Half of Black adults say they won’t take a coronavirus vaccine
New poll finds that even those planning to get a shot are worried early versions won’t be safe
Half of Black adults are not planning to take a coronavirus vaccine once one becomes available, even if scientists declare it safe, and it’s available for free, according to a new survey on race and health by The Undefeated and the Kaiser Family Foundation (KFF).
COVID-19 has killed more than 200,000 people since arriving in the U.S. in January and President Donald Trump has repeatedly promised that a vaccine is on the way. In a federally-led initiative dubbed “Operation Warp Speed,” the usual yearslong timeline has been condensed and four drugmakers are in phase 3 clinical vaccine trials in the U.S. — the final step before the Food and Drug Administration (FDA) can grant approval.
But even if all goes smoothly, that just opens up a new front in the fight against the coronavirus.
The poll found widespread distrust, with 34% of Americans saying they’ll either probably not or definitely not take a COVID-19 vaccine. Those numbers jump to 49% of Black people saying hard pass, despite being among those hardest hit by the pandemic.
Jessie Bell, 82, a retired air conditioner mechanic who lives in Las Vegas, says he won’t be taking a coronavirus vaccine anytime soon. “Usually when something comes out for the first time, it’s not exactly right,” said Bell. “And of course, me being Black, you know, you get the flashbacks to what they did to the Black people back in the ’20s, ’30s,’40s. How they used them as guinea pigs.
“I’m hearing Trump and he’s trying to pressure these drug companies to expedite this vaccine for this virus,” Bell said, “and because of the way he’s been talking about non-whites, it might very well be something to get rid of us.”
Toggle the buttons within the charts to filter the poll responses by demographic:
Among Black adults who say they’re not planning to get a vaccine, nearly 40% cite safety concerns, including that it will be too new and there won’t be sufficient testing. Another 35% attributed their concerns to a general lack of trust or have doubts about the government or the health care system.
Overall, 65% of Black adults said they are not too confident or not at all confident that the development of a coronavirus vaccine is taking the needs of Black people into account.
Coronavirus masks remind George Hayden, 70, a retired factory worker from Helena, Arkansas, of the masks worn by Black people picking cotton. “It’s like pulling me back in time,” he said, but he wears his anyway, even to his mailbox. “The president went around talking about why wear a mask when it’s for our own protection,” Hayden said. “We’re in dangerous times with this pandemic. And when a person tells me to put some cleaning fluid in my body just to see: Does it clear up?” Hayden says that means, “I can’t take the president’s word.”
Hayden is among the 50% of Black people who probably or definitely will get vaccinated. But he says he has to hear the vaccine facts from top doctors or scientists first. Then, maybe two or three years from now, he’ll be ready. “I’m not taking one right off the bat.”
Other poll respondents said they would need to see Anthony Fauci, National Institute of Allergy and Infectious Diseases director and a member of the White House Coronavirus Task Force, take a vaccine live on television, then reappear in good shape, 72 hours later, before they would consider getting vaccinated.
These demands reflect the strong majority, 61% of Black people who have little confidence that a vaccine will have been properly tested for safety and effectiveness. White people and Hispanics are also skeptical, but to a lesser degree, with 40% and 48%, respectively, expressing the same concerns.
Experts say countering public mistrust and raising understanding and awareness about medical research can take years.
In any public health crisis, clear and consistent messaging, based on scientific data and conveyed by trusted sources, helps build the collective will needed to rally the nation, save lives and get to the other side. But since the arrival of COVID-19, that is not what we have had.
Besides misleading statements from the president, regulatory agencies have shifted their guidelines about coronavirus transmission, flip-flopped on testing and been forced to clarify that their positions are rooted in science, not politics. Lawmakers have publicly sparred with top health officials over limits to public gatherings, whether to reopen schools and other efforts to mitigate the spread of the disease.
Those shifting messages have contributed to the disproportionate impact on Black people, who are more likely to be essential workers at greater risk of exposure to the coronavirus. Black pregnant women are more likely to get infected, Black children are more likely to be hospitalized; the age-adjusted mortality rate for Black people is 3.4 times as high as that of white people.
Georges Benjamin, executive director of the American Public Health Association, has been working with the FDA on how to increase acceptance of a future vaccine. He’s been in frequent contact with administration health officials who, he says, have tried to increase the focus on those especially vulnerable to COVID-19. But, “this administration can be very reluctant to lean forward on race and ethnic disparities. They came late to the party dealing with data and even talking about the fact those disparities exist,” Benjamin said.
He points out racial disparities in vaccinations are common, including for the flu shot. The federal Centers for Disease Control and Prevention (CDC) found that just 39% of Black adults were vaccinated during the 2018-19 flu season, compared with 49% of white adults. The Undefeated/KFF poll found that even among Black adults who normally get a flu shot, one-third say they probably or definitely will not get a coronavirus vaccine.
Benjamin has worked with the National Academies of Sciences, Engineering, and Medicine on how to prioritize the distribution of a coronavirus vaccine. He said it should focus on people who work in positions with heightened exposure who have underlying vulnerabilities, categories that include sizable numbers of white people. Because if African Americans, Hispanics and Native Americans are told to get vaccinated first, “it will be interpreted as you want Black people to be guinea pigs,” Benjamin said.
Two of the four historically Black college and university (HBCU) medical schools — Morehouse School of Medicine and Meharry Medical College — are clinical trial sites. HBCU leaders have called on researchers and the medical industry to also include the Howard University College of Medicine and Charles R. Drew University of Medicine and Science, and engage HBCUs more broadly to help educate Black communities.
But some of the usual broad educational campaigning around getting vaccinated — the radio and television ads, and social media posts — has not been done. That’s partially because there’s not yet an approved vaccine. But health officials also need to focus on generally defining what a vaccine does, bringing the process down to the kitchen table level so it’s understandable to average people, Benjamin said. (Vaccines introduce a killed or weakened part of the disease germ into the body to stimulate a person’s immune system to produce antibodies, so that people develop immunity to a disease without having to catch it.)
Convincing people to get vaccinated comes down to health and medical literacy. And, historically, to trust.
Poll respondent Margaret Glover, 65, a retired certified medical assistant, has health issues, including rheumatoid arthritis, and stays mostly inside her senior citizen building in the Bronx, New York. “I don’t think I’ll be getting it,” she says of a potential coronavirus vaccine. First, she said, nobody has explained anything about it to her, and secondly, “for the Black community, there was a lot going on, killing us and experimenting on us,” Glover said. “And it’s all just coming to light, everything that was done back then.”
Black people often cite the villainous 40-year Tuskegee syphilis experiment conducted by the U.S. Public Health Service and the 1951 story of Henrietta Lacks, whose cancerous cells were studied and used to create money-making drugs without consent from her or her family, as reasons to distrust medical research. But there are also generations of oral history, of lurid medical horrors, that have become a kind of bone memory: the amputations and organ transplants done without consent, grave robbers who stole Black bodies for white medical schools eager for cadavers, the ignoring or underestimating of Black pain that continues to this day.
This legacy of “hyperexperimentation on Black bodies” becomes the first hurdle in thinking about clinical trials and vaccines, said Kenyon Farrow, co-executive director of Partners for Dignity & Rights, which works with community groups nationally on issues of equity and justice.
“Health officials need to focus on generally defining what a vaccine does, bringing the process down to the kitchen table level so it’s understandable to average people.” Georges Benjamin, executive director of the American Public Health Association
But you don’t have to go back decades. The lack of a national strategy to contain the spread of the coronavirus has done the most to harden suspicions of what the government might be offering in terms of a vaccine, says Farrow. Part of that strategy could include partnering with community organizations that have experience reaching out to Black people around stigmatized viruses such as HIV, he said. Without a coordinated strategy around research literacy and clinical trials, Farrow said, “People have been left, frankly, to the internet and their own devices to figure out what’s true and what’s false and what they should do about a vaccine.”
Those concerns prompted Lisa Fitzpatrick, an infectious disease doctor who trained in public health at the CDC, to volunteer at George Washington University for phase 3 trials for a vaccine candidate being tested by the Moderna biotech company. Like Moderna, Pfizer, AstraZeneca and Johnson & Johnson are seeking to enroll tens of thousands of participants in their phase 3 trials. In vaccine development, drugmakers partner with academic and research institutions, which largely design the clinical trials. George Washington is exceeding its diversity target of 30%, but researchers at many of the more than 90 vaccine trial sites around the country have struggled to recruit adequate numbers of Black volunteers.
Fitzpatrick, who founded Grapevine Health to promote community literacy around health care, called the name “Operation Warp Speed” a misstep.
“I’m seeing a lot of conversations among people from all walks of life about how they don’t want to be part of anything that seems rushed,” she said. “I talked to a gentleman who said he wouldn’t take anything that had Trump’s name on it. I had to explain to him that Trump is not a scientist. He doesn’t make the vaccine. He’s not in the lab.”
She asked what it would take to convince him to get the vaccine and, “he said, ‘I would think about doing it if I could see some other Black people associate with it.’ So that encouraged me,” Fitzpatrick said. After her first shot in early September — she doesn’t know whether she’s getting the drug or a placebo — she had check-in calls for three weeks, and another shot four weeks later.
She’s hoping to demystify the process and counter the worry that there are no Black people in the trials. She wants to be able to answer questions about side effects or whether the shots hurt, and to detail the protections in place to avoid another Tuskegee experiment.
That kind of consideration for diversity and patient questions and concerns should be included in trial designs from the start, not as an afterthought, said C. Daniel Mullins, a department chair at the University of Maryland School of Pharmacy who is working on an FDA-funded project on COVID-19 testing in underrepresented populations. Mullins heads a team of researchers focused on engaging patients and community groups in the research process, known as the PATIENTS Program.
The absence of education and outreach “has led to distrust in two ways that are very extreme,” Mullins said. African Americans skeptical of a coronavirus vaccine say: They have one that works but they aren’t going to give it to me. Or, no matter what they come up with, I’m not going to take it.
“When you’ve got this much confusion and this much distrust, you have people on both ends of the spectrum,” Mullins said. It’s true across all populations, but is especially prevalent among African Americans.
“We try to be out there in the community having conversations about truths and the myths around research,” said Mullins. “And it is true, some of these historical atrocities have occured. And let’s talk about that. And let’s also talk about what changed because of those historical atrocities. Let’s also ask you about how do you make decisions to improve your own health.”
“This legacy of ‘hyperexperimentation on Black bodies’ becomes the first hurdle in thinking about clinical trials and vaccines.” Kenyon Farrow, co-executive director of Partners for Dignity & Rights
Having those conversations means that when someone gets sick, or hears about a clinical trial, it won’t be their first time hearing about research. They’ll have reference points other than historical horror stories.
Rodney Elliott Sr., community engagement specialist for the PATIENTS Program, said that before the pandemic he’d attend health fairs, back-to-school events, church events, establishing relationships. “I would be out and about in the community, hosting these events — if it’s having a table, if it’s speaking with seniors in the library,” Elliot said.
Elliott says he’s been approached by people and “the minute I mention that ‘R’ word, the research word, they freeze up. It’s my job, it’s my team’s job, to say, ‘You know what, we understand what you’re talking about, we understand where it’s coming from, but here’s what’s going on now.’”
They start to see the program and the University of Maryland talking about ways to improve their health, he said, instead of just reaching out when they have a drug and need a Black body in a chair.
Mullins has two big fears about a prospective coronavirus vaccine: “That there’s a harm that wasn’t picked up because we didn’t test in a diverse enough group to pick that up.” Or, “that there is no problem, but minorities and others don’t take the vaccine because they can’t get access.”
The Undefeated/KFF poll identified yet another fear: that things are moving too fast.
Aomie Joa Washington, 19, a student at Hamline University in St. Paul, Minnesota, said she doesn’t know if she’ll get a coronavirus vaccine if one becomes available. Probably, she says, but the science seems rushed, which feels jarring in a process we expect to be deliberative and apolitical. During the first presidential debate on Sept. 29, Trump repeated his insistence that “we’re weeks away from a vaccine.”
“How are you going to have a vaccine out before Election Day, and we’re still waiting on a stimulus?” Washington wondered. “This really exposes all of the deficits, with not just the nation, but specifically the communities that we continue to ignore. And those just so happen to be Black people, you know?
It’s another doubt in a public health crisis that leaves open the possibility of another bad outcome: A vaccine becomes available that is safe and effective. But not enough was done to convince Black people of that fact. So people keep dying.
“Is this going to be a cure? Is it going to fix everything? I don’t think so, you know?” Washington said. Like so many other Black people confronting potential coronavirus decisions, she’s just going to wait and see.