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I was convinced that 2020 would be my last year alive after a pandemic-related housing loss led to seven relocations. Medical information was ever changing, little was discussed about how to move safely, and there were few places I could actually be safe as a Black trans person. Nearly a year later, the COVID-19 vaccine rollout is underway, and data shows more than half of Black adults in the United States are hesitant to be vaccinated.

I am a 2020 Mailman School of Public Health graduate who was an Epidemiology Administration intern at the New York City Department of Health when the city was a COVID-19 epicenter. Though I am not an anti-vaxxer by any means, the widespread hesitation in Black communities is valid.

The health industry’s history of abuse and ongoing disconnect with Black realities throughout the COVID-19 pandemic fuels distrust. Before circumstances are dire, Black people deserve the ability to practice informed decision-making with full access to information, vaccines, and trusted providers. In her book, “Medical Apartheid,” Harriet Washington highlights how today’s U.S. health care system is built on centuries of medical experimentation on Black people. Even now, the response to the COVID-19 pandemic has felt like an ongoing experiment, leaving Black lives hanging in the balance.

The Trump administration’s behavior gave rise to suspicion of any vaccine developed under its jurisdiction. Trump’s order to strip the Centers for Disease Control and Prevention of its ability to report COVID-19 data increased already high levels of distrust in government response efforts.

The experiences of the Black community during the pandemic in the United States vastly differ from those of other racial groups: COVID-19 was initially described as life-threatening solely for older adults and those with pre-existing conditions, coding both as disposable. Only after national pressure were COVID-19 racial figures released. Data revealed Black people were dying of COVID-19 at younger ages and at nearly three times the rate of white people—primarily due to untreated underlying conditions and poor access to healthcare.

Black people across the country watched younger loved ones perish after prominent white health experts publicly implied the virus would not kill them.

Early New York Police Department enforcement of social distancing also sowed sour seeds. The effort was deemed “a tale of two cities,” as the police were seen being lenient and giving masks to white sunbathers while 68 percent of New Yorkers detained for social distancing violations were Black, despite Black people making up only 23 percent of New York City’s population.

Forcing people into cramped cells is counterproductive to stopping the spread of COVID-19. Black migrants in ICE detention report threats of deliberate COVID-19 exposure. Yet incarcerated people in New York, who are unable to socially distance, were not prioritized for vaccination until multiple groups filed a lawsuit against Gov. Andrew Cuomo.

COVID-19 health communications have also failed to address the unique adversities Black workers face. “Stay at home” advertisements continue to dominate despite being inapplicable to many Black workers who are overrepresented in frontline industries. Black people facing housing insecurity, which impacts 42 percent of Black trans people, seem like afterthoughts. Many in the Black community have been evicted in wake of moratoriums that expired or were not automatic. Meanwhile, information about how essential workers can protect themselves continues to be difficult to find.

These conflicts between widespread COVID-19 public health information and Black lived experience deepen distrust of the health industry, even as Black health experts are working to prevent vaccine rollout from meeting a similar fate.

Sixty Black health experts penned a letter to the Black community affirming the safety of COVID-19 vaccines and urging vaccination. Rep. Cori Bush, a former nurse, discussed the vaccine and the Black community with Dr. Camara Phyllis Jones in order to spread accurate information.

For Black people who want to get vaccinated in the U.S., finding vaccination sites is a struggle. A study revealed Black people are more likely to live in vaccine deserts. They also have to compete with people who travel in from other regions. Locally, the Armory mass vaccination site was intended to serve residents of Washington Heights, Harlem, and the Bronx, but non-residents initially swallowed vaccine supply and consequently had to be banned.

The belief that vaccines guarantee complete immunity from COVID-19 is fueling similar frenzies nationwide. The public is accustomed to one-time vaccination against viruses, with little worry about ever contracting it afterward. Vaccines alone, however, will not end the pandemic.

The Pfizer and Moderna vaccines are only 95 percent effective. The two-dose design of the vaccines also poses an issue for those who cannot afford to abandon daily responsibilities multiple times. Double masking and social distancing are the best practices regardless of vaccination status, especially as mutations emerge.

There are many ways to be part of the solution during global vaccine shortages. Prioritizing accurate information and improving access to vaccines in Black communities is key. Shame, coercion, and false notions of complete protection from COVID-19 based on vaccination status harm us all.

Anti-Black systemic failures in the national COVID-19 response mirror many of the shortcomings in public health practice and education in general. Vaccines that can reduce COVID-19 spread are being shunned and underutilized in Black communities as a result. Columbia University and other primarily white institutions of health must confront the long-standing neglect of the Black community using Critical Race Theory as a guide to shift institutional resources and invest in holistic Black communal health beyond Black History Month. This will ensure a more just future.

Dorcas (they/them) is a 2020 Human Rights Campaign ACTIVATE fellow, DotDash Anti-Bias Review Board Member, and 2020 Mailman School of Public Health graduate. Keep up with them on Twitter or Instagram @PubHealthDork.

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vaccine COVID health Black covid black vaccine hesitancy
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