For many people in the United States, the approval of the Pfizer-BioNTech and Moderna COVID-19 vaccines symbolize hope for the end of a virus that has plagued this country and the world. The Centers for Disease Control (CDC) has reported 373,167 COVID-19-related deaths across the United States as of January 11, with Black, Indigenous and People of Color (BIPOC) being disproportionately impacted.
In November, the CDC reported that when compared to White/non-Latinx persons; Indigenous, Asian, Black, and Latinx folks are more likely to be diagnosed, hospitalized, and die from COVID-19. Yet a recent national survey conducted by the COVID Collaborative, Langer Research, UnidosUS, and the NAACP found that the majority of Black and Latinx people do not trust the vaccine to be effective or safe.
So how can there be such levels of distrust in a vaccine and its effectiveness among some of the most impacted populations? While the answer to this is complex, it is directly connected to White supremacy, the all-encompassing centrality and assumed superiority of people defined and perceived as White and the practices and standards of norms based upon that assumption, and the role that structurally oppressive systems play in giving privilege to those with agent identities while disenfranchising others. Themes of power and dominance can be present in interactions between patients and doctors and the manner in which vaccination skeptics are often ridiculed or dismissed as uneducated. It is the way that some anchor institutions have centered their will and domination over the neighborhoods that they occupy.
The Tuskegee syphilis experiment seems to be the most mentioned medical experiment when discussing BIPOC medical mistrust, but the legacy of experimentation and unethical research of BIPOC and marginalized populations does not begin and end with Tuskegee. Instead, the roots of medical mistrust are much deeper and wider. One of the earliest documented cases involved experiments on enslaved women of African descent at the hands of J. Marion Sims, who is referred to as the “Father of Modern Gynecology.” His experiments on Anarcha, Betsy, and Lucy were conducted without anesthesia due to its high cost and high risk, the “subjects” being viewed as property, and the belief that Black people did not feel pain in the same way as White people. The latter, while seemly antiquated prevails in modern medical settings.
A 2016 study published in the Proceedings of the National Academies of Science, found that 50 percent of medical trainees surveyed believed at least one of the following: Black people’s nerve endings are less sensitive than White people’s, Black people’s skin is thicker than White people’s, and Black people’s blood coagulates more quickly than White people’s. Additionally, a textbook used in educating nurses, Nursing: A Concept-Based Approach to Learning, advises readers that “a client’s culture influences their response to, and beliefs about pain.” It lists the following:
Stereotypes like the ones above position medical professionals to employ bias to evaluate pain instead of listening to patients and assessing needs. It is inaccuracies like these that contribute to mistreatment of BIPOC patients, which contributes to medical mistrust. It is important to note that once Sims perfected his surgeries, they were performed on white women under sedation.
In the space afforded, I could not provide an exhaustive list of medical and scientific experiments, so the educator in me was compelled to leave the reader with an assignment. Below is a timeline that illustrates that scientific/medical experimentation are not isolated, spans across centuries, and impacts people across race, ethnicity, age, socio-economic status, freedom, language, and nationality. I urge you to conduct your own research on these and other experiments with the intention of understanding the historical and current context of medical mistrust and responses to COVID-19 vaccines.
