Racism and the COVID-19 Immunization

A good friend, a middle-aged African-American woman, asked me to comment whether African Americans should accept the COVID-19 immunization, given the concerns she’s heard about racism. 

Here’s what I responded:

I think it’s dangerous to spread fears of taking the vaccine (other than for people with a history of severe allergic reactions), especially because of the inordinately high rates of COVID-19 cases and deaths in Black and Latino communities. 

The two vaccines approved in December 2020 (from Pfizer and Moderna) both appear to have high efficacy, protecting about 95 percent of people. Their safety seems pretty good, but we won’t know how good until millions of people have gotten the vaccine. So far, most side effects are minor, similar to those from other vaccines such as influenza, although some people have gotten chills, fever, headaches and weakness in addition to the common soreness at the injection site. 

However, because two people with past anaphylaxis (a dangerous form of shock) had severe allergic reactions on the first day of immunization in Britain, anyone with a history of severe allergic reactions (especially to vaccines, but perhaps anyone with anaphylaxis from any cause) probably should not take the Pfizer vaccine. 

The rumors that vaccination could be a conspiracy against people of color seem to me to be fundamentally racist—perhaps even instigated by those hoping that more people of color will die. This is not the era of the notorious Tuskegee experiments, segregated hospitals and healthcare facilities. Today, racial inequality in healthcare is primarily about reduced access to care and inadequate insurance coverage. Just as the Reverend William Barber, co-leader of the Poor Peoples’ Campaign for a Moral Revival, promotes social distancing, mask-wearing, and avoiding congregate settings, people who are trusted in communities of color and among the poor in general should point out that the gravest healthcare danger we face in the U.S. today is this system’s refusal to grant equal access and good-quality care to all. 

Those of us who want to assure that the most vulnerable have the greatest access to care, including the COVID-19 immunization, are assuredly people who believe that Black lives matter. Does that mean that down the road we won’t discover that the vaccine has side effects not previously noticed? No, it doesn’t. The reason why the Food and Drug Administration gave the vaccine what’s called “emergency use” approval is precisely because they cannot guarantee no harm when they move quickly in an emergency situation. But I see zero evidence that racist discrimination could be behind giving people the vaccine, when the greatest racism would be in preventing them from getting it. 

Emergency-use FDA approval for a vaccine or drug that was tested on smaller numbers of people than is typical is always a two-edged sword. But it’s apparently what saved Donald Trump’s life; he was treated with monoclonal antibodies that had not been very widely tested. I suspect it’s also what just saved Rudolph Giuliani’s life, and perhaps those of other Republican politicians, many obese and elderly, who got the virus after blatantly ignoring basic public-health advice. They got preferential treatment, while more than 3,000 Americans who didn’t have died of COVID on some recent days. 

That denial of care is where the discrimination, racism, and disregard for human life is to be found. And in that the world’s richest countries, including the U.S., Britain, and much of Europe, have essentially bought up all the vaccines that will be produced in the next 6-12 months, depriving the people of Africa, Asia, and Latin America of protection. 

Marc Sapir, MD, MPH is a retired primary-care and public-health doctor who spent his 46-year career working in, creating and managing community health projects, including four years with the United Farmworkers Union and nine years as medical director of the Center for Elders’ Independence in Oakland. He joined demonstrations led by Dr. Martin Luther King Jr. at age 17, and has been continuously active in social-justice struggles since then. He is also a writer and media critic.

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