How Medical Racism Has Informed Vaccine Hesitancy

Since joining Intent Health four months ago, I’ve had a sharp learning curve on the art and science that is communications. One lesson that’s left a lasting impression is this: it’s not just about what you want to say and your message. If you wish to be understood, listening and learning your audience’s needs and wants come first. You have to ask yourself, ‘who am I talking to, how can I adequately communicate?’
I was thinking about this principle, and how it applies to the government’s communications around vaccinations, explicitly trying to reach me, a Black woman. Mistrust from some Black people in Black communities towards the COVID-19 vaccine results from a history of medical racism that isn’t being talked about nearly enough. Instead, we are scapegoated, blamed for holding up the overall vaccination progress without anyone asking the question ‘why?’

Medical racism: understanding the origins

When addressing hesitancy towards taking the vaccine within Black communities (we are not a monolith), it is essential to explore how healthcare systematically prioritises white health.

Dr James Marion Sims isn’t well-known, but he should be, for all the wrong reasons. Some hailed this man as the ‘father of modern gynaecology.’ He executed experiments that operated under the (false) belief that Black people do not feel pain. Dr Sims experimented on enslaved Black women and children without anaesthesia between 1846-1849, trying to find the “perfect” method to treat vesico-vaginal fistula. The experiments included over 30 painful surgeries on Anarcha Westcott at the tender age of 17.

Sims’ violent framework solidified by only using anaesthesia on white patients, which has opened a generational suffering portal. This belief that my pain does not exist or is lesser, relative to lighter-skinned people, has manifested itself in healthcare interactions today. His practices are so ingrained in the present medical protocol that reputable educational resources online reflect his views, “Blacks often report higher pain intensity than other cultures.”

When a medical professional who can hold my life in their hands, has this medical bias, they erase parts of my humanity. This dehumanisation overlooks the part of me that’s in pain and vulnerable. I can’t count the number of times my friends and I have discussed how our parents taught us to exaggerate our symptoms when seeking treatment. Why? Because the reality is Black patients are half as likely to obtain sufficient pain medication as their white counterparts.

The way we all prepare for medical appointments vary. But knowing I could be subject to medical bias and refused treatment I may need means over-preparation. I must remember and recite statements like, ‘I will need you to document on record the reason you are refusing me the treatment (or medicine) I have requested and the reason you are doing so.” People have even suggested bringing a white man who could advocate for me in the appointment. These are the realities I face as these biases are so historically validated, so inherent, they have become standard practice.

Changing the narrative

The perpetuation of these practices has made many medical professionals desensitised to the disproportionate statistics of Black suffering.

This desensitisation makes the media’s current language scapegoating of Black people no surprise to me with headlines reading: “COVID-19: Government very concerned about low vaccine uptake among BAME communities.” Or they will suggest a misleading connection between mortality rates and vaccine hesitation that insinuates ignorance instead of informed choice: “Hesitancy is highest amongst black, Pakistani and Indian people, despite these ethnicities being more likely to die of COVID-19.” While the real reason, rooted in generational trauma, goes unmentioned.

I spoke with a young, Black physiotherapist, Sarah Bernasko, on her thoughts about the government’s approach and language in the media. As the founder of @SarahsTruths on Instagram, YouTube and Twitter, Sarah uses her platforms to combat misinformation, providing insight about entering the Physiotherapy field and its day-to-day reality.
“I think these are sweeping, antagonist statements as they do not reflect nuance.”

“The conversation should centre on *why* some Black people are more disadvantaged and *why* they are hesitant to take the vaccine. It’s not new knowledge that some Black people within Black communities rightly hold suspicion due to generational experiences of medical racism.

The government and (vaccine) advocates’ approach assumes that the vaccine merely being available means people should obtain it. However, failing to go into precise, digestible detail about its effectiveness isn’t convincing to groups of people that mistrust the voice divulging the information.”

Finding a better way

This digestible dissemination of vaccine information and attentiveness to the systematic racism rampant in healthcare is required to start overturning medical mistrust. Dismissing these issues while only engaging pastoral leaders, community leaders or even “BAME” celebrities to champion the vaccination to ethnic communities is tokenistic.

Black reputable healthcare role models should be at the forefront of debunking vaccine misinformation. Otherwise, inaccurately informed views generated from other influential opinions within various communities is created. Bernasko states, “Some religious leaders are advising vulnerable people to ‘put their trust in faith’ and not science – suggesting that one must negate the other.”

“My aim isn’t to tell you to have the vaccine or not. I aim to help inform my community to evaluate their reasoning behind not having the vaccine and make an informed decision for themselves.”

As multifaceted as we are as a community, it’s apparent to me when companies are engaging in “diversity for diversity’s sake.” Pfizer’s vaccine is 92% effective, yet only 9.8% of over 40,000 people were Black or African American in one of their clinical trials.

Communications should start with listening and championing Black voices that are providing constructive criticism and demanding change. However, those who intend to address vaccine hesitancy in the communications space must understand there is no one size fits all approach to engaging Black communities. The government and media would do well to acknowledge the roots of this deeply triggering issue and engage in a genuine dialogue to address people’s concerns. I hope to see a more holistic conversation about vaccine hesitancy that centres on the Black British perspective. We are not a group that all think alike. We are diverse and have different needs. And it’s about time to consider your audience profoundly and what they need to hear, not just what you want to say.