Vaccines in Minority Communities – A Fraught Past, a More Hopeful Future
The Centers for Disease Control and Prevention, along with every other responsible medical and social service organization in the country, has acknowledged the checkered history of vaccination in minority communities in the United States. People in Black and brown communities have a complicated relationship with mainstream medical and public health institutions, including vaccination campaigns. It’s a problem thrown into stark relief by the COVID-19 pandemic.
The long legacy of medical racism
The growing American commitment to vaccine equity comes after centuries of medical racism that includes the horrific Tuskegee Syphilis Study conducted by the U.S. Public Health Service and the CDC from the 1930s to 70s.
The hundreds of Black men who took part in the study were not afforded the opportunity to give informed consent for their participation; researchers told them they were being treated for "bad blood" and did not inform the men that they had syphilis. Nor were the men offered penicillin, despite the fact that it was widely available and accepted as the standard, effective treatment for syphilis by the late 40s. Instead, they received placebos and other ineffective therapies.
By the time the national press learned of the study in the early 70s, more than 120 of the men had died of syphilis or complications from the disease, 40 of their wives had been infected, and 19 children were diagnosed with congenital syphilis. It was not until 1997 that the U.S. offered a formal public apology to acknowledge the injustices the Tuskegee researchers committed.
The afterlife of the cell line derived from Henrietta Lacks presents another case of medical racism, this one newly brought to public attention through the 2010 book The Immortal Life of Henrietta Lacks by Rebecca Skloot and a related 2017 film. Lacks was a young Black mother of five diagnosed with cervical cancer and treated at The Johns Hopkins University. In 1951, the university collected samples of her cells without her consent. The scientists found that Lacks’ cells—dubbed the “HeLa” line—showed remarkable longevity. Lacks' cells have since been used as the basis for lifesaving research into a wide variety of diseases.
But none of the researchers or the biotech firms that made billions from developing new drugs and treatments ever returned any portion of their profits to Lacks’ family and descendants. Nor did anyone ask the Lacks family’s consent to disclose Lacks’ personal medical information to the media. In 2020, the Howard Hughes Medical Institute, only one of the firms that has gotten rich from research based on the HeLa cell line, made a six-figure donation to the Henrietta Lacks Foundation.
American healthcare stymied by prejudice
In the 1950s, after the development of the polio vaccines, government healthcare officials often portrayed the higher rates of polio in Black communities as a result of residents’ ignorance of the importance of vaccination. However, their mistrust of mainstream medicine and government public health directives is eminently understandable—these institutions not only failed to serve Black communities, but actively harmed them. The experience of the men involved in the Tuskegee Syphilis Study and Henrietta Lacks are just two examples of this.
Many white physicians assumed that Black Americans were somehow inherently less susceptible to polio, when the reality was that they had less access to quality medical care, so fewer white medical practices encountered Black polio patients. To add further insult to injury, Black Americans made substantial contributions to fund President Franklin D. Roosevelt’s polio rehabilitation center in Warm Springs, Georgia, in the 1930s, but because of segregation, the facility did not admit Black patients.
Modern-day inequities
In addition to the painful history of medical experimentation, Black Americans still have less access to healthcare, medical information, and transportation to get to healthcare services today. Gaps in income and education persist. These inequities also account for the lack of progress in getting Black and brown folks vaccinated, and lead to higher numbers of COVID-19 illness and death in communities of color.
Other reasons for the pandemic's disproportionate impact on these communities include the fact that people of color are more likely than white people to work in front-line, essential jobs that do not permit remote work. In addition, people of color have higher rates of the pre-existing conditions associated with more severe cases of COVID-19.
From hesitation to progress
Early in the COVID vaccine rollout, Black Americans and other people of color lagged behind in their vaccination rates. Surveys conducted in the fall of 2020 showed that this group was the most likely to express hesitation about getting vaccinated. But by the close of 2021, those gaps were beginning to close. According to the CDC, looking at data from across 42 states, by mid-December, 58 percent of white Americans had received at least one vaccine dose, compared with 51 percent of Black Americans and 56 percent of Hispanic Americans. Not great, but getting there.
Back in December 2020, a Black woman became the first person in the U.S. to receive a dose of a COVID-19 vaccine. Sandra Lindsay, director of critical care nursing for Long Island Jewish Medical Center, had already witnessed the coronavirus’ devastation of minority communities. For Lindsay, and for the many other Black medical professionals whose perseverance and skill have helped alleviate the pandemic, it was an opportunity to show that, while historic wrongs can’t be righted, we now have the opportunity to get to a place of greater health equity in this generation.
Immunologist Dr. Kizzmekia S. Corbett, one of the key researchers whose work led to the development of Moderna’s mRNA COVID-19 vaccine, is also among the healthcare professionals to take the lead on vaccine education in communities of color. As a public face of science advocacy and a source of vaccine safety information, Dr. Corbett has helped to start the turning of the tide, letting Black and brown Americans know that the vaccine is safe and vital for protection against COVID-19.