Mistrust of the medical system has made some Black Americans hesitant to get a COVID-19 vaccine. It’s a mistrust rooted in history, and that includes the infamous U.S. study of syphilis that left Black men in Tuskegee, Alabama, to suffer from the disease.
Dr. David Hodge, lead ethicist at the National Center for Bioethics and Research in Health Care at Tuskegee University, is quick and careful to note the official name of the study: The U.S. Public Health Service Syphilis Study at Tuskegee.
“For too long, the name Tuskegee has become the metaphor for all that is wrong in medical ethics, particularly as it relates to Black people,” Hodge said during a February presentation at The University of Alabama College of Community Health Sciences as part of Black History Month. “You cannot turn on the TV or radio and hear conversations about (COVID-19) vaccine hesitancy and not hear Tuskegee mentioned. But there’s more to medical mistrust and distrust than Tuskegee.”
The U.S. Public Health Service study was an observational study on Black males in Tuskegee between 1932 and 1972. The U.S. Public Health Service ran the study on more than 300 rural Black men, offering free meals and checkups but never explaining that participants would be human subjects in a study designed to withhold medical treatment, even after the introduction of penicillin in the United States.
Hodge said it is an error to use the study as justification for why Blacks are hesitant about the COVID-19 vaccine. “The syphilis study was the effect of untreated syphilis in the Negro male, and the goal of the study was to not treat syphilis in the Negro male,” he said. There was even a system in place, he said, to ensure a lack of treatment for study participants. If they attempted to get treatment elsewhere, they were denied because they were in the U.S. Public Health Service study, he said.
“When we use the syphilis study as a justification for mistrust, we have to be careful because the COVID-19 vaccine isn’t about not treating, it’s about treating. And the vaccine is not about the Negro male, the vaccine is about all humans. We have to be careful in our correlation.”
Hodge likened trust to instinct. “You trust the air you breathe, that the ground will hold you. You trust your memory to get you to work.” He said because trust can be exploited, “it creates a vulnerability in those who are doing the trusting.”
He said the COVID-19 vaccine, with an approximate 95% effective rate, is “potentially the best vaccine that has ever come out.” Hodge said he believes hesitancy about the vaccine is directly correlated to trust. He noted that many Black Americans are more susceptible to COVID-19 because, as a result of health disparities, they often have underlying health conditions, such as diabetes, “and they often have the least insurance.”
Hodge said if trust is to be established, there has to be confidence on the part of people receiving the COVID-19 vaccine that they will be taken care of if they experience adverse effects. “There has to be that kind of commitment going in,” he said.