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Journalists need to go beyond Tuskegee when reporting on vaccines among Black Americans

Journalists need to go beyond Tuskegee when reporting on vaccines among Black Americans

Picture of Candace Y.A. Montague
 Lorraine Harvey, an in-home care worker, receives her first dose of the COVID-19 vaccine
(Photo by Mario Tama/Getty Images)

The COVID-19 vaccine rollout is arguably the most anticipated medical breakthrough in history. But not everyone is celebrating its debut. Some African Americans have reservations about the hype. And rightfully so. The atrocities of the past, including the infamous Tuskegee experiment, continues to haunt African Americans today. 

But the media’s practice of constantly referring to that clandestine and abusive experiment as the primary reason for vaccine hesitancy among Black Americans is myopic. Tuskegee appears in what seems like every story on the topic. At best, it has turned into a lazy form of shorthand for a long and complex history. At worst, the trope writes off Black people as apathetic victims. There are myriad reasons for vaccine refusal. Acknowledging and addressing them can change the narrative and deepen journalistic coverage of the vaccine rollout.

What we learn from surveys

Data can dispel a lot of myths. And what the data suggest so far is that Black Americans want to be vaccinated. According to the Kaiser Family Foundation Vaccine Monitor for December, 20% of African Americans said they had already been inoculated or intended to do so. By February 2021, the number doubled to 41%.

What changed? 

According to Lisa Fitzpatrick, epidemiologist and founder of Grapevine Health, taking the time to answer people’s questions has made a difference. “The people who are skeptical have so many questions. The science is not new. Yes, it went fast. It went fast because there was a medical breakthrough that happened that allowed a new mechanism to create the vaccine. But when you explain that kind of stuff to people they get on board. That’s what we need to be talking about instead of Tuskegee.” Fitzpatrick hosts weekly Q&A sessions on Zoom to address questions from the community.

Let’s be clear. Black people care deeply about their health. Prior to the 2020 election, a Washington Post-Ipsos poll found that 53% of Black people say health care is one of the most important issues in their vote. But health extends beyond going to see the doctor. It also encompasses health insurance, culturally appropriate mental health care and substance misuse treatment, and even housing.

In 2020, Third Way and the Joint Center for Political and Economic Studies conducted a research initiative to “study the attitudes, priorities, and values of Black Americans.” Research showed that out of 16 “kitchen table issues,” the second highest issue of concern was the cost of health care. Black Americans want to thrive just like everyone else. It’s the closed doors and inequalities that robs them of hope.

How the media gets it wrong

The media plays an important role in alleviating fears among minority communities. But it takes some work to bring forth all the relevant issues involved in vaccine hesitancy instead of being hyper-focused on the legacy of Tuskegee.

For example, some articles lead with headlines that assert that history is the sole reason why African Americans won’t get vaccinated against viruses. This is only partially accurate and highly misleading. These articles spend a lot of time diving into history and little time on what is happening now. Another way that reporting goes astray: The historical roots of vaccine hesitancy are heavily frontloaded and the connections to the everyday disparities in health care that Black Americans experience today are buried lower in the piece. Highlighting mistakes of the past is significant, but so is reporting on existing sources of inequity that continue to influence health behaviors and access today.

Some outlets are steering their pieces towards the present. And they are seeking advice from African Americans about African Americans. Great move. It’s true that no one person or organization speaks for all Black people. But if an outlet wants to truly provoke discussion and change, they need to talk to the people who have a proven, vested interest in the Black community.

Health literacy and misinformation

Americans have been getting an outstanding crash course on vaccine development over the past year. People want to know how it’s going to work in different populations, when they’ll be eligible, and when we’ll be able to get back to our “normal” lives. The answers to these questions are often wrapped up in complex jargon that most of us don’t understand.

LaMar Hasbrouck, internist, public health expert and founder of DLM LLC, a health care consultant company, said that the reluctance to get vaccinated among African Americans isn’t as widespread as people think, and where it does exist, it’s often rooted in a lack of knowledge.

“The majority of Blacks (about 65%) state they plan to get the COVID vaccine assuming it is free and proven safe. The fact is, there's a lot of hesitancy due to lower health literacy and the poorer access. … Targeted education by trusted leaders (in advance) and consistent access to medical services would probably make all the difference.”

One survey by the Kaiser Family Foundation showed that Black and Hispanic people are not receiving enough information about the vaccine to begin with. Poll results showed that 67% of Black respondents and 6% of Hispanic respondents said they didn’t have enough information about the potential side effects.

Hasbrouck also argues that the buzz about the vaccine should have begun long ago, rather than waiting for the rollout. “The push for Blacks and other minorities should have begun well before the vaccine was available. You never see a movie trailer two weeks after the opening. Promotion begins months before a new release. Now the public health officials and the government are playing catch up.”

Does that scientist look like me?

Think about who was involved in developing the vaccine. How many Black and Brown faces were present when production began? It’s worthy of noting that vaccine hesitancy can often stem from not seeing faces that look like the target population among those researching the vaccines.

Carla Williams, associate professor of medicine and public health at Howard University and co-director for community engagement at the Georgetown-Howard Center for Clinical and Translational Science, says the key to relieving trial and vaccine fears is to keep minorities involved from the start. 

“Having the community perspective can be invaluable to planning a research study,” she said. “Ideally, representatives from diverse communities can be part of the research team. People may be more likely to participate when the research represents their perspectives, priorities, and values. People need to see themselves represented in the research. This can be through advertising materials that reflect diversity.”

In short, if people can see that the vaccine was developed with Black people in mind, chances are they will be more willing to take it.

Present the whole story or not at all when it comes to vaccine hesitancy. The building blocks to this mistrust in African American communities went up long before and persist long after the Tuskegee experiment was unveiled as a fraud. Richer, more nuanced reporting can create much needed trust in media and health science at this crucial time in history.

Comments

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A very helpful article. Its analyses of the issue in the Black community are astute and comprehensive; we journalists should keep them in mind. We should also apply them whenever reporting on underserved communities.

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More effort should go into helping Black children get a firm grasp of science facts, along with an interest in various science fields. Someone that is working on vaccines has undergone a good deal of eduction.

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To quote Dr. Howard K. Koh " health literacy is the currency for everything we do" ( in healthcare ). We need more resources, both intellectual and financial, committed to this vital area of healthcare policy.

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