If you want to feel bullish about public health—and these days, we all do—four graphs I keep around in my office will put you in a rosy mood. All four show a sharp rise followed by an even steeper decline: they represent the appearance and disappearance of polio, chicken pox, whooping cough, and spinal meningitis, diseases that used to plague vast portions of the population before being curbed by the appearance of an effective and available vaccine.
You hardly have to be an epidemiologist to understand how vaccines succeed in doing so much good in such short periods of time: they work when most people get them and do so quickly, creating what we sometimes refer to as herd immunity. If substantial portions of the population refuse immunization, a vaccine, even one confirmed in clinical trials to have precisely the desired effect, is not going to do much to fight a pandemic.
Sadly, this is what we’re currently seeing among black and Latinx Americans: even though they are four times more likely to be hospitalized and nearly three times more likely to succumb to COVID-19, they are far more reluctant than white Americans when it comes to signing up for the vaccine. In the 16 states that have released data by race, for example, the records show white Americans being vaccinated at a rate that is two or three times higher than their black neighbors. And, addressing a recent poll, 35 percent of black respondents and 26 percent of Latinx respondents said they would probably or definitely refuse the vaccine altogether.
Their hesitation isn’t difficult to understand. Communities of color have frequently been mistreated by the medical establishment: in the most notorious example of such abuse, African American men were told they were receiving free health care from the U.S. government, which, in turn, conducted a 40-year-long unethical experiment—orchestrated by the United States Public Health Service and the Centers for Disease Control and Prevention—that denied them commonly available treatment for syphilis and led to the death of 128 people. Women from LatinX and other communities of color were mistreated and misinformed about sterilization for many years.
It’s understandable, then, that communities of color meet the promise of a vaccine with a healthy dose of skepticism. That’s why it is crucial that we address their concerns and make sure our communities get the information they need and the care they deserve. In parallel, we must prioritize giving these our very hard-hit communities of color access to the vaccine.
How to do that? We can lead by example by providing information and opportunities to educate the community. Having leaders and influencers speak to the community also makes a difference. Social media has a host of hashtags that have emerged on Twitter and that are dedicated largely to educating and encouraging communities of color to get vaccinated. The hashtag #blackmeninmedicine, for example, features African-American doctors, nurses, and other health care professionals, with rolled-up sleeves fresh from having received the shot. Seeing so many confident peers endorse the vaccine is a great way to spark a much-needed conversation.
Finally, health care providers, too, have a responsibility to make sure they’re doing everything they can to communicate with their constituents effectively and empathically. With distrust already high, and with the digital divide often placing people without easy Internet access at a disadvantage, officials should proactively partner with faith-based and community leaders to make sure the right information is conveyed in the right way through the most effective channels. Having good data helps, too, which is why the CDC would do well to expedite its promise to add race and ethnicity to its publicly available dashboard, giving us a real-time glimpse into how well we’re doing in providing access to the vaccine and closing up the racial vaccination gap.
One day soon, I hope, we can add COVID-19 to the list of pandemics stopped cold by science. But for that to happen, we must all work together to make sure racial equity catches up to the research.