://www.history.com/news/the-infamous-40-year-tuskegee-study