What Vaccine Hesitancy Among BAME Communities Tells Us

I haven’t seen my Dad since last March. Much like the rest of the world, Wesleyan University had just begun to shut down, leaving me in a race to make it past border controls and travel bans. When I finally arrived back in the UK, I was greeted by my Dad. As always, his beard was grey and patchy and his shoes were perfectly polished. After a lengthy hug, we picked up right where we had left off the last time I was home, bantering with one another and singing along to one of his CDs. As far as my Dad was concerned, nothing had really changed.

Two days later, British Prime Minister, Boris Johnson, announced the first national lockdown. Three lockdowns, three virus waves, and 112,000 deaths later, everything has changed. This pandemic has worn away at economies, devoured healthcare systems, and ravaged marginalized communities. BAME (Black, Asian, and Minority Ethnic) is a demographic used to describe all ethnicities excluding White ethnic groups. This can include individuals who identify as Arabic, Asian or Asian British, Black African or Black African Caribbean, Black British, Chinese, Roma, Irish (“White Other”), mixed-race, asylum seekers, refugees, and travelers. Over the past few months, I have constantly been reminded of the disproportionate effect that COVID-19 has had on many of these groups. If it isn’t my news feed telling me, it is my Dad. During our weekly phone calls, he expresses his fears of contracting the virus as a 64-year-old Black British man. He tells me how he has spent the last few days shielding in his one-bedroom apartment, turning away visitors and ordering his groceries online. Sometimes, on his better days, he talks to me about his plans to resume cricket practice once all of this passes. 

However, what I hear most from my Dad is his skepticism toward the ever-growing list of COVID-19 vaccines, several of which are now being administered up and down the U.K. For many, vaccinations offer a glimpse of hope, a sign that life can and will return to normal. My Dad doesn’t share this sentiment. His list of criticisms, worries, and doubts grows from each week of lockdown to the next. I’ve come to realize that my Dad isn’t alone in his concerns. In fact, he is simply one of many among these vast and diverse communities that are not only suspicious of the vaccine but may very well end up refusing it. According to recent data gathered from the Royal Society for Public Health survey, just 57% of UK BAME respondents said that they were likely to accept the vaccine, compared to 79% of White respondents. In another study, participants who self-reported as Black, Asian, Chinese, Mixed, or Other ethnicity were nearly three times more likely to reject a COVID-19 vaccine for themselves and their children compared to White people.

As a former hospital porter, Type 2 diabetic, and cancer survivor, my dad has navigated the British healthcare system as both a patient and staff member. From being treated differently than his White colleagues to feeling unheard and neglected by doctors, I’ve watched my Dad’s faith in our country’s healthcare system gradually dwindle over the past few years. Reports have consistently shown that BAME patients show lower satisfaction with the National Health (NHS) and cite less positive experiences with nurses and doctors than White patients while being treated for serious conditions such as cancer. What’s more, is that over 60% of Black people do not believe that their health is as equally protected by the NHS compared to White people and as a result are discriminated against by health care providers. “Mrs. Bibi” (or Begum) Syndrome, for example, is a term that was coined to mock South Asian women who supposedly exaggerate their health concerns while showing few signs of illness. Not only do ideas like this perpetuate harmful racial stereotypes, they weaken what confidence citizens have in a system that is supposed to care for its patients, not belittle, overlook, or invalidate them.

Several reports have confirmed the severe and long-lasting effects of COVID-19 on BAME communities. At the peak of the pandemic, the Office for National Statistics (ONS) found that Black men were more than three times as likely to die from COVID-19 as White men, while Black women are almost 2.5 times as likely to die as White women. COVID-19’s disproportionate effect on these groups can be tied to a number of factors. BAME people are more likely to live in urban areas, be members of overcrowded and multigenerational households, inhabit deprived areas, and hold jobs that raise their exposure to the virus. However, the government’s overwhelming lack of effort to mitigate the virus’s impact on BAME communities has only exacerbated an already strained relationship.

“Would you trust a government that accepts you’re more likely to die of COVID-19 than your White neighbors and does nothing very much about it?” Professor Sophie Harman asked in a recent HuffPost article.

Poor representation within clinical vaccine development as well as a surge of misinformation surrounding the vaccine has left many BAME communities fearful of how the virus might affect them, particularly where conflicts with religious and cultural beliefs are concerned. In the UK, 93% of those who signed up for the trials registry for the development of the vaccine (including ongoing tests) were White.

In the United States, a country that has a long and sordid history of medical racism, similar trends surrounding vaccine hesitancy have emerged. According to a poll released by the Kaiser Family Foundation on Dec. 15, Black Americans are the most hesitant to get a vaccine among racial and ethnic groups. Half of Black adults are not planning to take a coronavirus vaccine once one becomes available, even if scientists declare it is safe, and it’s available for free.

Focus groups found that Black participants cited systemic racism as a reason for their skepticism, with many participants referring to the outrageous Tuskegee Syphilis Study. The “Tuskegee Study of Untreated Syphilis in the Negro Male,” took place between 1932 to 1972.  After being told that they were being treated for “bad blood”, 600 Black men took part in the experiment. Dozens would go on to lose their lives.

Similarly, in 1951, White doctors experimented on the body of an African-American woman named Henrietta Lacks without obtaining consent. Doctors sampled Lacks’s cells and used these to create the cell line “HeLa cells,” which has generated billions of dollars in pharmaceutical research and development. Prior to this, enslaved Black women were the test subject for James Marion Sims —sometimes regarded as the father of U.S. gynecology—while 19th-century medical schools relied on enslaved Black bodies as “anatomical material.”

While the exploitation of non-White bodies, rampant “fake news” about the virus, and widespread dissatisfaction in healthcare services may have increased vaccine hesitancy among BAME communities, it would be wrong to assume that people, like my Dad, do not trust the vaccine because they think that COVID-19 isn’t real. Lumping together all of those who are reluctant to receive the vaccine is both reductive and harmful. To do so would be to ignore a shameful narrative within healthcare systems across the world that have treated their patients differently based on the color of their skin. To do so would be to ruin any chance we might have to work with these communities and restore their faith in systems of care. To do so would be to acknowledge BAME communities’ susceptibility to the virus and continue to turn a blind eye to it.

I don’t know when I’ll finally be able to see my Dad—COVID-19 will decide that for me. But for now, I’ll look forward to our weekly phone calls and hope that with time, greater support, and robust changes to the way that we think about and administer care, he’ll choose to protect himself.