Black People Have Concerns About the COVID Vaccine—Don’t Call It Fear

Since the advent of multiple COVID-19 vaccines, medical mistrust among Black communities has dominated the news cycle. Hundreds of published articles have seized upon the narrative that a disproportionate amount of surveyed Black people have indicated that they are hesitant about taking the vaccine.

The Financial Times’ alarmist report—“The fight to overcome vaccine hesitancy among African Americans”—was standard fare as far as the stories went. Predictably, it touched on medical experimentation, à la the Tuskegee Syphilis Study and the violation of Henrietta Lacks’ cells, as an explainer for why Black people distrust the medical industry, while ignoring the preventable and disproportionate deaths that Black people experience in medical settings every day as a cause for doubt.

Bad Interpretation of Bad Data

The problem with this narrative is that it relies on a faulty reading of statistics to make its conclusion while excluding other, equally relevant data points.

The surveys that are currently blowing up the internet were conducted by Kaiser Family Foundation (KFF)—a nonprofit that focuses on health policy analysis and journalism on a national scale—to gauge how different groups were feeling about COVID-19 vaccines. The first, and more extensive, of the two surveys was conducted in November and December 2020, while the second took place in January.

The initial survey involved 1,676 people—842 of whom were white, 390 Black, and 298 Latinx—with weighted answers for its Black and Latinx respondents to compensate for KFF’s failure to match the number of white people surveyed. A major issue with using weighted responses, instead of recruiting more Black and Latinx people, is that doubling up on results fails to accurately convey the complicated nuances that a living individual’s responses to over 70 questions would reveal.

Rather than report this suspect methodology, numerous publications filled their papers with accounts of doctors who have had trouble convincing their patients to take the vaccine. These stories are valid, but so are the stories of numerous people with whom I’ve spoken in my Black community of Bed-Stuy, Brooklyn, as well the many Black medical professionals I interview every day who make a point of cautioning me, “Don’t let anyone tell you that Black people don’t want this vaccine.”

Self-Fulfilling Bias

Unfortunately, that’s the tale many publications are selling, and it is doing great harm. Choosing one piece of data over another is a political choice. Some outlets emphasized that 20% of Black respondents answered that they would get the vaccine as soon as possible, compared to 40% of white people. However, 52% of Black people responded that they would wait to see how it affected other people, compared to 36% of white people. Both Black and white people responded in equal numbers—15%—that they would “definitely not get the vaccine.”

But with each month, as more data becomes available, the enthusiasm that Black people have for the vaccine increases. In the January survey, 43% of Black people said they would wait and see, compared to 26% of white people—a difference of 17%, which is still lower than the 33% of surveyed Republicans who reported that they would definitely not get the vaccine. Keep in mind that by mid-February, only 3% of Black people had been vaccinated, though not for a lack of trying. Even as Black people continue to request additional information about the vaccine so that they can make informed choices, their communities continue to lack access and resources.

Indeed, missing from much ongoing reporting about supposed disproportionate medical mistrust is that in the November/December survey, more Black respondents indicated that they trusted the government for accurate information about the vaccine than their white counterparts. Black respondents had more faith in the Centers for Disease Control and Prevention, Food and Drug Administration, their local health department, and Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, than white respondents by anywhere from 5% to 9%. Also, 22% more Black people than white people answered that they trusted President Biden for information, compared to 29% more white people who trusted Trump for information.

Cherry-Picking the Data Points

Currently, Republican respondents have not shifted their attitudes toward the vaccine. It’s an alarming point that even as the vaccine rollout has improved, this subgroup continues to hold onto an anti-science stance. Considering that 74 million people voted for Trump—30 million more people than the entire population of Black people in the U.S.—this should give people cause for alarm.

The relevant takeaway from both KFF surveys is that Black respondents revealed that they wanted more information about the vaccine, had greater faith in the government, were alarmed by the prospect of allergic reactions, and were concerned that not enough Black people were involved in the vaccine trials.

There is validity to this concern; after all, Black people accounted for only 9.8% of participants involved in the Pfizer vaccine clinical trials and 9.7% of those in the Moderna, compared to 81.9% and 79.4% white participants, respectively. This should not be considered hesitancy; rather, it should be acknowledged as a well-founded concern and provide motivation to do better in the future.

Misreporting that Black people are disproportionately wary of the COVID-19 vaccine, while ignoring equally compelling information, has potentially dire consequences. It presents an inaccurate picture to policy makers who are often more influenced by public opinion than they are by scientific data, which can result in fewer resources being allocated to communities that need it most, even as white people repeatedly swoop in to seize appointments in Black and Brown neighborhoods.

Consequences of Bias

When asked why I thought that was the case, I explained to an older white man that many Black people are essential workers and lack the flexibility that many white people who work from home have to schedule appointments. Prior to discussing the facts of KFF’s survey with this person, he believed that Black people didn’t want the vaccine. From there, he decided that they didn’t deserve it.

He is not alone in this assessment. When I think of anti-vaxxers, even as a reporter with compassion for what misinformation can do to people, I throw my hands up in frustration and say, “Then give the vaccine to someone else.” As part of an informal survey, I spoke to 12 different white people about this, and they all agreed with my assessment. The problem with applying this assessment to Black communities is that they are not anti-vaxxers, though racial and inaccurate reporting is pushing them into that category.

Within Brooklyn, policy makers responded to the accurate public outcry that too few Black people had access to the vaccine by creating a dispensation site at Medgar Evers College. Unfortunately, the “hesitancy myth” briefly combined with the very real fact that there are still hundreds of appointments left over at Medgar Evers because residents living within prioritized Black neighborhoods have yet to claim them.

Missing from that initial report was the fact that many elderly Black people were unable to make online appointments because they lacked internet access, computers, or the know-how. I know this, because I belong to a community group that is helping to spread the word among elderly people and helps them to get signed up. After recognizing the ongoing problem, the city announced that walk-in appointments would be allowed.

But because of the overflow of appointments, as well as the poorly managed prioritization plan, Medgar Evers opened its appointments to everyone in Brooklyn who was eligible for the vaccine, after only one week of focusing on residents of adjacent neighborhoods.

The entire rollout plan in New York has been inept; however, it cannot have helped that many people were influenced by the myth that Black people didn’t want the vaccine anyway. Looking at the success of West Virginia, we know that it did not have to be that way.

Choosing Competency Over False Narratives

Rather than follow trendy data findings—which found that rural communities, such as most of Kentucky, did not want the vaccine—Maj. Gen. James Hoyer, who leads West Virginia’s task force on COVID-19 vaccines, created an aggressive and intelligently designed rollout plan. Recognizing that as many as 30% of West Virginia’s residents lacked broadband internet, he activated a telephone hotline and staffed it within the state’s health department.

Because Hoyer provided the plan with sufficient resources, the average wait time on each call was only six minutes long in February. As a result, if West Virginia were an independent nation, it would have the third best vaccination rate in the world. That news has made the state a worldwide model, just as the cautionary tale about Black people has promoted an idea that they don’t deserve help against a virus that is disproportionately ravaging their communities.

Some Black people are wary of the vaccine, just as some people were wary of the polio vaccine in the 1950s. However, the answer to alleviating their concerns has been communicated clearly and repeatedly: provide more information about and access to the vaccine within Black communities, increase diverse representation in trials, show superior leadership à la President Biden versus Trump, avoid pathologizing Black people, and stop talking about Tuskegee as if Black babies aren’t currently three times more likely to die during childbirth when their attending doctors are white instead of Black.

But most importantly, stop conducting surveys without first investing in accurate representation. It is doubtful that KFF intended for its data to be misused. But by focusing on the discrepancies along weighted racial lines, it all but guaranteed that a biased and harmful story would dominate the headlines.

Hopefully, next time, KFF’s writers will focus on solutions and avoid promulgating fear-based narratives.