Never mistake hesitancy for rejection. Just because the average person might say she’s hesitant about going to the dentist or being admitted for surgery doesn’t mean she ends up not doing either, especially if they’re critical procedures. It just means that person is being human and weighing conflicted feelings. Some of us are private about that skepticism and some of us are public.
Harboring doubt, in that sense, is healthy because it keeps us alert. That’s exactly what most Black people who have been wrongfully accustomed to years of medical neglect, racism, and violence are doing right now: staying alert. We should be.
So, yes, you’re going to hear some Black people express concerns over everything from the safety and potential side effects of the COVID-19 vaccine to the competing degrees of efficacy. They do it every day, for example, when calling in to WURD radio, the only Black-owned talk radio station in Pennsylvania, where one of the authors of this op-ed hosts a show.
Does that doubt or hesitancy mean Black people, in general, are the weakest link in the larger national effort to inoculate most Americans by this summer to end the pandemic? No. So why do we keep being treated like America’s vaccine problem?
It’s not the business of public officials, whether they be governors or mayors or presidents, to scale public health response efforts according to subjective interpretations of public discourse — especially when those interpretations are based on myth. The most recent NPR/PBS News Hour/Marist poll found that 73% of Black Americans have gotten or planned to get the vaccine, compared with 70% of white respondents.
Yet in recent weeks we’ve heard, for example, Maryland Gov. Larry Hogan complain that Black residents are “refusing to take the vaccine.” Or we continue to see hesitancy framed as the driving reason behind troubling disparities in a city like Philadelphia, which is 44% Black, yet less than a quarter of those vaccinated as of early March were Black and nearly 55% were white (far exceeding the white population total).
Instead of making such excuses, the business of government and the people who run it is to, simply, “... fulfill its most important function, which is protecting the American people,” as President Joe Biden put it plainly in his first official public address. When we’re in the middle of a pandemic, it’s not up to the official in charge of a federal, statewide, or local response to calibrate who receives vaccine based on an impression of one or two communities that openly discuss vaccine skepticism. It is up to those officials to do their job and distribute as much vaccine possible.
Basing that decision on what jumps out in national polling numbers — often along the lines of bias — is wrong. It also oversimplifies the story on attitudes toward vaccination among Black communities.
“Black people should not be scorned and, therefore, punished or rationed for vaccine hesitancy.”
An International Journal of Environmental Research and Health study in 2018 found high rates of participation from Black people in the Atlanta metro area for vaccine-related clinical trials — over 30%, or almost proportional to the Black Georgian population, countering the notion that Black Americans won’t take vaccines. Another 2018 Population Health study on flu-vaccine intake showed that Black vaccine hesitancy is not “monolithic,” and it linked greater frequency of flu vaccine uptake with a wide range of factors that speak to the diversity of viewpoints that determine whether someone takes a vaccine: “better self-reported vaccine knowledge, more positive vaccine attitudes, more trust in the flu vaccine and the vaccine process, higher perceived disease risk, lower perceived risk of vaccine side effects, stronger subjective and moral norms, lower general vaccine hesitancy, higher confidence in the flu vaccine, and lower perceived barriers.”
What this says is that Black people should not be scorned and, therefore, punished or rationed for vaccine hesitancy. It means governments need to put in the work to earn their trust and stop treating us like a monolith.
Which makes it the height of irresponsibility and government malfeasance to do what’s called “white-splaining” the reason behind the inequitable distribution of COVID vaccine. If the science has approved now three available vaccines (Moderna, Pfizer, and Johnson & Johnson) for maximum COVID-19 protection, then it’s only logical that the next step is to identify and distribute vaccine to those Black, brown, and Indigenous communities suffering from pandemic at two to three times the rate of whites. Science dictates that we can’t reach “herd immunity” with only select pockets of communities receiving vaccine — adequate national protection will only come from all communities receiving vaccine. The last thing public officials should even be imagining is an array of unscientific and baseless excuses for why they’re unable to do that in the most complete way possible.
What public health and government officials need to do is pinpoint why vaccine distribution is so lopsided in favor of whites — see Rite Aid giving 21 times as many doses to white people in Philadelphia as to Black people — and why it’s not reaching the nonwhite communities hardest hit by the pandemic.
Such disparities should spring officials into action: aggressively closing those gaps and increasing Black community confidence in medical institutions as quickly as possible.
Ivan Walks is the former chief public health officer for the District of Columbia and principal of Ivan Walks & Associates. Charles Ellison is host/executive producer of “Reality Check” on WURD, senior fellow at the Council of State Governments Eastern Regional Conference Council on Communities of Color, and publisher of theBEnote.com