As states kick off their massive and complicated coronavirus vaccination programs, many Black Memphians – worried about the fast development of the vaccines and centuries of racism at the hands of the government and the medical establishment – are hesitant to receive an inoculation.
Most of the skeptics do not deny the breadth of the pandemic’s reach or the severity of the disease. Instead, they’re concerned that the solution to the pandemic might be as problematic as the virus itself. Medical experts worry, however, that without widespread adoption of the vaccine, the virus will continue to spread in Shelby County, where it has disproportionately affected the Black community.
The Food and Drug Administration approved Pfizer’s two-shot vaccine regimen under an emergency use authorization last week, with approval for Moderna’s similar vaccine expected as early as Friday. Hospitals in Shelby County are expected to receive initial doses of the Pfizer vaccine on Thursday, according to the Tennessee Department of Health, and will begin inoculating frontline healthcare workers, first responders and residents of long-term care facilities.
A doctor answers questions about the coronavirus vaccine
As Memphis receives its first batch of the coronavirus vaccine, we all have questions.
Why will you still have to wear a mask after you receive the vaccine? How can you be sure you’ll get your second dose? How will you know it’s your turn to get the vaccine?
Dr. Jason McKnight, a primary care physician at Texas A&M University, answers questions about the rollout and distribution underway for The Conversation.
The key to defeating the virus is for around 85% of Amercians to be vaccinated, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said Tuesday. But a major hurdle is convincing Black people to take the vaccine. Nationwide, Black Americans are dying at 2.8 times the rate of whites, government data shows. In Shelby County, Black residents have accounted for 61% of the county’s deaths though they comprise about 54% of the population.
“The worst thing to happen [would be] that we have something that can stop the spread and people don’t utilize it,” said Carla Baker, a nurse for more than 30 years who is Black. She also is the chief operating officer for Common Table Health Alliance, a nonprofit healthcare collaborative that serves Memphis and the Mid-South region.
A Kaiser Family Foundation report released Tuesday found 35% of Black Americans definitely or probably would not get a vaccine “determined to be safe by scientists and available for free to everyone who wanted it.” That’s down from September when 49% said they wouldn’t get a vaccine, but still higher than the 26% skepticism rate for both white and Hispanic Americans.
Experts say people’s fears are founded in historical abuses like the infamous and prolonged “Tuskegee Syphilis Study,” in which hundreds of Black men were falsely told they were receiving treatment for decades, or the violent and unethical operations performed on enslaved women by Dr. J. Marion Sims in the 19th century, a white doctor often considered to be the father of gynecology and obstetrics despite his racist work.
“It’s not an irrational fear,” said Timothy Moore, who was raised in Tuskegee, Alabama, and now lives in Memphis. “This fear and this anxiety is built from a real place and that in and of itself is part of the burden of being Black – that we carry awarenesses that other races don’t have to carry,” Moore said.
“This fear and this anxiety is built from a real place and that in and of itself is part of the burden of being Black – that we carry awarenesses that other races don’t have to carry.”
Timothy Moore
Skepticism is rooted in deep, historical mistrust of the government and the medical system, but also in present day experiences, said Kristie Lipford, assistant professor of health equity and urban studies at Rhodes College. Lipford, who is Black, said she’s noticed hesitancy in conversations with Memphians.
“People’s mistrust comes from direct experience,” Lipford said. “We know that African Americans report very low levels of satisfaction with doctors and hospital visits, and they also report very high levels of discrimination, particularly compared to white Americans. So all of that definitely contributes to (low) trust levels, which in turn contributes to that vaccine hesitancy.”
Not everyone is skeptical. Wiley Brown, a 48-year-old Memphis photographer, is enthusiastic about taking the vaccine.
“As Black people, we have a right to be skeptical about it,” Brown said. But, he added, “I’d rather take the chance on a theory versus what I know is fact, and I know the fact is COVID is killing a lot of people.”
Beyond Tuskegee
Health officials are working on ways to get the message out to the Black community about how crucial the vaccine is, said Joan Carr, a county health department spokeswoman. The department has reached out to influential people in the community, like pastors, as potential messengers.
Carr said many are “eager to encourage the vaccine” and noted that “some have volunteered to post video testimonials” when they’re vaccinated. In New York state, the first vaccine was administered during a livestream by a Black doctor to a Black critical care nurse.
Memphis Mayor Jim Strickland’s office may have local data on vaccine hesitancy, Carr said, but a spokeswoman for his office did not respond to requests for information via phone and email on Tuesday.
The county also is seeking input from citizens about their concerns and to identify barriers to vaccine access, said Dr. Alisa Haushaulter, the health department’s director. Those campaigns will “continue to evolve” as the department gets more information, she said.
Health disparities persist in the U.S., with Black people faring worse medically than white people. Data from the Centers for Disease Control and Prevention shows the Black maternal mortality rate is about three times that of white women and Black men have the lowest life expectancy of any demographic group.
The Tuskegee experiment is often cited as an example of racism in the medical community. More than 600 men participated in the 40-year-long study in which their syphilis was intentionally untreated so researchers could study the long-term effects of the disease.
Moore heard firsthand accounts of the effects of the experiment, and it scarred him.
The high school English teacher and poet has been vaccinated before – he got his first flu shot three years ago, though he didn’t get one this year. But he’s “leery” of the coronavirus vaccines and doesn’t plan to get a shot for at least a few years. He’s frustrated with the narrative that his anxiety is unfounded.
“I’m far from a conspiracy theorist. I’m far from thinking that the government is out to get us,” Moore, 39, said. “At the same point, there is a track record of the government not treating Black and brown folks fairly when it comes to scientific studies and outcomes.”
Lipford said socioeconomic barriers, like access to transportation and childcare, could also prevent people from seeking vaccinations. That could disproportionately affect low-income cities like Memphis, which had a poverty rate of about 22% in 2019, though the rate was higher for Black Memphians, at about 26%.
Lipford, who has been inoculated before, is herself hesitant about this vaccine, though she isn’t dismissing the possibility of ever getting it. She doesn’t always trust the intentions of pharmaceutical companies that, she said, “tend to put profit over people.”
Myths and Misconceptions
Vaccines alone will not stop the pandemic, the head of the World Health Organization has said. The CDC advises that even after being vaccinated, people should still expect to social distance and wear face masks, because “stopping a pandemic requires using all the tools available.”
There also isn’t data yet to indicate whether the Pfizer vaccine will stop asymptomatic transmission of the virus, though nearly 95% of the time it does prevent both mild and severe cases, according to the FDA.
Baker, who is Black, also sits on the Health Disparities Task Force at the state health department. The task force has been listening to people’s concerns and is working on crafting messaging and finding community leaders to communicate vaccine-positive messaging.
Baker plans to take the vaccine when she’s eligible. “I believe vaccines save lives,” she said.
While many are eager to see the pandemic end, they’re also worried about the speed at which the vaccine was developed. Politics under the Trump administration-funded program – and the president’s often contradictory advice – are also a concern.
People are used to vaccines taking years to be tested before they’re approved, and are worried that politics may have influenced the speed at which it was developed. Last week, it was reported that Trump’s chief of staff, Mark Meadows, told FDA Commissioner Dr. Stephen Hahn the agency needed to approve Pfizer’s vaccine that day or Hahn would be forced to resign. Federal regulators have said politics would not come into play when considering approval.
Patricia A. Rogers, 62, has seen conspiracy theories online, including that the vaccine will be used to wipe out the Black population. But she’s more worried about long-term side effects.
“I just want to see how things are going to be handled and what the effect of the vaccine is having on people who actually want to take it,” said Rogers, who works in public relations. “[There have been] so many myths and so many misconceptions about the vaccines, and I don’t think that has been cleared up enough for me to want to take it.” Rogers, however, said she might reevaluate her stance in about a year.
Lipford hopes that a conversation on vaccine hesitancy will lead to a deeper interrogation of inequities in public health.
“In order to really deal with these health disparities that we see with COVID-19 and these health issues, we really must deal with racial inequality and ethics concerns that people are now paying more attention to.”
Hannah Grabenstein is a corps member with Report for America, a national service program that places journalists in local newsrooms.
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