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Photographer: Eric Lee/Bloomberg

Understanding Vaccine Hesitancy Among Black Americans

Black skepticism of vaccines goes far deeper than the Tuskegee experiment

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Over the past few months, you’ve probably heard a lot about the Tuskegee experiment.

That was a study that began in 1932 in which hundreds of Black men with syphilis were told they were being treated for “bad blood.” In fact, researchers wanted to study what would happen if their syphilis went untreated. The study ran for 40 years—in that time, the men never received the proper treatment to cure their illness.

The study has become shorthand for why people of color may hesitate to trust vaccines, even though Black Americans have died at twice the rate of White Americans due to Covid-19, according to Centers for Disease Control and Prvention data.

In the fifth episode of “Doubt,” a new series from the Prognosis podcast that explores vaccine hesitancy, we look at efforts to address resistance in the Black community.

The disproportionate impact of Covid-19 on people of color has meant many vaccine outreach efforts have focused on Black communities. But skepticism runs deep among Black Americans for good reason: Tuskegee is just one episode in a long history of institutionalized discrimination, generational trauma and outright racism in the U.S.

“Those stories that trickle down, they come with a sense of a guards-up mentality in your way of life,” says Timothy Sloan, the head pastor at The Luke, a 5,000-member Baptist church in Humble, Texas.

In October, Sloan’s church did a survey that found that only 35% of its congregation was comfortable getting vaccinated. When Sloan found himself questioning whether to get inoculated, he wondered how he might help his congregants make their own decision about whether or not to get the shot.

The pastor wrote to Anthony Fauci, the head of the National Institute of Allergy and Infectious Disease, who agreed to record an interview with Sloan. But Fauci didn’t just address the facts of vaccine safety — he also said he understood why people of color are suspicious of government health programs. For Sloan, it was that more than anything that made him decide to get the shot. In his sermon, after airing the interview, Sloan encouraged his congregants to do the same.

“He legitimized a lot of the pain and trauma of African-Americans,” says Sloan. “And so we were like, ‘OK, all right. So here's someone who really understands where we're coming from.’”

Sloan says he’s heard from many church members that the interview helped them decide to get vaccinated, too.

“I felt like for the thousands of people who were watching, guards automatically went down. And there was a receptiveness toward what he was saying,” Sloan says.

It appears that approach may be making a difference in the country at large. A recent Kaiser Family Foundation poll found that 24% of Black adults say they plan to wait to get the vaccine until more people have taken it, compared with 16% of White adults. Those numbers are far better than they were before vaccines began rolling out, and they’re continually improving.

Polling has also shown significant hesitancy among Hispanics and people who live in rural areas, which tend to vote Republicans. Polls show Republicans are far more likely than any other demographic to say they won’t get the vaccine.  

Every community’s relationship to health care and vaccines is different, but efforts to inspire vaccine confidence among Black Americans may hold lessons for other hesitant groups as well. It’s not about facts. It’s about trust.