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Vaccine rollout won’t be equitable unless health care reckons with racism

Vaccine rollout won’t be equitable unless health care reckons with racism


‘There really needs to be some healing’

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New York’s Northwell Health Hospital Administers Covid Vaccines
Dr. Michelle Chester, right, rolls up the sleeve of Sandra Lindsay, a nurse at Long Island Jewish Medical Center, before she is inoculated with the Pfizer-BioNTech COVID-19 vaccine, December 14th, 2020. Lindsay was one of the first people in the United States to get a dose of the newly authorized vaccine.
Photo by Mark Lennihan / Pool / Getty Images

The pandemic has been anything but “the great equalizer” that some people called it when it started more than a year ago. Here in the US, COVID-19 has sickened and killed a disproportionate number of Black, Native American, and Latinx people. Vaccine rollout is proving to be inequitable, too. Black and Latinx elders in Los Angeles, for example, have been vaccinated at a lower rate than their white and Asian American counterparts. 

Distrust in vaccines has been a challenge across the board. But Black Americans were less inclined than other racial and ethnic groups to want to get vaccinated, according to a Pew Research Center survey from December. To fix a system that isn’t fully serving Black Americans and other people of color, “There really needs to be some healing,” says Melva Thompson-Robinson, executive director of the Center for Health Disparities Research at the University of Nevada, Las Vegas.

The Verge spoke with Thompson-Robinson about the roots of that distrust and how to heal.  

This interview has been lightly edited for length and clarity.

How does distrust for vaccines in communities of color differ from white celebrities or conspiracy theorists who are anti-vaxxers?

It’s not just a simple matter of, “Oh, I don’t believe that something works because this is what I heard.” This is about that deep-rooted, historical trauma that has been carried down through generations. That distrust comes out of the racism that they experience. When you’re talking about African Americans, in particular, you’re talking about a group of people who are descendants of slaves. 

And so it’s a different kind of thing. It’s not “I believe that these vaccines aren’t effective because I heard that’s what somebody said.” This is “I’m not trusting because of the experience that my family has had under slavery.”

A big thing now is people are looking at who’s in charge. Who’s running the vaccine trials? Who’s participating in the trials? They say, “Well, I don’t see people who look like me.” Or “I do see people who look like me.” And all of that is huge. We need to see people who look like us who are involved.

What are some of those historical traumas that have led to distrust of vaccines among some people of color?

When you start to talk particularly about slaves, one of the men who is credited as being the founder of gynecology actually did surgery on Black women because they were considered property. He was doing gynecological surgery with no anesthesia because part of the thought was “Well, they don’t experience pain.”

That’s not true. All people experience pain. 

You can jump the Tuskegee syphilis study. You could also even look at the story of Henrietta Lacks, who had cervical cancer. And they harvested her cells at Johns Hopkins and still to this day still use her cells for research. 

“That’s not true. All people experience pain.”

So people are saying, “Well, you need to trust the health care system.” But health care systems, health care facilities, and health care providers need to act in a trustful manner. You can’t just expect people to say, “Oh yeah, I’ll now trust you” after centuries of mistrust. 

How do we see inequities playing out today when it comes to vaccine rollout in the US? 

The challenge has been with some of the vaccines that you have to have very specialized storage capabilities, which then has limited where some of these can be distributed. Communities of color don’t always have access to those storage facilities. 

For people working in grocery stores or other retail and food outlets, it’s not as simple for them to take time off to go to an appointment. If they don’t have sick leave or they have a limited amount of leave, they can’t go and stand in line for hours at a time. 

“You can’t just expect people to say, ‘Oh yeah, I’ll now trust you’ after centuries of mistrust.”

Another challenge is the messaging that’s going out to people. You already know that you have populations that are concerned about getting the vaccine. So the messaging for that population needs to be different.

There’s no “one size fits all” prescription for how to reach out to different communities of color. But what should solutions or outreach strategies look like?

Here in Clark County where Las Vegas is located, the governor just came out last week with an equity initiative. Because if you look at the data, where the cases are versus where people are who are getting the vaccine — it’s two different places within the same city. It’s not the same group of people. We’re seeing this inequitable distribution of resources. We’re in this perfect storm, and in order to survive it, I think there has to be some relinquishing of power.

There really needs to be some healing and some stepping back. Not rushing, but stepping back and saying: “You know what, we hear what you’re saying. We understand where we’ve done wrong, and we want to do better.”

Here’s what else is happening this week.


The fast-spreading coronavirus variant is turning up in US sewers
Some researchers are tracking coronavirus variants through US sewer systems. For more on sewers and COVID-19, check out Verge Science’s video from last year. (Antonio Regalado / MIT Tech Review)

Doctors and lawmakers call on FDA to address racial disparities in pulse oximeters
Pulse oximeters can measure the amount of oxygen in people’s blood through their skin, but they aren’t as accurate in people of color. Some experts are calling on the FDA to review these devices’ effectiveness. (Erin Brodwin and Nicholas St.Fleur / STAT)

Childhood Colds Do Not Prevent Coronavirus Infection, Study Finds
For a while, some people thought that children might be less vulnerable to the coronavirus that causes COVID-19 because they had been exposed to other coronaviruses that cause colds. This is not the case. A study found that those other coronaviruses didn’t produce antibodies that were effective against the new coronavirus. (Apoorva Mandavilli / The New York Times)


How Merck, a Vaccine Titan, Lost the Covid Race
A look at why a “pharmaceutical giant” dropped out of the vaccine race — and where they might go from here. (Katie Thomas / The New York Times)

AstraZeneca’s COVID-19 vaccine has been confusing from the start
Earlier this week, South Africa decided to pause the rollout of the AstraZeneca vaccine after it performed poorly against a widespread variant in a small trial. Later this week, the WHO recommended that the vaccine should still be used. (Nicole Wetsman / The Verge)

Covid-19 vaccination rates follow the money in states with the biggest wealth gaps, analysis shows
States with large wealth gaps, like Connecticut, are seeing huge disparities in vaccination rates. In Connecticut, there’s a 65 percent difference in vaccination rates between the wealthiest and poorest communities. (Olivia Goldhill / STAT)


“I do my shift, wash my face, change my clothes and then get on the app.”

— Emergency room doctor Daniel Fagbuyi tells Bloomberg about his voluntary second shift: countering vaccine misinformation on social media app Clubhouse. 

More than numbers

To the more than 108,030,043 people worldwide who have tested positive, may your road to recovery be smooth.

To the families and friends of the 2,377,268 people who have died worldwide — 479,458 of those in the US — your loved ones are not forgotten.

Stay safe, everyone.