COVID-19 and the virus that causes it, SARS-CoV-2 (formally, “novel coronavirus”), has spread quickly throughout the world, causing more than 560,000 confirmed cases in the United States as of April 2020. Once the virus began spreading on U.S. soil, the number of cases rose exponentially, leading to some of the most significant restrictions ever imposed on United States citizens. In addition to causing more than 110,000 deaths worldwide, the novel coronavirus has also disrupted nearly every industry and caused unprecedented damage to the economy. Because of the virus’ catastrophic impact, researchers are racing to develop a vaccine that would protect those individuals who have not yet come into contact with this pathogen.

If effective, a coronavirus vaccine has the potential to save countless lives. However, because of a disturbing history of medical and scientific mistreatment and preexisting beliefs about the safety of vaccines in different communities, some groups of people may receive less protection than others. One group that is more likely than others to reject a coronavirus vaccine is the black community.

Medical Mistrust and the Black Community

Throughout history, the black community has suffered racist, unfair, unequal, and discriminatory treatment at the hands of the U.S. medical profession. In the period between the War of 1812 and the Civil War, black Americans were forced to submit to medical examinations and surgical procedures against their will for the purpose of discovery and medical advancement. During this time, doctors also robbed graves containing black bodies to carry out their experiments.

When black Americans attempted to flee from slavery and gain freedom, the medical community regarded them as mentally ill. They were diagnosed with a specific (and purely conjectural) mental illness known as “drapetomania.” In some cases, their limbs were amputated as “treatment” for this disorder under the pretense that amputation would cure this supposed disorder of the mind, when in reality both were perpetuated to protect the institute of slavery by preventing slaves from running away. Some members of the medical community concept of mental illness to further subjugate the black community. They attributed the actions of black activists to severe conditions, like schizophrenia, in order to discredit them and incite fear.

Perhaps the worst evidence of the historical medical mistreatment of blacks is the Tuskegee Syphilis Study. In this experiment, the United States Public Health Service denied the proper treatment to hundreds of black men infected with syphilis. They were enrolled in the study under false pretenses, with doctors telling the subjects that they would be treated for “bad blood.” The study progressed for a total of 40 years. Even when penicillin became available as a preferred and effective treatment for syphilis, it was not offered to the participants of the Tuskegee Syphilis Study. Study participants were never informed of the study’s real purpose, and they were never given the option to leave the study.

Even in modern times, the mistrust of the medical community among black Americans persists. When examining the history of the black community’s experiences with medicine in the United States, this ongoing skepticism comes as no surprise. Because black Americans have been subjected to such violations at the hands of the medical and scientific community in both past and present, they are resistant to put their faith in modern medicine out of fear that violations will continue.

Vaccines and the Black Community

According to the U.S. Department of Health and Human Services Office of Minority Health, non-Hispanic blacks over the age of 65 are less likely than non-Hispanic whites in the same age group to receive a flu vaccine. Likewise, black women are less likely than white women to receive the HPV vaccine. When it comes to childhood vaccines, black children and white children are vaccinated at similar rates. However, the absence of disparities in this category may be due to the fact that childhood vaccines are typically required by law before children can attend public school.

Several factors may come into play to explain the lower rates of vaccinations among blacks. For example, some blacks may neglect optional vaccines because of a lack of access to quality medical care and financial issues. However, according to a study published in Social Science and Medicine, one of the primary issues is trust in the vaccines and the medical community itself. This study attributes mistrust to the history of racism and unfair treatment of blacks in the medical community, along with the higher likelihood of minorities to accept conspiracy theories.

Looking Forward

Vaccines are not the only preventative health measure that is utilized less frequently by members of the black community. Even more concerning, blacks also have poorer health than whites overall, with significantly higher levels of heart disease, hypertension, and diabetes. The issue even extends to younger members of the population. In fact, according to Harvard’s School of Public Health, black children are 500 percent more likely than white children to die from complications of asthma.  The greater prevalence of respiratory disease and other COVID-19 risk comorbidities combined with distrust of the medical community in general and vaccines in specific points to a higher risk for blacks to experience preventable complications and death related to COVID-19.

The novel coronavirus does not discriminate based on race. This pathogen can cause severe symptoms in all races and social groups, including the black community. Many people within this community have already been infected with the novel coronavirus, and there have already been deaths related to the complications of infection.

When a vaccine becomes available, it is in the best interest of every person, regardless of race, who does not have a specific contraindication to accept this vaccine. If members of the black community refuse the novel coronavirus vaccine, the outcome will likely be grave. As the virus continues to spread, more members of this community will become ill and face the potential for severe and even fatal complications. Low levels of vaccination among black Americans will also enhance the spread within the black community, making it more likely that the virus will reach vulnerable individuals who would not qualify for the vaccination on medical grounds. Even those who eventually recover from COVID-19 will deal with ongoing consequences, such as diminished health and economic hardship, that will themselves further predispose them to poorer health outcomes. All of these issues will come together to widen the health disparity that already exists between blacks and other races in the United States.