When the Past Holds Us Back

How the struggle to increase vaccination rates is hampered by horrors of the past

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James Campbell receives a coronavirus vaccine at Community of Hope health clinic on February 26 in Washington, DC. Vaccination rates in Wards 7 and 8, where a majority of the people are African-American, are the lowest in the city. (Photo by Jahi Chikwendiu/The Washington Post via Getty Images)

Maybe it’s my nightly viewing of “The Underground Railroad,” brilliantly directed by Barry Jenkins and based on Colson Whitehead’s Pulitzer Prize-winning novel, that’s got me obsessing over man’s capacity for evil and whether we can ever escape a traumatic past—particularly a wound as overwhelming as slavery. But the current challenge to increase vaccination rates in the US and make the whole country safer offers a vivid snapshot of how the past—even the very recent past—can keep dragging us down.

Yes, the speed of the Biden Administration’s strategic planning and execution to get the nation vaccinated offers an extraordinary demonstration—and a stark contrast from recent history—of how genuine compassion combined with expertise and good governance can make a world-altering difference. Over 182 million Americans have gotten at least one shot and COVID-19 cases and deaths are down by 90 percent since January. Underscoring the madness, President Biden noted that “study after study after study has shown that, since early May, virtually every COVID-19 hospitalization and death in the United States has been among the unvaccinated.”

But the grim determination of Trump to turn COVID-19 and the response into a deadly political issue—think how nuts it was and is to make not wearing a mask or getting vaccinated a political statement—still defines the fate of millions of Americans; it continues to infect the population who listened to this homicidal talk. As NPR noted, 17 of the 18 states with the lowest adult vaccination rates were won by Trump (the guy who refused to admit publicly that he was vaccinated).

President Biden—offering up an expanded vaccination plan to get vaccines to family doctors, more pharmacies and even workplaces—tried to speak to all Americans:  “Do it now—for yourself and the people you care about; for your neighborhood; for your country.  It sounds corny, but it’s a patriotic thing to do.” Yet we all have seen how tightly the unvaccinated crowd is clinging to the Trump lies, even if it kills them.

But the reality of vaccination resistance goes beyond Trump and his accomplices. It’s a matter of trust—and a mistrust that dates back to the history of medical treatment of African Americans. After a federal ban on importing slaves in 1808, slave owners aligned with white physicians to perform experiments to increase healthy births. As “The Underground Railroad” portrays, that included gynecologists performing dangerously invasive tests.

Better known is the Tuskegee Study: 600 recruited Black men never gave their informed consent for the experiment and those with syphilis were never told that “they were not being treated but were simply being watched until they died and their bodies examined for ravages of the disease.” What were these men from Alabama told in the fall of 1932? That they would get special treatment for “bad blood.” Only later did the public discover the truth of this study, which was conducted by the US Public Health Service and continued for 40 years.

Is it any wonder that when the AIDS epidemic hit, many African Americans believed that both the disease and the treatments intended to combat it were “part of a conspiracy to wipe out the Black race”? In 1990, a survey of Black church members found that 35 percent thought AIDS “was a form of genocide.”

Is it any wonder that a 2020 study of 1,835 adults in Michigan found the highest levels of medical mistrust among the Black population and the greatest unwillingness to participate in COVID vaccine trials and actual vaccination? In a study of Philadelphia vaccination rates, 52 percent of white people have received at least one dose while only 34 percent of Black people have.

In their excellent Washington Post article entitled “Anatomy of a health conundrum,” Akila Johnson and Dan Keating describe “missteps and misunderstandings, the legacy and loss that have fostered the disproportionate pain of death and disease in communities of color.” They quote Ala Stanford, a surgeon and founder of the Black Doctors Covid-19 Consortium, which has administered nearly 50,000 vaccinations as of June 11 and 75 percent of those to African Americans: “I get mad when I see the numbers.”

Education. Reliable information. Trustworthy leadership. Increased access to familiar healthcare providers. Increased health. These are among the necessary components to getting people vaccinated and reducing the mistrust, misinformation and fear that continue to keep people vulnerable and in danger—especially as the easily transmissible Delta variant has begun to spread and raise new fears.

On our darker days, we may doubt that these drags on our nation’s health and wellbeing can be overcome. But the ever-optimistic Joe Biden isn’t having it. He talked on Tuesday about going neighborhood to neighborhood and even door to door to get help to those who’ve resisted vaccination: “Look, equity, equality—it remains at the heart of our responsibility of ensuring that communities that are the hardest hit by the virus have the information and the access to get vaccinated.” 

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