Vaccine Hesitancy Stems From Trauma, Not Ignorance
When Sandra Lindsay decided to get vaccinated, this moment was historic. Not because she was the first American to receive the COVID-19 vaccine dose but because she was black.
The relationship between African-Americans and medicine is riddled with betrayal, invasion and pain. The stories of ill slaves being tortured were known to the common ear. However, what doctors and scientists did to African-Americans behind the closed chambers of 'experiments' remains untold. Since the inception of the United States of America, Black Americans have always been an 'experiment' to science. Their bodies (dead and alive) were used to irrationally pursue hypotheses.
In the 1840s, black women were forced to undergo reproductive procedures without anaesthesia. Doctors pricked and prodded around the reproductive organs of women as young as seventeen. Even when caesarean sections were fatal for the mother and baby, and white women evaded it, most Black women had caesarean sections only. The logic behind this callousness was simple— it was not worth keeping a slave alive if they cannot contribute to society with labour, more slaves or scientific discoveries.
From denying 400 black sharecroppers the cure for syphilis to digging up dead bodies from slave cemeteries in the name of "medicine", there is undoubtedly a deep history that complicates the relationship between medicine and African-Americans. In all fairness, not just African-Americans but Jews, the incarcerated and the list goes on.
With Josef Mengele at the forefront, approximately 15,754 people were documented as the victims of the crude Nazi experiments. The aim was to revolutionize the military using science. Nobody could have anticipated that the mass murder and deformation of thousands of people could lead to the constitution of a set of research ethics: the Nuremberg Code. The lack of consent and the horrific disguise of mass murder as euthanasia propelled the international community to wake up from their slumber and decide—enough was enough.
The Nuremberg Code was designed after the Doctors Trial, one of the 12 war trials to punish the war crimes of World War 2, in 1947. It comprised ten guidelines for any clinical research and emphasized elements like consent, the unconditional worth of human life, transparency and provisions for participants to exit at one's will. It was considered the foundation of good clinical practice. At least, in an open society.
Behind bars, however, is a different case story. To say that these codes of ethics were flouted would be an understatement. It would be fairer to say that the pledge of humanity was flouted. Throughout history, prisoners have been perceived as akin to lab rats. They are considered the section of society that has been discarded as garbage.
It was only 1946 when hundreds of Guatemalan prison inmates were deliberately infected with syphilis: either through injections or through visits from purposely infected prostitutes. This was done all in the name of medical science. During the 1950s and 1960s, cancer cells were injected into healthy prisoners in the United States of America to quench the curiosity behind: "What would happen if a human being was exposed to cancer cells?" The brilliance behind this research trial was Chester Southam, who later became the elected president of the American Association for Cancer Research.
Consent was asked as a courtesy. When a prisoner refused, he was threatened to be put in isolation. Even when prisoners did consent, the reason was simple—the privileges a prisoner received was a clear break from the mundane incarceration. Pitching the same research trial to somebody who is not incarcerated would not be successful. Another reason behind consent was the problematic idea of monetary gratitude. Researchers provided prisoners with money in exchange for participating in research. This amount was small and sometimes, not worth the damage it could cause. Exhibit A: the research experiment ideated by the Atomic Energy Commission to determine the effects of radiation on male reproductive function. The participants were paid but were likely not told about the tiny risk of testicular cancer.
In 1978, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research did institute a moratorium on research in correctional settings and between 2010 to 2012, 0.7 per cent of health studies have featured prisoners. Technically, the marginalization of prisoners has decreased but this long history of medical abuse cannot vanish. It certainly influences us today and these communities as vaccination dates roll in.
It is not ignorance or willingness to extend harm to society that propels people to avoid vaccination. It is a history of abuse that has cemented this lack of trust in medical institutions.