Habiba Katsha is a journalist who covers race, gender and culture. Here, she dives into the complex, nuanced reality that is behind COVID-19 vaccine hesitancy in some of the Black community.
Editor's note: both approved COVID-19 vaccines are safe for people of every sex and ethnic group. The MHRA, the official UK regulator which authorises licensed use of medicines and vaccines by healthcare professionals, has said these vaccines are safe and highly effective. You can read answers to more commonly asked vaccine safety questions, here.
The official narrative, for much of this twisted, sticky, time, has been this. Our escape route from persistent fear about the health of yourself and loved ones, of not being allowed to hold your friends on dancefloors and from trying to educate children while holding down a job, is a vaccine: A syringe of medicine that will innoculate us from COVID-19.
Now, close to the one year anniversary of the debut UK lockdown in March 2020, the early rounds of such a protectant are being rolled out. So far, more than 2.2 million of the most vulnerable people in this country have taken their first of out of two necessary doses.
How many people are worried about the COVID-19 vaccine?
Like you know, though, not everyone is in a rush to receive the jab. According to an Oxford survey, 72% of individuals would take the vaccine, 16% are very hesitant and 12% are strongly hesitant. The NHS chief executive has told MPs that the government anticipates a take-up of around 75%. (Estimates vary and the modelling is flux, but the general thinking is that around 70-80% of the population needs to be vaccinated, for herd immunity to be achieved.)
The latest data from the London School of Hygiene & Tropical Medicine and Public Health England, meanwhile, suggests that people from Black, Asian or Minority Ethnic backgrounds – who have suffered disproportionately at the hands of this virus and its social impact – are almost three times more likely to reject a COVID-19 vaccine than people from a white background. Polling from Queen Mary university paints a similar picture. This indicates that 39% of Black and Minority Ethnic Londoners say they are 'likely' to take the vaccine, compared to 70% of white Londoners. One other survey, released this month, suggests that 72% of Black people say they are 'unlikely' to get the jab.
There are, of course, certain pieces of wild misinformation circulated by antivaxx conspiracy theorists (Microsoft founder Bill Gates' dastardly plan to microchip the world, hello). There's also historic antivaxx theories rooted in the debunked work of disgraced former doctor Andrew Wakefield, who published a discredited study, which linked the MMR vaccine with autism.
However, not everyone worried about the vaccine is a signed up anti-vaxxer. When it comes to the concerns of some of the Black community, specifically, a lot more nuance is at play.
Why are some Black people concerned about the COVID-19 vaccines?
In this demographic, there are several reasons which could explain the worry present in some quarters. In my conversations, previous negative experiences with the medical establishment are the primary cause of distrust. These can lead to unease at the thought of heading to the site of a previous scary or frustrating incident; or of placing faith in an institution that has previously harmed, rather than helped you.
The Western medical establishment has a history of discrimination
Many Black women, in particular, have stated they’ve had bad experiences with doctors and often feel dismissed by medical professionals. The history of anti-Blackness in the western medical establishment is another cause of concern for Black people. This is not something that is in the past: The latest data shows that Black women in the UK are four times as likely to die in childbirth than white women; earlier in the pandemic, a French doctor was accused of racism after suggesting on a TV debate that coronavirus vaccines should be trialed 'in Africa'.
Serena, who is a twenty-four-year old from East London, says she’s not completely against the vaccine – but she’s also in no rush to take it.
Generally, she has had a good experience with medical professionals. But she has often felt that they don’t take her concerns seriously and mentioned an often-cited issue around disbelief of pain in Black patients. 'The medical establishment needs to do better with Black patients, as I don't think they believe when Black people say they're in pain. They need to drop this belief that we have a higher pain tolerance. I have been to A&E and have had to exaggerate my symptoms to be taken more seriously although I was already in agony,' she details.
Data bears out this truth. Falsehoods such as that Black people have thicker skin or less sensitive nerve endings have been shown to persist in 40% of medical trainees according to one American survey, while a meta-analysis examining over two decades of studies found that Black patients in the US were 22% less likely to receive pain medication than white people.
Dr Annabel Sowemimo, a community sexual and reproductive health doctor and the founder of ‘Decolonising Contraception,’ explains how Western medicine profited from Black bodies for centuries. 'During colonialism and transatlantic slavery, a lot of colonized populations were used to advance medical endeavours,' she says. This often took the form of grotesquely unethical medical experiments, performed without consent or anesthetic.
'There is a commonality that science and medicine put Black people at the bottom of this racial hierarchy. And we see that still in the systems that people access today,' she adds.
COVID-19 has exposed racial health inequalities
Dr Sowemimo believes that Covid-19 has brought a lot of these discussions around racial health inequality and racial science to the forefront of the national conversation. This, naturally, can add to feelings of distrust in the medical establishment. 'The interest currently is on these huge health disparities that we've seen for particularly Black, Brown, and generally non-white patients globally,' she says.
'And it's been a trend that we've seen, mainly in the global north, that people who are racially minoritized seem to [bear] a higher burden of COVID-19 than their white counterparts in the same country.' (ONS data from May 2020 showed that people from the Black community were four times as likely to die from COVID-19 compared to white people.)
Serena adds: 'I would rather wait until it’s settled and see everyone's side effects and benefits. I admit I do need to do some more personal research. But my main fear is potentially developing fertility problems in the future – this is a common fear with most Black women I’ve spoken to.'
To note, there is no evidence that the vaccines harm fertility. On this topic, Dr Edward Morris, President at the Royal College of Obstetricians and Gynaecologists, says: 'We want to reassure women that there is no evidence to suggest that Covid-19 vaccines will affect fertility. Claims of any effect of Covid-19 vaccination on fertility are speculative and not supported by any data.
'There is no biologically plausible mechanism by which current vaccines would cause any impact on women's fertility. Evidence has not been presented that women who have been vaccinated have gone on to have fertility problems.'
Social media can distribute misinformation
When we talk broadly about hesitation around vaccines, it's important to note that the spread of theories on social media plays a role. A new report by the Centre for Countering Digital Hate has found that social media pages run held by anti-vaxxers – who have used the chance of the confusion around the pandemic to crystalise their message – have increased their following by at least 7.8 million people since 2019.
Here, misinformation around the vaccines, from the outlandish (see previous microchipping example) to the more insidious (that the vaccines have been 'rushed' and are, therefore, 'unsafe') are spread. For the sake of clarity, these are untrue. You can read about how the vaccines were formulated at speed, due to near-limitless funding and high public interest, here.
Antivaxxers are targeting specific groups
The report notes that antivaxxers are explicitly targeting certain groups, such as parents and people from different Minority Ethnic backgrounds. These platforms, the report says, tailor key antivaxx theories to specific demographics. In doing so, they might dissuade someone who was previously on the fence into refusing a vaccine.
Of course, this is not the truth for everyone. Alicia Lartey, a 21-year-old student, is eager to take the vaccine. She’s currently studying biomedical science and says that vaccines have never been something she’s worried about, as she’s in a scientific field. 'As long as I have access to information that has allowed me to understand the vaccination I’m open to taking it,' she tells me.
She does, however, understand the concern from some members of the Black community. 'I think Black people have every right to be skeptical as medicine is an inherently racist institution, which has now boiled down to a lot of distrust. The government also has not taken enough time to properly address this concern either.'
Dr Sowemimo has had her first dose of the vaccine. Her advice? 'People need to obviously make their own decisions, but you need to make decisions based on factual information. Try not to make it based on feelings and emotions towards an institution or previous experiences.'
Shout out to the wonderful staff at Leicester General Hospital who gave me my first Pfizer jab this morning 💪🏿 Smooth process. They’ve now vaccinated over 12,000 people! Doing another 400 today. #covid pic.twitter.com/9woFlkcl8k
— Dr Annabel 🙅🏿♀️(she/her) (@SoSowemimo) January 17, 2021
Where do we go, from here?
Unless you are in a priority group, it's likely that your vaccination offer is still a little way off. The Health Secretary, Matt Hancock, insists that we are on track for a target of offering a vaccine to just shy of 14million people of the most vulnerable people by mid-February. Hancock has also said that the plan is to offer vaccination to every adult in the country by the 'autumn' – although whether that will be the full two doses required for inoculation, as opposed to just the first, and whether this will be actually be met – remains to be seen.
My take is this. Moving forward, medical professionals and politicians need to start listening to the stories from the Black community. We’ve heard countless complaints from Black women who have been gaslit or ignored when speaking to medical professionals. Additionally, the medical establishment and the state should acknowledge the historical role it has had in racial science and ensure that all medical professionals unlearn false narratives related to Black pain and trauma.
Many anti-vaccine arguments are problematic and harmful to the Covid-19 discussion. However, medical professionals must look at the ways they’ve possibly contributed to igniting medical fear within the Black population of the UK. Addressing the community's concerns – and reaching out with reassurance – is key.
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