COVID-19 Vaccine Hesitancy Reveals Public Health Failures for BIPOC

By Brigitte Carreiro for WORLD Channel

Doubt in the system weighs heavily on BIPOC who have yet to get a COVID-19 vaccine, while for others, personal politics continue to foster skepticism.

With COVID-19 vaccines now widely available in the U.S., the country has settled into a limbo between a "new normal" and the lingering distress of the pandemic. The plan to return to work has halted for many employers, leaving employees in a hybrid, work-from-home environment; airplane travel is steadily increasing even as the TSA extends its mask mandate through 2022; and parents are faced with sending their children to school safely as pediatric cases are spiking. COVID-19 rocked the foundation of the way we all live, and while Americans are coming out of the lockdown with high hopes and vaccines at the ready, progress out of this global pandemic remains tied to vaccination status.

Since Sandra Lindsay, a Black immigrant nurse in Queens, New York, received the first COVID-19 vaccine out of trials in December 2020, 76 percent of Americans have received at least one dose. President Joe Biden’s inoculation goal of getting at least one dose into 70 percent of adults was reached on August 2, nearly a month behind his intended deadline of July 4 and just as the Delta variant was becoming the dominant strain in the U.S. 

In tandem with the World Health Organization’s declaration of the pandemic in March 2020, two of the country's emergent COVID-19 vaccine developers – Moderna Therapeutics and Pfizer/BioNTech – worked with a newer technology, mRNA medicine, to create the first vaccines, which were approved for emergency use by the U.S. Food and Drug Administration in December 2020 with upwards of 90 percent effectiveness. In August 2021, the FDA granted full approval of the Pfizer vaccine.

With case numbers once again increasing, and as the president aims for vaccine mandates to stop the spread, the decision of whether or not to get vaccinated can have dire consequences.

It’s a choice seen at the center of 'This Body,' a film by Zac Manuel through the HINDSIGHT initiative by Reel South, Firelight Media and the Center for Asian American Media. When Sydney Hall, a young Black Louisiana State University medical student, volunteers as a COVID-19 vaccine trial participant, she falls back on her faith in the medical industry and a calling to help others in order to inform her decisions. Hall faces skepticism from family and friends who voice their distrust in the same systems she wholly believes in.

Hesitancy in Americans eligible to get vaccinated has emerged as a harmful deterrent toward efforts to curb the spread and occurrence of further mutations of COVID-19. According to the Guardian, the vast majority of current hospitalizations due to COVID-19 infection are of people who have not received a vaccine. This has prompted frustration in healthcare workers, parents of children under the age of 12 and families with loved ones who are immunocompromised and aged 65 and above.

While vaccine hesitancy is subjective to the individual, it does serve to look at where and why different populations may be experiencing doubt around immunization.

In Black communities, low vaccination turnout was a foreseeable outcome when we examine the complicated history between Black people, the government and the medical industry.

In 1932, the U.S. Public Health Service’s Syphilis Study at Tuskegee in Tuskegee, Alabama commenced a trial using a group of 600 Black sharecroppers for a study into treating syphilis. Approximately 400 of the men, infected and unaware of the true nature of the trial, were withheld treatment, only to be told that they were to be tested for "bad blood" – they spread the disease to spouses and their children, with many dying of syphilis and related complications.

The Tuskegee trial is thought of as the most infamous example of the unethical mistreatment of Black populations, but a precedent for this type of manipulation was set earlier, when slave ships crossed the Middle Passage. Men and women sick with unknown illnesses were thrown overboard; some were forced to take harmful medications. Enslaved people were unable to initiate their own medical care without a slaveowners’ permission. Cemeteries were often desecrated as hospitals and medical students sought cadavers to experiment on.

In more recent history, the health of Black Americans has been openly disregarded: Though her contribution to medicine is celebrated today, Henrietta Lacks' cancerous tumor was unknowingly sampled and studied in the 1950s. In the ‘60s, Black women, including civil rights activist Fannie Lou Hamer, were given hysterectomies with no knowledge or consent as a form of forced sterilization.

This historical indifference to the physical and mental safety of Black people, combined with low diversity rates within the COVID-19 trials, results in a not-so-outlandish concern and a consequence of scarce vaccinations in Black neighborhoods.

Understanding the current state of vaccine hesitancy means looking deeper into the systemic inequalities at play. In areas with little public funding for items like infrastructure and education, and where poverty and language barriers limit accessibility, efforts to make healthcare necessities – like vaccines – accessible go undersold, hesitancy around them more transparent.

Coupled with historical mistreatment, a lack of social equity poses a challenge for BIPOC to feel comfortable getting vaccinated. The reality for some is that they may not see a way to safely or viably – both for themselves and their families – make the effort. Reliable transportation, childcare and time off from work to attend a vaccination appointment or tend to potential side effects are real-life problems for communities of color that their white counterparts often aren't faced with. The risk of side effects, though at times overinflated by the spread of misinformation, frighten those who cannot financially afford to stay home sick from work or pay to leave their children with a babysitter or daycare, and undocumented immigrants stay away from seeking appointments where record-keeping is an element.

Yet surveys suggest that BIPOC alone do not make up the majority of those that remain unvaccinated.

According to the New York Times, there are two dominant thought processes among the unvaccinated, which can be fairly split by demographic: In predominantly rural, white, politically right-leaning communities, those who are not vaccinated are adamant in their refusal, whereas those in communities that are urban, left-leaning and primarily made up of Black and Latinx Americans are hesitant yet open to vaccines. This second group, studies show, makes up less than half of all unvaccinated adults in the U.S.

If we further explore who is getting vaccinated, and where, we can begin to see and understand further demographic patterns, with education, wealth and politics factoring in. In the conservative South, specifically Alabama, Mississippi, Arkansas and Louisiana, vaccination rates are well below the national average, hovering around 40 to 50 percent, whereas highest rates – 70 to 75 percent – are occurring in liberal Northeast states like Vermont, Massachusetts and Connecticut.

For people who remain unvaccinated that aren’t deterred by social obstacles, a resistance to the vaccine has been perpetuated by politics and misinformation.

In April, the New York Times found that both willingness and actual vaccination rates averaged lower in counties in which the majority of constituents voted to reelect former President Donald Trump in 2020. Trump, who hasn’t publicized his vaccination, unlike most world leaders, discounted the dangers of COVID-19 over the length of his last year in office; his endorsements of the vaccine have been few and far between, despite Republicans making up a large majority of those resisting vaccination.

Even with the ongoing divide among those vaccinated and those unvaccinated in the U.S., medical professionals and government officials continue to agree that vaccination is the best – and potentially only – way to curb the pandemic.

Luckily, over the last two months, vaccinations have reportedly been increasing steadily in all 50 states, even in those with the fewest distributed shots. While attempts to incentivize the unvaccinated, like Vax-a-Million drawings in some states and free doughnuts in others, have seemed feeble (though not entirely useless), the recent uptick in vaccinations is being attributed to the Delta variant, citing its more transmissible nature as the motivation some resistors needed.

What we’re seeing is that as more Americans become sick, more may make the choice to get vaccinated.

Whether one decides to get vaccinated against COVID-19 or not, uncertainty surrounding the vaccine has exposed societal inequities across the nation, revealing what little action is being taken to rectify them. The pandemic has decidedly highlighted the fraught divisions within the U.S. in more ways than one, but by acknowledging these frictions, we leave room for conversation, healing and unity.

For more, explore our COVID-19 Collection.

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Watch a virtual screening of 'This Body,' a HINDSIGHT film by Firelight, Reel South and the Center for Asian American Media, and hear filmmaker Zac Manuel and special guests, Dr. Thomas A. LaVeist, Dean and Weatherhead Presidential Chair in Health Equity at Tulane University, and activist Shana Griffin, discuss the film and answer questions. Moderated by Tambay Obenson, staff writer at IndieWire.

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