Black people are more likely to die from COVID-19 than the general population as whole. But after hundreds of years of institutional racism at the hands of government and health care, they are also more likely to be distrustful of the vaccine that could help their communities the most.

That well-deserved distrust is – finally – being openly discussed. Headlines such as “Years of medical abuse make Black Americans less likely to trust the coronavirus vaccine” and op-eds such as “Don’t blame African Americans for fearing the COVID-19 vaccine. Blame America” make the case that this is a problem the government created. And the government, and health care, must be involved in solving it.

Yvonne Dixon, Novant Health's director of health equity, is a general in the army fighting to get the skeptics to understand: This time is different. African Americans were included in the clinical trials that test the safety. She’s gotten the shot herself.

But, Dixon explains, the past must first be acknowledged — not swept under the rug. For the healing to begin, she said, the truth needs to be put on the record.

A history of abuse

Black distrust of a government-funded and -distributed vaccine was well-earned. A few examples:

  • The incident most often cited as the top source of distrust is the Tuskegee experiment. From 1932 to 1972, the U.S. government withheld treatment from a group of Black sharecroppers in Alabama to study the progression of syphilis. They were never informed of their diagnosis and were told instead they were getting free health care.
  • Henrietta Lacks is the Black woman who came to posthumous prominence when author Rebecca Skloot wrote about her in “The Immortal Life of Henrietta Lacks.” Lacks was treated at what was then called The Johns Hopkins Hospital for cervical cancer. The cells taken in her biopsy replicated easily and soon scientists far and wide used cells reproduced from Lacks’ cancer to test treatments. Lacks never gave consent, and she and her family never received compensation. But her cells have led to medical breakthroughs that include the polio vaccine and cancer and AIDS treatments.
  • North Carolina has a shameful history of forced sterilization of poor, mostly Black people.

This kind of inequity is still happening today, Dixon said. “Look at those individuals diagnosed with sickle cell disease. They may come into the hospital seeking hydration and pain therapy, and they are viewed – not at Novant Health, but elsewhere in this country – as drug seekers.

“These instances show how prevalent institutional racism is,” Dixon said. “When you think about just those few things, why would people of color trust our government?”

Addressing the trust gap

The government is attempting to atone for past wrongs. And Black leaders across the country – in government, medicine and members of the clergy – are getting the vaccine and documenting it. At Novant Health Presbyterian Medical Center, the first team member to receive the vaccine was a Black doctor. (The second was a Latina COVID ICU nurse.) Dixon had her photo taken on the day she got the vaccine. So did now-Vice President Kamala Harris.

Faith leaders are also taking a leading role in educating their congregants about vaccine safety.

Novant Health is also committed to fair and equitable distribution of the vaccine. Dixon tells nearly everyone she meets, “Right now, we are providing vaccines to all races of people – not just one race. The vaccine has been thoroughly scrutinized, and it's being given to all races.”

One of the most frequent refrains during the pandemic has been “We’re all in this together.” And it is going to take all of us – all races, colors and creeds – getting the vaccine to finally end this deadly pandemic.

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