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Coronavirus Disease 2019
Want Black People to Get Vaccinated?
Address cultural mistrust to combat COVID disinformation.
Posted December 5, 2020 Reviewed by Abigail Fagan
This post was written by Dr. Kevin Cokley and Dr. Germine Awad, associate professor of educational psychology at the University of Texas at Austin.
I (Kevin Cokley) was recently talking to my mother about the COVID-19 pandemic. We talked about how bad things had gotten, and I optimistically mentioned that the pending vaccine would help make things better. To my surprise, my mother (a 70+-year-old Black woman raised in the deep South of Mississippi), responded that she was not going to be a guinea pig and that she would need to see evidence of people taking the vaccine and being OK before she would take it.
I have also spoken to members of the Association of Black Psychologists who have shared that they have heard similar sentiments from older African Americans. In fact, there have been many articles written about why some Black Americans (and Latinx Americans too) are hesitant about taking any COVID-19 related vaccines (see stories by CNN, the Washington Post, and NPR).
Like many Black folks of her generation, my mother grew up experiencing Jim Crow segregation and discrimination. When she was born, the Tuskegee Syphilis study had been going on for 17 years. Started in 1932 and ending in 1972, the Tuskegee study was funded by the U.S. Public Health Service and examined untreated syphilis among African American males.
The purpose of the study was to observe the course of untreated syphilis in approximately 400 Black men. Under the guise of receiving free health care from the federal government, African American men were recruited into the study. Although the men were initially told that the study would last for six months, it actually lasted for 40 years. When there was no longer funding, the study continued without informing the men that they would never be treated, in spite of the fact that penicillin had been developed by 1947, two years before my mother was born and 15 years after the study started.
Having learned about the Tuskegee syphilis study in college, and being reminded about it whenever we update our Human Subjects Research Board training, it is easy to forget, or perhaps take for granted, that individuals from my parents’ generation and others may not be familiar with the Tuskegee study (although my parents have heard of the Tuskegee airmen).
This is important to mention because historical incidents like the Tuskegee study are believed to contribute to cultural mistrust, the psychological adaptation to help Black people navigate racist environments and deal with racist people and racist institutions. Cultural mistrust among African Americans has been found toward white mental health professionals, physicians and nurse practitioners, and the health care system at large. Other sources of mistrust of the system may stem from lack of access to high-quality care, lack of practitioner cultural competence, and bias in diagnosis and care. Specifically, research has found that medical mistrust is higher among African Americans than white Americans.
Of course, mistrust of the medical establishment and health care professionals, and specifically of a COVID-19 vaccine, is not exclusive to African Americans. There is a general public mistrust in a COVID-19 vaccine across race and ethnicity. Many factors contribute to this mistrust. In the case of my mother, I assumed that it was cultural mistrust based on her lived experience as a Black woman from the South.
While I have no doubt that cultural mistrust is ever-present among African Americans and is at least partially responsible for racial health disparities, in a follow-up conversation, my mother clarified that her vaccine attitude was because she did not trust anything said about the vaccine by President Trump. She said that when the Centers for Disease Control and Prevention and Dr. Anthony Fauci approve of a vaccine, she will then take it.
Support for taking the vaccine is also not helped when you have high profile Black people such as Black Panther star Letitia Wright sharing conspiracy theories about COVID-19 vaccines on Twitter (which she later deleted after receiving backlash).
The messaging around the COVID-19 vaccines will determine the likelihood that Americans will be willing to be vaccinated. According to a recent Gallup Poll, 58% of Americans surveyed said they would be willing to get the COVID-19 vaccine. When broken down by race, 60% of whites agreed to be vaccinated while 48% of non-whites were willing to get vaccinated.
Compared to whites, the COVID-19 death rate for Black Americans is 2.5 times higher and Black Americans are five times more likely to be hospitalized due to the disease. Given the disparities, it is imperative that health care professionals and scientists make concerted efforts to increase vaccination rates for Black Americans and other minoritized groups.
The CDC has posted information about the benefits of getting the COVID-19 vaccine to help allay fears surrounding vaccinations. They outline the benefits of receiving the vaccine and provide a general fact sheet about COVID-19 vaccines. This information must be disseminated widely by trusted sources. Public health professionals should reach out to Black community leaders to recruit them to help curb COVID-19 misinformation and provide training on how to increase general science literacy about the vaccines.
The willingness of Black Americans to get vaccinated for COVID-19 is not only impacted by cultural mistrust. Similar to many Americans, there is a lack of understanding about how vaccines work and what it means when a vaccine has been tested and approved. Improving scientific literacy is another way of combatting cultural mistrust, especially given that for some, vaccination has become a political issue and not just about public health. Scientists must not only translate complex scientific concepts but also do so in a way that allows Black people to feel that the process of vaccine approval and administration is transparent and non-political.
In addition to distilling and disseminating scientific information about the vaccines, understanding which sources and what types of information are legitimate and likely to convince Black Americans to get vaccinated is crucial. This is especially important because of efforts to spread disinformation to people through conspiracy theories.
For example, one conspiracy theory alleged that 5G mobile phone signals transmitted the virus while another conspiracy theory alleged that Bill Gates had masterminded a plan to implant microchips into humans along with a vaccine. In some cases, disinformation campaigns target Black Americans. This is why initiatives such as the National Black Cultural Information Trust (where I, Kevin Cokley, serve on the advisory board), is important for combatting cultural disinformation that targets Black communities.
The use of personal narratives that center experiences of Black Americans and COVID-19 is an especially powerful and effective approach. In one CNN story, when interviewed, a Black woman stated that she was not going to get the COVID-19 vaccine because she did not want to be used as a “guinea pig.” However, later in the story, she revealed that she had since changed her mind after hearing about the death of a 59-year-old Black woman who left behind a husband and children. It may be these types of personal stories that ultimately change people’s minds about the vaccine.
