At a hearing last weekend about a Colorado bill on vaccination, Dr. Reginald Washington had originally planned to make several urgent points in support of the bill.
First, that diseases like measles are resurging, and they’re serious. (He’d know. He’s treated patients with complications from measles and pertussis.) Second, due to COVID-19, children are missing well-child visits and skipping vaccinations, putting them at risk of outbreaks of vaccine-preventable diseases.
He didn’t expect to spend most of his time at the hearing countering misinformation about retracted studies on the impact of vaccination on African American boys, or refuting connections opponents made to the infamous Tuskegee syphilis experiment, a decades-long study in which government researchers withheld treatment from Black men with syphilis.
That is, he said, “Not until I found out Kennedy was coming.” That’s Robert F. Kennedy, Jr., a well known anti-vaccine activist.
Then, said Washington, who is chief medical officer at the Rocky Mountain Hospital for Children and Presbyterian/St. Luke’s Medical Center, “My main goal in testifying was to dispel the racial innuendos that are being presented related to immunizations and particularly in the Black population.”
Robert F. Kennedy, Jr. was the first witness to speak against the bill Sunday. As ABC News reported in the fall, Kennedy and other “anti-vaccine leaders have their sights focused on a new target: they’re infiltrating minority groups with existing skepticism of the medical establishment and exploiting the historically fraught relationships those groups have with doctors.”
Studies have repeatedly shown that the majority of parents accept vaccines. But the sliver of people vehemently opposed to vaccination appear to be shifting their focus.
In September, news outlets noticed that anti-vaccine protesters – most of them white – were taking on the language of the civil rights movement to promote their cause, even singing “We Shall Overcome” at the California Capitol when the state got rid of non-medical exemptions for childhood immunizations there. In October, public health experts were worried when civil rights activist Rev. Al Sharpton organized a forum on vaccination featuring anti-vaccination activists (in the end, it was canceled). In November, as ABC News reported, Kennedy tried to “enlist” the writer Harriet Washington to speak out against vaccines, and “all signs point to an effort to undermine the Black community’s fragile relationship with doctors.”
This past weekend, as Black Lives Matter protesters took to Denver for the eleventh day in a row, it was evident that anti-vaccine activists’ message is resonating in Colorado, too.
“I don’t generally align with conservatives, especially in the age of Trump. We have deep disagreements about the direction of the country and what the problems are. But I find myself aligned with them on this one,” said Theo Wilson, an activist and writer who spoke against the bill on Sunday. "There's been a concerted effort to get the message into the African American community."
Senate Bill 163 would change the mechanics of how parents opt out of routine vaccines for their school-aged children. In a state with the lowest-on-record kindergarten rate of vaccination against illnesses including measles and chickenpox in the country, the bill would require parents to get a certificate signed by a health professional, or to do a “short online class” about vaccines, as states like Utah have already done. It would also require schools to publish their vaccination and exemption rate and distribute it to parents and students.
At a February hearing about the Colorado bill, Wilson wrote in an opinion piece in the Colorado Sun that he was “one of the few Black faces” present. “The other African Americans I saw gave testimonies that supported Senate Bill 163, encouraging the unbroken partyline of Democrat support for the bill.”
Sunday, at least four of the couple dozen people speaking against the bill were Black.
“Black Americans not lending your voice to this...I am deeply offended,” said Kevin Jenkins, with the Urban Global Health Alliance. “Black Americans have a history of being lied to in this country. We have a history of being used as guinea pigs.”
“There are people out there marching in the streets because of injustice and intolerance,” said Erik Underwood, until recently a candidate for U.S. Senate. “This country has a history, especially in regards to people of color. Do you not know about the Tuskegee experiment?”
“Be careful, Democrats, because what you’re about to do is cause a backlash to your party the likes of which you’ve never seen, especially among people of color,” said Wilson, after identifying himself as a community activist involved in the movement for Black lives.
“Mistrust continues in our community,” said Joyce Brooks, with the NAACP Denver chapter, before urging legislators to vote against the bill. “The history of pharmaceutical misconduct in relationship to the Black community is well known and clear evidence exists that it’s still happening today.”
Brooks brought up a 2014 study that concluded the MMR vaccine put African American boys in particular at risk of autism, calling it “damning evidence.” But as Dr. Reginald Washington pointed out, the journal retracted the study, just over a month after it came out, saying the author had a conflict of interest and “the Editors no longer have confidence in the soundness of the findings.”
Plus, Washington pointed out, “The bill does not take away their right to not immunize their children. The bill simply provides a mechanism whereby those numbers can be tracked.”
“If someone is exposed to measles in a school setting, public health officials have to quickly decide how vulnerable that population is going to be,” said Washington. “Should you isolate the whole class? Should you make them stay home for the incubation period? You can’t do those kinds of things until you know how many are immunized.”
The narrative around mistrusting how institutions treat Black and brown bodies is a powerful one, especially right now.
“If you’re a Black person, look what the establishment has already done to you,” said Washington. But, he said, look at what diseases like measles or pertussis can do to a person.
“I’ve been in medicine for 40 years and it was not uncommon to see measles when I was younger,” said Washington. “Most kids do just fine, but some get pneumonia. Some get encephalitis, which is an inflammation of the brain. Some died from encephalitis. Some died from pneumonia…I’ve seen children who couldn’t breathe because they were coughing so much. Pertussis is whooping cough. I’ve seen kids expire from that.”
‘Embracing the language of civil rights'
Amelia Jamison is an anthropologist and epidemiologist studying vaccine acceptance with the Center for Health Equity at the University of Maryland School of Public Health. Lately, she has focused on the anti-vaccine movement on social media.
“Within the anti-vaccine movement itself, you'll find that they're embracing the language of civil rights and claiming that vaccination and vaccine freedom is the next civil rights battle, essentially,” said Jamison. “I don't publicize this, but I went to their rally at the National Mall in November. They were quoting Martin Luther King, Jr., Nelson Mandela. And if you follow their Twitter accounts right now, they're very active on the subject of race, particularly after the protests. And although I feel like most of the leaders of this movement are white, I do know that there's a specific online profile targeting African Americans.”
Two years ago, Jamison and her colleagues published a study showing that on Twitter, Russian trolls were polarizing the vaccine debate.
“Subsequent research has revealed that within the Russian trolls, there are different personas that they had created,” said Jamison. “And one of the particular personas that they had created was a Black Lives Matter, African American persona.”
As that research team wrote in the American Journal of Public Health in April, “Even if small in magnitude, the intentional Russian spread of antivaccine discourse targeted at specific subpopulations that are susceptible to it (e.g., pro-Trump users and African Americans on Twitter) could be the beginning of a new front in the ongoing informational cyberwar.”
It’s important not to overemphasize the role of social media trolls, “Because that's just a small piece of what's happening,” Jamison said. “The online vaccine environment is very different than what’s happening in real life. They’re very vocal and they seem bigger than they really are.”
But, she said, “comparing the suffering of people who choose not to vaccinate with the civil rights movement” is a trend that’s hard to ignore.
“It is such a potent narrative and it's a powerful dividing point in the United States, as we've seen, so it can be co-opted and it's important to be on the lookout for that kind of behavior,” said Jamison.
Especially during a pandemic, where a vaccine could prove to be the only exit strategy.
Alvertis Simmons has been a civil rights activist in Colorado since well before many Black Lives Matter protesters were born.
“I’ve done over a thousand marches and protests in this town,” he said. “Two weeks ago I did the largest peaceful protest in the state of Colorado. That’s what the news said.”
“I deal with legislators, people on the street, activists and common, everyday Black folks,” he continued. “This Black Lives Matter stuff – folks are using this as a tool to get their agenda across because it’s getting so much publicity.”
He said vaccines just haven’t come up before.
“Where's the scientific data that vaccines hurt the Black community? I haven't seen any,” he said. “The African Americans who spoke at that hearing, did not speak with data and science, they were speaking off emotion.”
Simmons encourages people to get their children vaccinated against measles, polio, all manner of diseases, because no community can afford to go through preventable outbreaks.
“Let me talk about the Black community. It would destroy us,” he said. “We already have a hard time with getting decent, adequate medical help.”
But when it comes to adult immunization, it’s another story. The COVID-19 vaccine, for example?
“I’m not taking it,” said Simmons. “Because I don’t trust white America.”
He is not alone.
'The twin harms of racism amidst a pandemic'
Jonathan Jackson, a neuroscientist who directs a research center at Massachusetts General Hospital dedicated to diversifying clinical trials, said it’s an especially important moment to bring communities of color into the conversation around vaccines.
“We’re going to have a really rude awakening when a vaccine is available and we can map very clearly who’s taking it and who’s not,” said Jackson. “We do need to do a better job of creating empowerment and building trust and building literacy. And until we do that, this is a community that will absolutely not be participating in any kind of vaccination related to COVID-19.”
During a presentation for his local NAACP chapter in Massachusetts, Jackson surveyed the attendees. When a vaccine is available for COVID-19, will you be taking it? “Everybody said no,” said Jackson.
A study that came out in June from the Pew Research Center found that Black Americans were least likely to want to get a future COVID-19 vaccine. Almost half of Black adults surveyed said they wouldn’t take it, compared to about a quarter each among Hispanic and white.
“It’s disheartening but not surprising, because so many of those harms are completely true and valid,” said Jackson. “This is the system that has failed to look out for them for hundreds of years and has in fact put them directly in harm’s way. Why wouldn’t that system do the same thing this time?”
As a researcher studying health disparities that affect Black populations, Jackson said lately he’s been spending most of his days fighting “the twin harms of racism amidst a pandemic.”
As his research center’s Twitter account has outlined at length, the Tuskegee study is just one of many examples of the medical system mistreating Americans of color.
According to the Centers for Disease Control and Prevention, the study “became unethical” about a decade in, when a cure was discovered and withheld from study participants. In addition to hundreds of men suffering from treatable syphilis, the study resulted in a number of their wives contracting the disease, in addition to some of their children – 11 of whom are still alive today, according to the CDC.
However, Jackson said, the full legacy of Tuskegee does not end there.
“The major consequence of the Tuskegee syphilis study was something called the Belmont Commission, which produced the Belmont Report,” Jackson said. “The Belmont Report contains the absolute foundations of human subjects research in the United States.”
The document, which Jackson calls “the Rosetta Stone” of research ethics, says that “vulnerable subjects,” including racial minorities “should be protected against the danger of being involved in research solely for administrative convenience, or because they are easy to manipulate as a result of their illness or socioeconomic condition.”
But there’s a fine line between protecting vulnerable populations and excluding them from medical research.
“After 1979, we fundamentally excluded Black communities from research, unless we had a specific research question that involved Black people,” said Jackson. “At the same time, health disparities as a function of race really started to ramp up. And part of that – not all of it, but part of it – is because we started testing, refining and optimizing, vaccines, drugs, treatments on relatively affluent white populations.”
In other words, he said, treatments were optimized for white patients.
“So it's not that Black people's health got worse,” Jackson adds. “But white people's health got a lot better, a lot faster.”
Now, the same harm of exclusion remains.
“The harms are not what we saw with Tuskegee, where Black people like me are being exploited. The harms are that we are being neglected entirely,” said Jackson. “So, we're being left out of the process and that is not well understood by either the Black community or the research community.”
Indeed, exclusion was one of the refrains among Black speakers at Colorado’s immunization bill hearing Sunday – that they hadn’t been consulted during the bill’s creation.
“I’m very saddened that no one came to us when this bill was started,” Joyce Brooks with the Denver NAACP told legislators.
“We have not been a part of this conversation,” said Kevin Jenkins, with the Urban Global Health Alliance.
Alvertis Simmons also wished he’d been consulted. “Absolutely,” he said.
Jarrett Freedman, communications director for Colorado House Democrats, pointed out that a number of representatives are leaders in the Black community “and they have been on board and supportive of this bill for a long time.”
That includes Rep. Leslie Herod, who chairs the Black Democratic Legislative Caucus, and Rep. Janet Buckner, who said in a statement, “I am proud of this bill. As a member of the Black Caucus, I deplore any characterizations of this modest public health measure as anti-Black, and I completely repudiate those who have used this issue to sow discord and distrust in the Black community.”
Despite the opponents’ passion, Sunday the bill cleared another legislative milestone, passing a House committee with seven Yes’s, three No’s and one “Hell, No.” By Wednesday it made it through the House. There are now two days left before the legislative session ends. In order to pass, Senate Bill 163 would just need to jump through one last hoop: back to the Senate for a final test.
“I see vaccines as a Black Lives Matters issue,” said Theo Wilson. But he said, a diverse group of Black Lives Matter protesters were marching down the street “right next to us” on Sunday. Among the hundreds of immunization protesters, he said, “I could still count the Black people on one hand, it seems.”
This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, KUNR in Nevada, the O’Connor Center for the Rocky Mountain West in Montana, KUNC in Colorado, KUNM in New Mexico and support from affiliate stations across the region. Funding for the Mountain West News Bureau is provided in part by the Corporation for Public Broadcasting.
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