Vaccine Hesitancy Amongst Black People

Photo Credit: Getty Images
By Dr Omobolaji Oyebanjo Popoola, MD, ABPN, ABPM and
Ferdinand Orleans-Lindsay, LLB (Hons)

It is a shocking observation that within a year of its start, the COVID-19 pandemic has
chalked up a global total infection rate of 111,754,512 (figure as at 21st February 2021), with
the number of deaths at 2,474,138! It is salutary to note that with just 4% of the world’s
population, the United States accounts for 20% percent of the deaths so far. Equally troubling
is the death figure for the United Kingdom, which at 119,000 and counting, renders the little
island-nation the fifth in a global death count. Amidst those alarming figures is the still
troubling figure of Black deaths from the pandemic.

The Colour of COVID-19

Number of Deaths From Covid-19 (Per 100,000 People)


The Colour of COVID-19According to the current running total of figures for deaths from COVID-19 in the United
States, 444,000 people have perished in respect of whom the racial breakdown is as follows: –


● For African Americans, the deaths are 1 in 645 or (155.2 deaths per 100,000)
● For White Americans, the deaths are 1 in 825 or (120.9 deaths per 100,000)
● For Latino Americans, the deaths are 1 in 835 or (119.5 deaths per 100,000) and
● For Asian Americans, the deaths are 1 in 1,320 or (75.8 deaths per 100,000).


Figures From Africa


At the initial stages of the COVID-19 pandemic, when countries like Italy, the US, and France
were hit quite hard, there was much concern for the potential fate of Africa in the impending
circumstances of mass infection, inadequate health infrastructure, and an acute lack of
resources. Remarkably, by the end of the first wave, Africa seemed to have escaped the worst of the pandemic, with incredibly low rates of infection and even lower mortality rates. On further evaluation, it would appear that Africa’s relatively young population, sparse
population densities, and fewer elderly populations, all conspired to reduce the otherwise
drastic effect of a pandemic run on the continent. There has been some attribution to poor or inadequate reporting from the region, including little contact with formal health care systems and crucially, lack of testing, but there is no question that as of now, the pandemic has affected Africa less adversely than other regions. It is noteworthy, however, that
notwithstanding the relatively low COVID-19 mortality figures reported from Africa, there
was a higher incidence of corpses than patients. The cost of hospital care is generally out of
the reach of the average African and so formal reporting would suffer accordingly. The
stigma that attends diseases such as Ebola and HIV, was reflected somewhat in many
attitudes to the COVID-19 pandemic. Due to the low COVID-19 mortality rates reported
from Africa, many even believe that COVID-19 is not real, while others believe that Africans
are uniquely immune to the disease for still inexplicable reasons. The tropical climates with a
lot of sun and heat, have also been pressed into the myth-making of some perceived African
immunity. This has been done even as figures in equally high-temperature jurisdictions such
as India and Brazil, have been amongst the highest in the world. The disinformation
campaigns that proliferate on social media platforms, constitute a dangerous impediment to
the acceptance of accurate, science-based information that has grown exponentially and requires urgent attention.

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The Second Wave of the Current Pandemic


Following the lull of the summer period characterised by premature loosening of restrictions,
a second wave of the COVID-19 pandemic has taken hold across much of the globe, with
mutant variants of the original virus, the most dangerous of which appear to be the UK, the
South African and the Brazilian variants. They appear to have a higher infectivity rate and
cause more deaths. The mortality rate has crept up in Africa while it appears to be reducing
globally and there is now even a Nigerian variant of the virus. The global mortality rate is
2.2%, while the mortality rate in Africa has gone up to 3.7%. There is no sign of relenting at
the moment in respect of the death rates in Africa, with numbers climbing inexorably
wherever reliable figures are being presented. With all that in the background, the myths and misinformation referred to above do not help much with focussing efforts to control the
disease spread in Africa.

The world heaved a sigh of relief when the first applications were made for emergency use of a vaccine by Pfizer-BioNTech, within a year of the start of the COVID-19 pandemic. This
was followed promptly by similar applications submitted by Moderna and the
Oxford-AstraZeneca group. As well as offering protection from hospitalisation and mortality,
the vaccines are also reputed to prevent the spread of the disease. There are also many
therapeutics in the pipeline with promising prospects. There is an active roll out of the
vaccines that have been authorized in most developed countries and it is early days yet but
the initial uptake by black populations in those countries have been rather low, compared to
their white and other race counterparts. Given that current vaccination rates are running at a ratio of 3 to 1 in favour of Whites to Blacks, in spite of the latter having higher mortality
rates, a major effort is required to boost Black vaccination numbers. There is some general
hesitancy to accepting the vaccines attributable to the disinformation campaigns referred to
above, but the Black hesitancy is notable for its relative strength, which has a history behind
it.

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Definition of vaccine hesitancy


Vaccine hesitancy, also known as anti-vaccination or anti-vax, is a refusal or reluctance to
accept vaccination against contagious diseases or refusal of such on behalf of one’s children or ward. This hesitancy is manifest in either their delay or complete refusal in spite of overwhelming scientific evidence supporting the safety and efficacy of the vaccines. Such people are now commonly referred to as “anti-vaxxers”. There are a variety of reasons
underlying this hesitancy including, mistrust of the government, healthcare provider, the
vaccine itself, and historical events. Other factors include religious reasons, lack of
understanding, and convenient access. Anti-vaxxers have existed for almost as long as
vaccines have been used by humans to curtail ravaging pandemics. The World Health
Organisation (2019) has identified vaccine hesitancy as one of the top ten global health
threats.

The history of vaccines

Evidence exists that the Chinese practiced vaccination as long ago as 1000 AD, whilst Africans and the Turks are also said to have practiced it long before its use in Europe and the United States. In the early 1700s after the outbreak of smallpox in Boston, United States, a black slave there, one Onesimus from Africa, is recorded to have introduced a potential way of saving people by inoculation, a practice he recalled from his original home in Africa. The idea was ultimately adopted by an American doctor and this represents some of the earliest known use of vaccination in the West.


Tuskegee and others


Starting from 1932 until 1972, the United States Public Health Service conducted a study of
the effects of untreated syphilis in Black men in Macon County, Alabama, whose county seat
is Tuskegee. For the study, 399 Black men with late latent syphilis and another 201 without
the disease, the latter forming the control group, were initially enrolled. Further participants
were added on as the study evolved, thus rendering the total number variable according to
the source of data. Contrary to the popular narrative, the 399 were adopted for the study because they already had latent syphilis and no record exists of anyone having been wilfully injected with the disease for the purposes of the study. While the study subjects were monitored for the duration of the study, they were merely given placebos such as aspirin and mineral supplements, notwithstanding the fact of the emergence of penicillin as the recommended treatment for syphilis 15 years into the study in 1947. Many of them went blind, lost their hearing or developed other complications connected with syphilis and a significant number died from the malign neglect and failure to treat.


The Mindset of the “Anti-Vaxxer”

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Black citizens of the US and the UK have glaring historical reasons for their attitude, not
least the terrible example of the Tuskegee experiment and a multiplicity of lived experience
with discriminatory healthcare systems that have been shown in various studies to
disadvantage them. The underrepresentation of people similar to them in positions of
authority in the healthcare systems and limited access to healthcare have not helped with their
confidence in those systems. The politicisation of COVID-19 by various powerful groups
within society, including governments, the influence of religion, and a steady campaign of
misinformation on social media and elsewhere has created a mindset of deep resistance to
accepting the vaccines amongst many in Black communities.


The Benefits of Vaccination

COVID-19 is supremely unpredictable in who it kills. There is no telling who its victims will be or how it affects them. Some of its victims are young and healthy yet still succumb to death or long-term debility from the affliction, while others who might be older and have a higher risk, survive with minimal complication. Some people are even asymptomatic carriers of the disease and may unknowingly infect loved ones, some of whom may end up dying in the most tragic of circumstances, all alone in the hospital. Because of this uncertainty, it must be a strong consideration, unless there are contraindications or advised otherwise by a person’s own physician, to take the vaccine. Before a decision is made, it is essential to consult with a trusted healthcare provider.
Vaccination pride we have had our Many celebrities, politicians and other leaders have publicly taken their vaccines. Indeed, both writers have successfully taken our vaccines and are much happier and relieved for it. While considering and waiting for your turn, do not forget to mask up, maintain social distancing, wash your hands and avoid crowded places. Until we are able to achieve herd immunity, those are the only protection we have from the COID-19 virus. Hopefully, this too shall pass.


*The contents of this article reflect the writer’s personal opinion. No doctor-patient
the relationship is assumed or intended. If you have any queries of a personal nature, please
reach out to your personal physician

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