Health experts wanting to understand vaccine hesitancy in racialized communities should look beyond simple answers, according to a team of Western researchers.
Marginalized groups in Canada continue to grapple with a legacy of medical racism, said Sinéad Osivwemu, a third-year science student who recently co-led a research project about race, distrust and vaccine hesitancy.
Osivwemu and Kharissa Edwards, BSc’21, conducted an undergraduate research project, supervised by philosophy professor Carolyn McLeod, about how some media describe people who have not been vaccinated against COVID-19.
“Vaccine hesitancy for people in marginalized communities is not the same as being an anti-vaxxer. Their distrust of the medical establishment is often grounded in historical and present reality,” Osivwemu said. “Yet sometimes, they’re written off as having a lack of knowledge or a lack of intelligence.”
Osivwemu and Edwards were students in McLeod’s Power, Oppression and Privilege course prior to leading the research project.
They presented their findings with McLeod during a webinar that was part of a philosophy lecture series, Race and Racism, run by Western’s Rotman Institute of Philosophy and the philosophy department in partnership with the London Public Library.
Black and Indigenous people have faced centuries of historical injustices, Edwards said.
Enslaved Black persons were experimented upon with vaccines in the 1700s and 1800s; experimental high dosages of measles vaccines were administered to African-American and Hispanic babies in the 1980s and 1990s; and tuberculosis vaccines were tested on Indigenous children in residential schools, without parental knowledge or consent.
These experiences are not limited to history, added Osivwemu. Racism in health care today can include the false claim that Black people feel pain less than whites or that an Indigenous person in the emergency room is not truly sick.
“Our research is a bit more personal because Kharissa and I are both Black women and we’ve experienced microaggressions in a health-care setting. It can be disheartening and distressing.”
In the context of deciding whether to be vaccinated, she said, marginalized people then have to rely on health-care institutions that have shown themselves to be untrustworthy.
Their hesitancy should not be lumped in with those who believe conspiracy theories or social media myths about the vaccine, added McLeod, who is also chair of the philosophy department and a fellow of the Royal Society of Canada.
“The distrust we’re concerned with does not target the safety or efficacy of the vaccines, at least not directly. Rather it targets the motivations of those who are responsible for the vaccine rollout and whether they can be relied on to have the best interests of Black and Indigenous people at heart.”
That means strategies to improve vaccination rates should take a different tack: not primarily to inform or educate the patient, but instead to inform the health-care provider and educate those who perpetuate medical racism, often unconsciously.
The problem to be solved is not Black people’s attitudes towards medicine, Osivwemu said. Rather, it’s to make medicine and medical systems more deserving of Black and Indigenous people’s trust.
In the long-term, building that trust should include increasing the number of Black and Indigenous medical and health-care practitioners – through programs such as ACCESS Pathway at Western’s Schulich School of Medicine & Dentistry, which encourages and reduces barriers for applicants who are under-represented in medicine.
In the shorter term, solutions also lie in listening to racialized communities about their vaccine hesitancy and acting on the needs they express.
Osivwemu cited a vaccine pop-up clinic the Middlesex-London Health Unit organized with leadership from London’s Black community as a good example that others could follow. The clinic was a celebration of community and resilience, she said.
“It seems like we’re moving in the right direction. I’d like to see that expand province-wide and nationwide,” she said.