Anjali Mangla, Contributing Photographer

On Tuesday, STEM and Health Equity Advocates at Yale hosted doctors Julian Watkins and Calvin Sun to speak about why certain populations are more critical of the vaccine in context of COVID-19 disparities. 

Watkins and Sun, physicians who practice and teach in New York, shared their insights on questions of race and racism surrounding vaccine access. They covered important topics about why many minority populations, especially Black and brown communities, are hesitant toward receiving the vaccine.

“Something that has stuck with me that Dr. Watkins said is shifting the language, talking about how it’s a need to take people’s concerns seriously,” Joanna Radin, associate professor of history of science and medicine, said. “Not just say people are hesitant or skeptical [of the vaccines] or that the problem is with them. This is wrong. Physicians need more willingness to listen.”

According to Watkins, vaccine hesitancy is rooted in a history of distrust with the U.S. health care system. He cited the 40-year Tuskegee syphilis study, in which Black men in the South participated in a study that observed the progression of syphilis in their bodies without participants’ informed consent — they did not know the syphilis would not be treated or that the study would take place over such a long period of time.

However, even after scientists discovered effective syphilis treatments, the physicians in charge of the study withheld these cures from the subjects. According to Radin, U.S. public health officials found it more important to map the progression of the disease in these individuals rather than treat them. The progression of syphilis treatments is one of “many instances” in which America’s systems failed Black and other communities of color, according to Watkins, which is part of why many members of those communities are critical of the COVID-19 vaccine.

Language was a theme throughout the talk –– whether it be the language of addressing vaccine confidence, or language used to talk to communities that have reasons to fear a system that has failed them before. 

According to Ngozi Okoli ’22, an organizer of this workshop, Watkins’ point that using the term “vaccine hesitancy” shifts the blame onto the individuals that are hesitant of a system rather than the system itself was something she had not thought about before. 

“It’s important that we know how to use our language,” Watkins said. ”There’s this phrase like vaccine hesitancy, and we need to use person-first language.”

Instead, Watkins suggested that physicians’ goals should be to increase vaccine confidence.

Watkins and Sun both talked about the fear and mistrust that people in communities that historically have been harmed by health care institutions have and how important it is to use empathy when speaking to them about sensitive issues like the vaccine.

“I have to adjust my vocabulary to meet people where they are with the purpose to ultimately get as many people vaccinated as possible,” Sun said. “The purpose is to make them want the vaccine, rather than do what they were told to do. We need to understand that most of this hesitancy is due to an emotional argument. Why should they participate in something that for generations exploited them?”

Sun said that it is important for physicians to connect with these communities using emotional arguments, placing empathy at the center of conversations around vaccines. He emphasized that doctors should act like guides for patients, helping them understand issues that may be scary and difficult to deal with.

At the talk, Watkins painted a picture of the complex history of those communities’ distrust of American systems. He said that there is a lack of anti-racist education within medical training, which manifests into large-scale problems like physicians overlooking the pain of people in racial minorities.

“There are a lot of times where single Black mothers think twice before taking their children to the emergency room,” Watkins said. “It’s the same thing in medicine, where people go in looking for safety and healing, and they meet with a judge and jury. There’s study after study that physicians don’t treat Black people’s pain. They have this racist antiquated belief that Black people don’t experience pain at the same level. So I would say, in many instances, folks can look from the outside in and see that it’s perfectly rational for people to feel this way.” 

Radin added that physicians are now aware of a greater amount of literature on racism in medicine, in the wake of last summer’s growth of the Black Lives Matter movement.

Watkins emphasized that he understands why COVID-19 is not always the top priority issue for Black and brown communities, as many of them face several pressing issues on a daily basis.

“People are just like, why does COVID matter so much when I live in the Bronx, and 80 percent of the people getting HIV in the Bronx are Black and brown,” Watkins said. “We have to look at these communities and understand that people aren’t living single issue lives. COVID is a big issue, but it’s still not the single issue. There’s still people who can’t put food on the table, who can’t find a job.”

With the current push to get everyone vaccinated, Sun explained that there are potential future global inequities that could occur in the race towards herd immunity. He added that there is a large problem in the way Americans focus on the vaccine as a way of reaching “normality.” 

Sun spoke about how under-resourced countries and communities are less able to access vaccines, which could make it difficult for the world to get back to normal.

“There are certain developing countries in the world that will never get the vaccine for years,” Sun said. “People don’t think far ahead. They don’t realize that if you don’t vaccinate the developing world, the virus is going to go there, mutate and we will all have to do this over again. I don’t know why people want to go back to normal so fast. If you want to go fast, go alone. If you want to go far, go together. No one really wants to go far together because it’s not fast enough.”

Radin said that she left the talk with a new outlook on how communities of color can approach confidence in vaccines.

“Love maybe feels too amorphous and not an emotion that is appropriate to think from the context of STEM,” Radin said. “But listening to the doctors talk about how much love was important to support their own communities in getting access to health care, getting health care in a way that was safe was inspiring, and made me want to think more about ways of navigating these issues. Gaining this trust is a practice that involves love.”

STEM and Health Equity Advocates will be hosting another event on March 25 about global vaccine distribution.

Anjali Mangla | anjali.mangla@yale.edu