Former Tuskegee, Ala., mayor Johnny Ford rolled up his right sleeve and smiled behind his mask as the first dose of coronavirus vaccine entered his arm — a televised display of faith he hoped would save Black families from suffering.
Ford, whose wife nearly died of the virus this winter, is frustrated that so many African Americans are still resisting the vaccine. “For those folks who want to stand around and debate, let them debate,” Ford said. “I’m sorry for them and regret that they want to do that. But if they don’t want to take it, then please move out of the way of those who do want to take it.”
The vaccine hesitancy that Ford is fighting has emerged as a crucial test for the Biden White House, which has repeatedly said racial equity will be central to his presidency. The administration is planning a sweeping campaign to promote the vaccine to minorities, but activists like Ford say the problem is already critical.
Cameron Webb, Biden’s senior policy adviser for covid-19 equity, acknowledged the administration is “swimming upstream” when it comes to vaccine hesitancy. He said it is working to get information into the hands of influencers and community leaders who can spread the word and dispel rumors.
Biden addressed the issue directly Thursday when he visited the National Institutes of Health, where he was hosted by NIH Director Francis Collins and Anthony S. Fauci, who is spearheading the administration’s covid-19 response.
“I know people want confidence that it’s safe. Well, listen to Dr. Fauci. I did. I got my shots,” Biden said. “It’s safe. And we need more people to get vaccinated to beat this pandemic.”
Resistance to the vaccines is not limited to minorities. A hard-line anti-vaccine movement based on misinformation, for example, uses emotional appeals on social media to win over Americans of various political stripes.
Vaccination disparities can result from lack of access as well as hesitancy, said Robert A. Bednarczyk, a professor of global health and epidemiology at Emory University. “We talk food deserts,” Bednarczyk said. “Do we know where physician deserts are? Where nurse deserts are?”
Another factor is “vaccine gentrification,” White House covid-19 adviser Andy Slavitt said: Inoculation sites will be set up to provide easy access to underserved or minority communities, only to have wealthier suburbanites drive in and use them.
But hesitancy among African Americans is a particular source of concern to a government that’s become more sensitive to the inequities imposed on Black communities for centuries. The pandemic has had an outsize effect on people of color — killing Black Americans at nearly three times the rate of White Americans — and the White House wants to use the unprecedented national vaccination drive to help address that disparity.
Biden has invoked the Defense Production Act to increase vaccine supplies and marshaled federal resources to balloon the number of vaccination sites. Last Tuesday, the administration announced it would ship vaccine doses directly to local health centers in underserved communities.
But such scaling-up efforts will not amount to much if people don’t take the vaccines.
Vaccine hesitancy has declined over time, to the relief of many activists, but it is still significant. While the data is uneven on who is getting the vaccine, according to a recent Kaiser Family Foundation poll, 43 percent of Black adults say they plan to “wait and see until it has been available for a while, to see how it is working for other people” — compared to 31 percent of the overall population who say that.
Such delays can be dangerous, especially as virus variants emerge that may be less affected by the current vaccines. Fauci said hesitation by Black Americans means a vulnerable population could “suffer doubly.”
“We can’t fail at this,” Fauci said in an interview. “We’ve got to get a substantial proportion of the African American population to embrace the idea of vaccines.”
He added, “It would be really tragic . . . if a demographic group that has already suffered disproportionately from this terrible pandemic should — for reasons that are understandable but unfortunate — feel that they don’t want to take the one tool that can prevent them from getting infected, from getting sick, and from dying.”
Fauci has spent months trying to debunk vaccine myths with Black audiences. He has videotaped conversations with NBA star Stephen Curry. Since last summer, he has been dialing into Zoom gatherings of Black churches to answer congregants’ questions.
He often finds himself addressing the misconception that political pressure prompted vaccine makers to skip safety steps. Other unfounded worries tilt toward the conspiratorial: that mRNA vaccines can alter a person’s DNA, make people infertile or allow the government to track a person’s movements.
The Biden administration says it will soon launch a full-scale persuasion program aimed at minorities. While Fauci will play a role, he and other officials concede that the White head of a public health agency might not be the best person to reach Black and brown audiences.
“Who is giving the vaccine — and where you are getting it — matters,” said Ala Stanford, who founded the Black Doctors Covid-19 Consortium in April to address health disparities through testing and now vaccination.
She praised Vice President Harris for getting a vaccine on television but said even such role models have less impact than a neighbor, relative or friend.
“The vice president matters,” Stanford said. “But it matters more that your barber got it.”
The Department of Health and Human Services is running ads about the vaccine and other virus safeguards on 2,300 radio stations, 40 of them minority-owned. HHS is also targeting minority audiences in newspaper ads and providing experts to host Facebook Live town halls sponsored by the Black Coalition Against Covid-19.
The Centers for Disease Control and Prevention, for its part, is funding campaigns by groups like the National Urban League, the National Council of Negro Women and the Conference of National Black Churches. It’s partnering with retired football stars Warren Moon and Franco Harris in hopes that “trusted messengers” can increase vaccine confidence.
Outside government, the Ad Council, a nonprofit run by the advertising industry, has prepared videos featuring doctors from diverse backgrounds. In one of them, Valerie Montgomery Rice, president and dean of the Morehouse School of Medicine, says it’s critical to have Black doctors involved in the vaccine push.
“This will go a long way to building the trust we need between the underrepresented minority communities and the health system at large,” she says.
But such efforts are up against decades of mistrust stemming from government abuse of Black bodies in the name of science. For 40 years, government-financed doctors allowed syphilis to run unchecked through Black test subjects in the Tuskegee experiments, knowing for much of that time that penicillin would cure them.
In 1951, doctors biopsied a cancerous tumor in a woman named Henrietta Lacks, cells that became the first immortalized cell line. The cells have been used in many experiments and continue to feature in medical research today — even though Lacks, a Black woman, never consented and was not compensated.
And J. Marion Sims became “the father of modern gynecology” by experimenting on enslaved women without anesthesia. A statue honoring his achievements stood in New York’s Central Park until 2018.
That history is now being compounded by wariness of the record speed at which the coronavirus vaccines were created. Several versions were midwifed by Operation Warp Speed, a government program shepherded by President Donald Trump, who made no secret of wanting a fast cure at almost any cost, at one point tweeting at an official: “Get the dam vaccines out NOW.”
The best antidote, said Webb, the Biden adviser, is communication from trusted figures.
“We’re not trying to sell anybody a vaccine, but I believe that if people have accurate, truthful information about what we know and what we don’t know, they’ll make the decision that’s in their best interest,” Webb said. “There are a lot of myths and disinformation out there that clouds that picture, so part of our work is helping to sift through all that.”
Part of the sifting, Webb stressed, is ensuring minority and underserved communities actually have a steady supply of the vaccines; it’s no use convincing people that a vaccine is necessary, after all, if they can’t get it.
Early vaccination data has been spotty, in part because not all recipients report their race or ethnicity. But the figures that do exist suggest racial disparity has already crept into inoculation efforts.
In New York City, for example, 12 percent of people over 65 who received at least one dose of vaccine were Black, even though Blacks make up 22 percent of the city’s over-65 population.
For Ford, the former Tuskegee mayor, the goal for the next few months is clear: convince as many people as possible to take the vaccine.
The virus tore through his family this winter, pinballing the former mayor and his ailing wife from hospital to hospital as she tried to beat an infection that nearly killed her. Ford spent nights in a cot by her bedside while doctors debated putting her on a ventilator. As he cared for his wife, they missed the funeral of his first cousin, who died of covid.
In his 50 years in office — as mayor, state representative and now city councilman — Ford figures he has built up a lot of credibility, which he now intends to put on the line to motivate his community.
“The disease does not discriminate,” Ford said. “Whether you are a judge or a mayor or Black or White, it doesn’t care. I can testify to how dangerous this disease is. And that’s why my life’s work now is convincing other Black people that they should be tested and receive the vaccine as soon as possible.”
The vaccine, he said “may not be perfect. But it’s way better than getting covid.”
Scott Clement and Paige Winfield Cunningham contributed to this report.