Opinion | How to Reassure Black Americans That the Vaccine Is Safe


Many Black Americans say they are wary of taking the coronavirus vaccine, the logical result of centuries of abuse and exploitation by the United States health care system. We empathize with the patient who told one of us, “Baby, I just don’t trust vaccines,” and with our friends and family who say they are “just going to wait.”

And so we find ourselves with a complex problem: ​The Black​ communities most at risk in this pandemic are the least likely to take a potentially lifesaving vaccine when it becomes available to them.

We and our fellow Black health care workers have an important role to play in encouraging Black patients to get vaccinated. But that’s not enough.

In addition to the much needed, longer-term strategy of increasing Black representation among health care providers, we need a national public health campaign with local momentum that uses trusted voices in the Black community. As a short-term solution to a centuries-old problem, the Centers for Disease Control and Prevention should collaborate with the country’s most influential Black Americans, along with community organizers and Black health care workers, to make clear that the vaccines are our only way out of this pandemic.

To start with a few obvious names: Oprah Winfrey could use her television network to bring to life Covid-19 survival stories and the reality of the disease’s long-term effects. Michelle and Barack Obama could be vaccinated on national television, as Vice President-elect Kamala Harris was this week; LeBron James could tweet about the importance of getting the shot to his 49 million followers. Black social media influencers could post photos of their shots. The “Divine 9” historically Black fraternities and sororities could host a national vaccine stroll encouraging immunizations. Pastors and hairdressers could use their social ties to rally their communities around vaccinations.

Why is this necessary? Vaccine reluctance is a direct consequence of the medical system’s mistreatment of Black people. The culture of medical exploitation, abuse and neglect of Black Americans is best exemplified by the Tuskegee Syphilis Study, which for 40 years kept some 400 Black men with syphilis in rural Alabama ignorant of their diagnosis and denied them adequate treatment. J. Marion Sims, the 19th-century doctor known as the father of modern gynecology, operated on Black enslaved women without anesthesia or consent. To perfect his technique, he performed a gynecological surgical procedure on one woman 30 times, never with anesthesia.

This isn’t a problem relegated to the past; Black patients are still treated poorly today. Just this month, a Black doctor in Indiana died of Covid-19 after complaining of racist treatment. Given this history, it’s no surprise that Black Americans are reluctant to get the vaccine.

A recent Kaiser Family Foundation survey found that about a third of Black adults​ say they probably or definitely won’t get vaccinated. Among the main reasons they cite are fear they may contract Covid-19 from the vaccine or mistrust of vaccines in general. Most notably, about half of Black adults lack confidence that vaccine development has taken Black people’s needs into account.

The pandemic has magnified the need to design for equity. We cannot ignore the more than 1.5 million Black people infected with Covid-19 and the disproportionate hospitalization and death rates they are experiencing. Black Americans die from Covid at 1.7 times the rate of white people. While there is no single antidote for the systemically racist and discriminatory health care structures and policies in this country, we can make it our goal that every Black household will have a meaningful conversation with someone they trust about vaccination.

The challenge is twofold: to help Black people learn more about the vaccines from sources they trust and to deliver the message in an accessible and equitable way. We know that our patients trust Black-owned businesses, faith-based organizations and community institutions. A recent report by the N.A.A.C.P., Covid Collaborative and others reveals that Black Americans are twice as likely to trust a message if it comes from another Black person.

The C.D.C’s Office of ​Minority Health and Health Equity and Vaccine Task Force have​ offered resources and guidance, and can further partner with prominent advocacy groups like Color of Change, New Georgia Project, New Virginia Majority and Dream Defenders to acknowledge Black people’s genuine fears and educate them about the benefits of Covid-19 vaccines.

Medicine has broken the trust of the Black community. Now it must work hard to earn it back. Otherwise, Black people will be further marginalized by our health care system and further victimized by this pandemic.

Benjamin Thomas​ (@BTMD5150) is an emergency physician at Kaiser Permanente Northern California in San Leandro. Monique Smith​ (@drmoniqueasmith) is the executive director of Health DesignED at Emory University and an emergency physician at Grady Memorial Hospital in Atlanta.

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