Racism in COVID-19 Vaccination? Reluctance to Vaccinate in the U.S. Black Population
Abstract
The COVID-19 vaccine has been the subject of overt distrust linked to the development process of the vaccine itself, as well as to the uncertainty generated by the virus and the disease. Although there are numerous factors that influence reluctance to be vaccinated, it is of interest to explore the influence of race on attitudes of distrust and rejection of the vaccine. In this article, the black population in the United States is taken as a case study because of the preponderance of race in that country. After recognizing and identifying a series of general causes linked to distrust of the COVID-19 vaccine, the specific causes affecting the black population, which was more reluctant to be vaccinated and remained the demographic sector with the lowest vaccination rates during the first steps of the campaign, are examined in depth.
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Appiah, K. A. (2006). The politics of identity. Daedalus, 135(4), 15-22.
Badr, H., Zhang, X., Oluyomi, A., Woodard, L. D., Adepoju, O. E., Raza, S. A., Amos, C. I. (2021). Overcoming COVID-19 Vaccine Hesitancy: Insights from an Online Population-Based Survey in the United States. Vaccines, 9(10), 1100. https://doi.org/10.3390/vaccines9101100
Balasuriya, L., Santilli, A., Morone, J., Ainooson, J., Roy, B., Njoku, A., Mendiola-Iparraguirre, A., O’Connor Duffany, K., Macklin, B., Higginbottom, J., Fernández-Ayala, C., Vicente, G., Venkatesh, A. (2021). COVID-19 Vaccine Acceptance and Access among Black and Latinx Communities. JAMA Network Open, 4(10), e2128575. https://doi.org/10.1001/jamanetworkopen.2021.28575
Best, A. L., Fletcher, F. E., Kadono, M., Warren, R. C. (2021). Institutional Distrust among African Americans and Building Trustworthiness in the COVID-19 Response: Implications for Ethical Public Health Practice. Journal of health care for the poor and underserved, 32(1), 90-98. https://doi.org/10.1353/hpu.2021.0010
Blum, L. (2002). “I’m not a Racist, But…”: The Moral Quandary of Race. Ithaca: Cornell University Press.
Blum, L. (2004). Systemic and Individual Racism, Racialization and Antiracist Education: A Reply to Garcia, Silliman and Levinson. Theory and Research in Education, 2(1), 49-74. https://doi.org/10.1177/1477878504040577
Boulware, L. E., Cooper, L. A., Ratner, L. E., Laveist, T. A., Powe, N. R. (s. f.). Race and Trust in the Health Care System. Public Health Reports, 118(4), 358-365.
Coustasse, A., Kimble, C., Maxik, K. (2021). COVID-19 and Vaccine Hesitancy: A Challenge the United States Must Overcome. Journal of Ambulatory Care Management, 44(1), 71-75. https://doi.org/10.1097/JAC.0000000000000360
Haslanger, S. (2012). Resisting Reality: Social Construction and Social Critique. Nueva York: Oxford University Press.
Jeffers, C. (2019). Cultural Constructionism. En J. Glasgow, S. Haslanger, C. Jeffers y Q. Spencer (eds.), What is Race? Four philosophical views (pp. 38-72). Nueva York, Estados Unidos: Oxford University Press.
Jimenez, M. E., Rivera-Núñez, Z., Crabtree, B. F., Hill, D., Pellerano, M. B., Devance, D., Macenat, M., Lima, D., Martinez Alcaraz, E., Ferrante, J. M., Barrett, E. S., Blaser, M. J., Panettieri, R. A., Hudson, S. (2021). Black and Latinx Community Perspectives on COVID-19 Mitigation Behaviors, Testing, and Vaccines. JAMA Network Open, 4(7), e2117074. https://doi.org/10.1001/jamanetworkopen.2021.17074
Kadambari, S., Vanderslott, S. (2021). Lessons about COVID-19 vaccine hesitancy among minority ethnic people in the UK. The Lancet Infectious Diseases, 21(9), 1204-1206. https://doi.org/10.1016/S1473-3099(21)00404-7
Khubchandani, J., Sharma, S., Price, J. H., Wiblishauser, M. J., Sharma, M., Webb, F. J. (2021). COVID-19 Vaccination Hesitancy in the United States: A Rapid National Assessment. Journal of Community Health, 46(2), 270-277. https://doi.org/10.1007/s10900-020-00958-x
Kriss, J. L., Hung, M.-C., Srivastav, A., Black, C. L., Lindley, M. C., Lee, J. T., Koppaka, R., Tsai, Y., Peng-Jun, Lu., Yankey, D., Elam-Evans, L. D., Singleton, J. A. (2020). MMWR, COVID-19 Vaccination Coverage, by Race and Ethnicity — National Immunization Survey Adult COVID Module, United States, December 2020–November 2021. https://www.census.gov/programs-surveys/metro
Ndugga, N., Hill, L., Artiga, S., Haldar, S. (2 de febrero de 2022). Latest Data on COVID-19 Vaccinations by Race/Ethnicity. KFF. https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/
Padamsee, T. J., Bond, R. M., Dixon, G. N., Hovick, S. R., Na, K., Nisbet, E. C., Wegener, D. T., Garrett, R. K. (2022). Changes in COVID-19 Vaccine Hesitancy among Black and White Individuals in the US. JAMA Network Open, 5(1), e2144470. https://doi.org/10.1001/jamanetworkopen.2021.44470
Peteet, B., Belliard, J. C., Abdul-Mutakabbir, J., Casey, S., Simmons, K. (2021). Community-academic partnerships to reduce COVID-19 vaccine hesitancy in minoritized communities. EClinicalMedicine, 34. https://doi.org/10.1016/j.eclinm.2021.100834
Pigliucci, M. (2013). What are we to make of the concept of race? Thoughts of a philosopher-scientist. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, 44(3), 272-277. https://doi.org/10.1016/j.shpsc.2013.04.008
Pigliucci, M., Kaplan, J. (2003). On the Concept of Biological Race and Its Applicability to Humans. Philosophy of Science, 70(5), 1161-1172. https://doi.org/10.1086/377397
Restrepo, N., Krouse, H. J. (2022). COVID-19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned? Otolaryngology - Head and Neck Surgery (United States), 166(6), 1147-1160. https://doi.org/10.1177/01945998211065410
Rosenberg, N. A. et al. (2002). Genetic Structure of Human Populations. Science, 298(5602), 2381-2385.
Savoia, E., Piltch-Loeb, R., Goldberg, B., Miller-Idriss, C., Hughes, B., Montrond, A., Kayyem, J., Testa, M. A. (2021). Predictors of COVID-19 vaccine hesitancy: Socio-demographics, co-morbidity, and past experience of racial discrimination. Vaccines, 9(7). https://doi.org/10.3390/vaccines9070767
Shiao, J. L., Bode, T., Beyer, A., Selvig, D. (2012). The genomic challenge to the social construction of race. Sociological Theory, 30(2), 67-88. https://doi.org/10.1177/0735275112448053
Siegel, M., Critchfield-Jain, I., Boykin, M., Owens, A. (2022). Actual Racial/Ethnic Disparities in COVID-19 Mortality for the Non-Hispanic Black Compared to Non-Hispanic White Population in 35 US States and Their Association with Structural Racism. Journal of racial and ethnic health disparities, 9(3), 886-898. https://doi.org/10.1007/s40615-021-01028-1
Tan, S. B., deSouza, P., Raifman, M. (2022). Structural Racism and COVID-19 in the USA: a County-Level Empirical Analysis. Journal of racial and ethnic health disparities, 9(1), 236-246. https://doi.org/10.1007/s40615-020-00948-8
Wells, L. y Gowda, A. (2020). A Legacy of Mistrust: African Americans and the US Healthcare System. Proceedings of UCLA Health, 24.
Yasmin, F., Najeeb, H., Moeed, A., Naeem, U., Asghar, M. S., Chughtai, N. U., Yousaf, Z., Seboka, B. T., Ullah, I., Lin, C. Y., Pakpour, A. H. (2021). COVID-19 Vaccine Hesitancy in the United States: A Systematic Review. Frontiers in public health, 9, 770985. https://doi.org/10.3389/fpubh.2021.770985
Zack, N. (2018). Philosophy of Race: An Introduction. Palgrave Philosophy Today Series. Cham: Palgrave Macmillan. https://doi.org/10.1007/978-3-319-78729-9_1
Appiah, K. A. (2006). The politics of identity. Daedalus, 135(4), 15-22.
Badr, H., Zhang, X., Oluyomi, A., Woodard, L. D., Adepoju, O. E., Raza, S. A., Amos, C. I. (2021). Overcoming COVID-19 Vaccine Hesitancy: Insights from an Online Population-Based Survey in the United States. Vaccines, 9(10), 1100. https://doi.org/10.3390/vaccines9101100
Balasuriya, L., Santilli, A., Morone, J., Ainooson, J., Roy, B., Njoku, A., Mendiola-Iparraguirre, A., O’Connor Duffany, K., Macklin, B., Higginbottom, J., Fernández-Ayala, C., Vicente, G., Venkatesh, A. (2021). COVID-19 Vaccine Acceptance and Access among Black and Latinx Communities. JAMA Network Open, 4(10), e2128575. https://doi.org/10.1001/jamanetworkopen.2021.28575
Best, A. L., Fletcher, F. E., Kadono, M., Warren, R. C. (2021). Institutional Distrust among African Americans and Building Trustworthiness in the COVID-19 Response: Implications for Ethical Public Health Practice. Journal of health care for the poor and underserved, 32(1), 90-98. https://doi.org/10.1353/hpu.2021.0010
Blum, L. (2002). “I’m not a Racist, But…”: The Moral Quandary of Race. Ithaca: Cornell University Press.
Blum, L. (2004). Systemic and Individual Racism, Racialization and Antiracist Education: A Reply to Garcia, Silliman and Levinson. Theory and Research in Education, 2(1), 49-74. https://doi.org/10.1177/1477878504040577
Boulware, L. E., Cooper, L. A., Ratner, L. E., Laveist, T. A., Powe, N. R. (s. f.). Race and Trust in the Health Care System. Public Health Reports, 118(4), 358-365.
Coustasse, A., Kimble, C., Maxik, K. (2021). COVID-19 and Vaccine Hesitancy: A Challenge the United States Must Overcome. Journal of Ambulatory Care Management, 44(1), 71-75. https://doi.org/10.1097/JAC.0000000000000360
Haslanger, S. (2012). Resisting Reality: Social Construction and Social Critique. Nueva York: Oxford University Press.
Jeffers, C. (2019). Cultural Constructionism. En J. Glasgow, S. Haslanger, C. Jeffers y Q. Spencer (eds.), What is Race? Four philosophical views (pp. 38-72). Nueva York, Estados Unidos: Oxford University Press.
Jimenez, M. E., Rivera-Núñez, Z., Crabtree, B. F., Hill, D., Pellerano, M. B., Devance, D., Macenat, M., Lima, D., Martinez Alcaraz, E., Ferrante, J. M., Barrett, E. S., Blaser, M. J., Panettieri, R. A., Hudson, S. (2021). Black and Latinx Community Perspectives on COVID-19 Mitigation Behaviors, Testing, and Vaccines. JAMA Network Open, 4(7), e2117074. https://doi.org/10.1001/jamanetworkopen.2021.17074
Kadambari, S., Vanderslott, S. (2021). Lessons about COVID-19 vaccine hesitancy among minority ethnic people in the UK. The Lancet Infectious Diseases, 21(9), 1204-1206. https://doi.org/10.1016/S1473-3099(21)00404-7
Khubchandani, J., Sharma, S., Price, J. H., Wiblishauser, M. J., Sharma, M., Webb, F. J. (2021). COVID-19 Vaccination Hesitancy in the United States: A Rapid National Assessment. Journal of Community Health, 46(2), 270-277. https://doi.org/10.1007/s10900-020-00958-x
Kriss, J. L., Hung, M.-C., Srivastav, A., Black, C. L., Lindley, M. C., Lee, J. T., Koppaka, R., Tsai, Y., Peng-Jun, Lu., Yankey, D., Elam-Evans, L. D., Singleton, J. A. (2020). MMWR, COVID-19 Vaccination Coverage, by Race and Ethnicity — National Immunization Survey Adult COVID Module, United States, December 2020–November 2021. https://www.census.gov/programs-surveys/metro
Ndugga, N., Hill, L., Artiga, S., Haldar, S. (2 de febrero de 2022). Latest Data on COVID-19 Vaccinations by Race/Ethnicity. KFF. https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/
Padamsee, T. J., Bond, R. M., Dixon, G. N., Hovick, S. R., Na, K., Nisbet, E. C., Wegener, D. T., Garrett, R. K. (2022). Changes in COVID-19 Vaccine Hesitancy among Black and White Individuals in the US. JAMA Network Open, 5(1), e2144470. https://doi.org/10.1001/jamanetworkopen.2021.44470
Peteet, B., Belliard, J. C., Abdul-Mutakabbir, J., Casey, S., Simmons, K. (2021). Community-academic partnerships to reduce COVID-19 vaccine hesitancy in minoritized communities. EClinicalMedicine, 34. https://doi.org/10.1016/j.eclinm.2021.100834
Pigliucci, M. (2013). What are we to make of the concept of race? Thoughts of a philosopher-scientist. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, 44(3), 272-277. https://doi.org/10.1016/j.shpsc.2013.04.008
Pigliucci, M., Kaplan, J. (2003). On the Concept of Biological Race and Its Applicability to Humans. Philosophy of Science, 70(5), 1161-1172. https://doi.org/10.1086/377397
Restrepo, N., Krouse, H. J. (2022). COVID-19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned? Otolaryngology - Head and Neck Surgery (United States), 166(6), 1147-1160. https://doi.org/10.1177/01945998211065410
Rosenberg, N. A. et al. (2002). Genetic Structure of Human Populations. Science, 298(5602), 2381-2385.
Savoia, E., Piltch-Loeb, R., Goldberg, B., Miller-Idriss, C., Hughes, B., Montrond, A., Kayyem, J., Testa, M. A. (2021). Predictors of COVID-19 vaccine hesitancy: Socio-demographics, co-morbidity, and past experience of racial discrimination. Vaccines, 9(7). https://doi.org/10.3390/vaccines9070767
Shiao, J. L., Bode, T., Beyer, A., Selvig, D. (2012). The genomic challenge to the social construction of race. Sociological Theory, 30(2), 67-88. https://doi.org/10.1177/0735275112448053
Siegel, M., Critchfield-Jain, I., Boykin, M., Owens, A. (2022). Actual Racial/Ethnic Disparities in COVID-19 Mortality for the Non-Hispanic Black Compared to Non-Hispanic White Population in 35 US States and Their Association with Structural Racism. Journal of racial and ethnic health disparities, 9(3), 886-898. https://doi.org/10.1007/s40615-021-01028-1
Tan, S. B., deSouza, P., Raifman, M. (2022). Structural Racism and COVID-19 in the USA: a County-Level Empirical Analysis. Journal of racial and ethnic health disparities, 9(1), 236-246. https://doi.org/10.1007/s40615-020-00948-8
Wells, L. y Gowda, A. (2020). A Legacy of Mistrust: African Americans and the US Healthcare System. Proceedings of UCLA Health, 24.
Yasmin, F., Najeeb, H., Moeed, A., Naeem, U., Asghar, M. S., Chughtai, N. U., Yousaf, Z., Seboka, B. T., Ullah, I., Lin, C. Y., Pakpour, A. H. (2021). COVID-19 Vaccine Hesitancy in the United States: A Systematic Review. Frontiers in public health, 9, 770985. https://doi.org/10.3389/fpubh.2021.770985
Zack, N. (2018). Philosophy of Race: An Introduction. Palgrave Philosophy Today Series. Cham: Palgrave Macmillan. https://doi.org/10.1007/978-3-319-78729-9_1
Martínez González, C. M. (2022). Racism in COVID-19 Vaccination? Reluctance to Vaccinate in the U.S. Black Population. Artefactos. Philosophical Studies on Science and Technology, 11(2), 97–111. https://doi.org/10.14201/art202211297111
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