A Holistic View of Vaccine Hesitancy

From the perspective of Black people, particularly many young ones, the government is not to be trusted.

By Charles M. Blow, for The New York Times Opinion.

I recently had a conversation with a younger friend of mine — a Black man in his 30s here in Atlanta — about whether I was going to get the Covid-19 vaccine when it becomes available to me and whether I should.

My answer was clear: Absolutely.

So was his: Absolutely not. At least not yet, not until he was able to see over a longer period of time how others responded to it. In fact, he was somewhat astonished that I was eager to be vaccinated, treating it as a gullibility or naïveté on my part.

It wasn’t necessarily that he didn’t trust vaccines, it was that he didn’t trust the government that was pushing it. This mistrust, I believe, is an underappreciated part of vaccine hesitancy, particularly among younger Black people.

It is now a well-established fact that Black people are getting the vaccine less than their white counterparts and also express more doubt about it. But those numbers are more complicated than the top-line takeaways might suggest.

A survey released Thursday by the National Foundation for Infectious Diseases found some interesting age variations. As CNN reported:

“The survey, which was conducted in December 2020, also revealed that older Black adults and men are more willing to get the Covid-19 vaccine. For example, 68 percent of adults age 60 and older said they planned to get the vaccine while only 38 percent of Black adults age 18-44 planned to get it. Many of the younger respondents expressed distrust in the health care system, saying it treats people unfairly based on race and ethnic background, according to the survey findings.”

The “distrust in the health care system” is real in the Black community. I have written about the effect of the full history of the United States’ failures and abuses in the medical field, relative to Black people.

Perhaps most notably, at least in the last century, was the Tuskegee experiments in which hundreds of Black men were told they were being treated for syphilis when in fact they were not. They were being observed to see how the disease would progress. Those men suffered under this experiment for 40 years. The Associated Press exposed the program in 1972.

But the Black people in the age group most resistant to the vaccine today were not alive when that experiment was conducted. Indeed, older men, those who might have been alive during that time — those whose peers were targeted by the Tuskegee experiment — are more likely to want the vaccine.

It occurs to me that something bigger might be contributing to those numbers: an overall mistrust of a government that has repeatedly disappointed, disrespected and dehumanized Black people. This is a phenomenon that may be most acutely felt by young people.

These young people have come of age in an era in which mass incarceration has sucked whole neighborhoods dry of brothers and cousins, fathers and uncles. They have come of age where the rapacious war on drugs ground up Black bodies and wasted human capital.

They have come of age in an age of a rash of killings of unarmed Black people by the police, and those officers and the systems that animated them have rarely been held accountable.

They have come of age watching the government cover up poor treatment of Black people. They’ve watched the government allow — indeed cause — the Flint water crisis, and drag its feet as the people of New Orleans suffered after Hurricane Katrina and the people of Puerto Rico suffered after Hurricane Maria.

They have watched four years of nonstop corruption by Donald Trump, a man who lied incessantly and whose government failed to constrain the virus in the first place.

From the perspective of Black people, particularly many young ones, the government has demonstrated by deed that it is not to be trusted, that the health and welfare of Black people and Black bodies is not its concern. Indeed, the opposite may well be true.

I went back and forth with my 30-something friend, arguing the science of the vaccine, discussing the disproportionate impact the virus was having on the Black community and how it was imperative that as many Black people get vaccinated as possible.

As a 2018 Pew Research Center poll found:

“On this scale, the share of whites who show high levels of trust (27 percent) is twice as high as the share of Black (13 percent) and Hispanic adults (12 percent). The older a person is, the more likely they are to tilt toward more trustful answers.”

But I could see in his eyes that his vision was clouded by the darkness of distrust. How could the same government that destroys so many Black lives be trusted in its intentions to save his?

To him, the vaccine wasn’t simply a product of medical research and science, it was also part of a governmental campaign and an imposition of the system. In an America where Black people have too often seen tools used as weapons, hesitancy will be a high hurdle.

Charles Blow joined The Times in 1994 and became an Opinion columnist in 2008. He is also a television commentator and writes often about politics, social justice and vulnerable communities.