As of this week, every adult in the United States who wants a vaccine is eligible to receive one, and the steady stream of pictures on your timeline showing off that little white vaccination card will only increase. At this stage of the vaccine distribution, these cards are not only a marker of newfound immunity, but also a window into a familiar kind of privilege given that the pandemic’s racial disparities have persisted in the vaccine rollout. But we have the chance to prevent new mitigation measures from repeating the same old mistakes: By recovering lost narratives about community-based healthcare, we can identify strategies that will make the road to herd immunity more equitable.
By recovering lost narratives about community-based healthcare, we can identify strategies that will make the road to herd immunity more equitable.
Vaccine passports are the emerging health technology that promise to launch us into the next phase of the pandemic. The term “vaccine passport” encompasses varying forms of documentation, both digital and analog, that show proof of immunity to COVID-19 through vaccination status. At our recent Databite, we invited a panel of experts to discuss a number of challenges posed by the development, application, and implications of vaccine passports. By all accounts, we believe that inequities in access to vaccines will be replicated in vaccine passports, meaning that access to public, private, professional, and international spaces may be interrupted for marginalized people who cannot or chose not to be vaccinated.
Vulnerable groups like undocumented people may fear requirements to provide documentation that ties immunity to location and movement restrictions. At the same time, conservative lawmakers are introducing legislation to outlaw vaccine passports within their jurisdictions to prevent government and private sector oversight on private health information. Privacy concerns about vaccine passports are compounded by a sense of impending doom expressed by community advocates and experts that the pandemic’s racial disparities will repeat (yet again) and people of color will be left behind as the rest of the country embraces the safety of immunity and newfound mobility.
If there is any hope to interrupt the circling drain of health racism in our efforts to achieve a post-pandemic world, renowned Jamaican novelist and philosopher Sylvia Wynter argues that we require new narratives that reframe the fight against the pandemic as a truly global effort. In an interview with Black Studies professor Bedour Alagraa, Wynter states that the cure for the cyclical curse of the pandemic is to “enact a transformation of the whole entire society.” This solution may sound insurmountable, but Wynter also shares her thoughts about where to start: “We have to retell the story of the past and the present in order to change the course of this virus.”
…we require new narratives that reframe the fight against the pandemic as a truly global effort.
Retelling the story of pandemic racism begins with setting straight the misconceptions about Black people and our willingness to take the vaccine by dismantling over-simplified narratives. Intuitively, hesitancy among minoritized populations with legitimate reasons for distrust in the medical system is understandable, but the reality is more complex: recent data from Pew Research Center shows that white evangelicals are one of the demographic groups most likely to refuse vaccination. The Black vaccine hesitancy narrative also relies heavily on historical justifications for medical mistrust among Black people, while ignoring contemporary ways that Black people (and Black women in particular) experience ongoing medical violence across this country. The problem became us and our mistrust, resulting in misplaced blame and diverted focus from the very system that caused the mistrust, leaving room for history to repeat itself. More importantly, the narrow focus of this misguided media strategy obscured a key fact: Our community needs the vaccine and we know it.
A recent study by Pew Research Center found that the majority of Black adults (61%) either planned to get a COVID-19 vaccine or have already gotten one, marking a 19% increase since November. Black people who have all the reasons to mistrust medicine have stepped up to save ourselves because we are motivated by the same force that has propelled our ancestors for generations: life. In a CNN interview about Black vaccine hesitancy, Jefferson County Commissioner Sheila Tyson communicates this mission clearly: “This is a matter of life and death for a lot of us because we have seen our parents, our brothers, our church members, our neighbors, our coworkers die from COVID-19… But we still are willing to take the vaccine if they would give it to us because we are trying to live.”
Not only did the media’s focus on Black vaccine hesitancy echo a history of labeling people of color as dangers to public (read: white) health, it also ignored a longer history of alternative networks of care. Health-focused activism has existed in Black communities for generations. After all, as Alondra Nelson notes in her book Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination, Black Americans have dealt with unequal epidemics for generations. In her book, Nelson traces the history of the Black Panther Party’s health politics as seen through the establishment of community clinics that served as “sites of social change where preventative medicine was dispensed alongside both extramedical services (e.g., food banks and employment assistance) and ideology via the Party’s political education (PE) classes.” This imaginative praxis which Nelson calls “social health” sought to combat health inequality, deficient medical care, and waning confidence in medicine that was not accountable to its patients through a holistic approach that uplifted healthcare as a right, not a privilege.
If we are to disrupt reactive health racism, we must…relocate ourselves in the present through an understanding of our innate interconnectedness.
Although the United States government tried its best to weed out the presence of Black racialism in this country, the same tactics used by the Black Panther Party are being replicated today by Black activists and allies alike. The work of reinterpreting scientific findings, conducting independent research programs, and employing scientific analysis to demonstrate that “racism, not rationality” is at the root of faulty scientific claims about Black health is active and abundant today. Trusted messengers in the form of Black doctors speaking to their patients, community members sharing where and how they got the vaccine, and leadership by example are helping Black Americans find a way out of the pandemic independent of the hegemonic systems that seek to relegate us to unhealthy obscurity.
In Philadelphia, the Black Doctors COVID-19 Consortium (BDCC) led by Dr. Ala Stanford outpaced the city in vaccinating Black Philadelphians, who comprise the city’s largest racial demographic but have received just 23% of vaccinations. This achievement was made possible in part by the Consortium’s wildly successful Vaxathon event in combination with deep community connections and adaptable practices to meet the needs of the elders they serve. Despite receiving praise from the city for its services, the BDCC only recently received state funding, highlighting the continued lack of investment in community-centered health activism.
If we are to disrupt reactive health racism, we must reject the simple acknowledgment of racism and its history and, as Wynter argues, relocate ourselves in the present through an understanding of our innate interconnectedness. Vaccine passports will be nothing but a marker of privilege unless we mitigate vaccine inequities at home through alternative networks of health care and seriously commit to a global vaccination effort.
Instead of resigning ourselves to the prospect of unequal vaccination and vaccine passports for the few, we can push for actions that will keep all of us safe in the long term. Resist the urge to buy that “Kiss Me, I’m Vaccinated” t-shirt or post your vaccination card without care for those yearning for the privilege you are promoting. Instead, let people in your community know how you got your vaccine, help others make appointments, or answer questions about your experience to assuage hesitancy. Find and foster interdependent support systems so that unequal health technologies do not dictate the terms of a reopening society.
Joan Mukogosi is a research assistant on the Health and Data team at Data & Society, and a data researcher at COVID Black.