A new direction in the fight against Covid-19 has been declared with the first person to receive the much-awaited Pfizer jab being a 90 year old woman in Coventry. The news could not have come at a better time. In the UK, the current number of deaths attributed to Covid currently stands at over 61,000 with concerns that increasing numbers of people will be diagnosed with the virus after the upcoming festive season.
But as the news broke that a mass immunisation programme is being developed, it is estimated that one in three people are not likely to have the vaccine. You may be surprised by this number, but figures show that rates of vaccination in the UK have been falling for a number of years. Increased access to spaces, particularly online, where people can share and discuss ideas have given more prominence to scepticism of vaccination programmes. Within such perspectives there are a range of people, from a wide range of backgrounds, locations and identities.
However, to dub everyone that may be wary of the Covid vaccine an anti-vaxxer or conspiracy theorists ignores the reasons why people or communities may be suspicious and hesitant. The government has bungled this crisis so thoroughly it is a surprise that so many people have any faith in the vaccination programme. But dismissing those that are sceptic also misses important points that have and continue to shape health (and other outcomes) for different communities.
For Black communities in the UK who may be wary of the vaccination, it is not necessarily a denial of science. In fact, the facts of science exist very sharply in our communities as we have carried some of the heaviest burdens of Covid-related bereavement – pain that is made sharper by the inability to be able to comfort each other and say goodbye to loved ones in ways that our communities usually do. So, why would Black communities be wary of a vaccine?
Because we do not live our lives in boxes that carve out neat lines between the axis of our existence. Rather, across these lines issues of trust and distrust shape experiences that bring us to our conclusions.
Because of a long and painful relationship with the research and practice of medicine that has not been for our health benefit, but uses our bodies as sights of experimentation and control. The Tuskegee experiment is probably the most famous instance of this type of scientific betrayal, but there is a long list of unethical research practices in the pursuit of ‘health’ that have indeed denied this for many Black and many other communities in the Global South.
Because, long before Covid we have seen, felt and cried over the realities of health inequalities in the UK. In a health system that Black communities have contributed so much to Black women are five times more likely to die in childbirth; Black men have a higher mortality rate from prostate cancer and; mainstream and professional knowledge of sickle cell remains limited while being one of the most serious conditions in the UK. The list could go on.
The result of these diasporic and national experiences mean that Black people are the most likely to express that they do not trust health care systems, research and the practice that underpins it.
The issue of trust is about the politics that shape the wider society we live in. A society that has a sliding scale of citizenship, with the Windrush scandal on one side, deporting Jamaicans on the other and the continued hostile environment creating danger and uncertainty in the middle is hardly a foundation to build any trust upon. Trusting institutions to give justice for Grenfell and Ella Kissi-Debrah as citizens denied healthy living spaces, makes us wary of attempts to give with one hand and deny with another.
So, maybe the mistrust is not about the science. In this case, it’s not even about the vaccines per say. It’s not science that causes health inequities. Rather, it is systematic discrimination woven into the fabric of society that presents unequal outcomes as part of the package. It’s about living in a world that does not value our lives – which is why ‘Black Lives Matter’ continues to resonate. It echoes the mantras that we have told ourselves for generations whilst living in systems that do not. Distrust of the vaccine is a mistrust of society as a whole. The onus then needs to be pushed from some Black communities being against vaccines but back to where the distrust comes from.
This would have been a good opportunity to develop a body of research concerned with Black communities and Covid and how best to create and embed models of health intervention. It could have been rooted in new ways of thinking about trust, which could benefit some of the most Covid devastated communities. But, alas, this does not appear to be on the agenda.
Having said all of this, I am writing this piece as someone who is in the highly vulnerable category and will take the vaccine when offered. As much as I may have my own questions, I understand that to protect myself, my family and wider community this is a pill I have to swallow, or indeed jab I have to take. We cannot allow histories to play out in our futures where our communities continue to be the most impacted by Covid.