Infamous Tuskegee Study sparks mistrust of COVID vaccine among many Black Americans
TUSKEGEE — In 1972, then Tuskegee Mayor Johnny Ford made a promise to Charlie Pollard.
A “fairly well-to-do" local farmer, Pollard had been approached by men from the United States Public Health Service in 1932 and offered a free physical examination at a nearby school. The medics told him he had “bad blood.”
Pollard had never heard of it, but doctors offered him and more than 600 Black men in Macon County, Alabama, free medical care for the ailment. They would never receive adequate treatment.
The “Tuskegee Study of Untreated Syphilis in the Negro Male,” was an observation “in nature” meant to follow the subjects’ until death to examine the fatal venereal disease’s undisturbed effects. When penicillin was discovered as an effective cure in 1945, the men were denied the life-saving treatment. When some sought care from county doctors, the physicians were advised by USPHS officials against treating them.
In exchange for their unwitting participation in the federal government’s research, they were promised free medical care, meals and burial insurance. The proposed six-month study continued for 40 years, until a whistle blower leaked the story and it landed on the front page of the New York Times in July 1972.
Ford, a former SNCC (Student Nonviolent Coordinating Committee) organizer who had marched with civil rights stalwarts the Rev. Martin Luther King Jr. and John Lewis from Selma to Montgomery, would be elected Tuskegee’s first Black mayor just three months later.
“We were shocked, hurt and dismayed. I had grown up and lived [among] people who had suffered with the effects of syphilis,” said Ford, who now serves as chair of the National Black Leadership Commission on Health.
“We wanted more than an apology,” he said. Ford promised Pollard action. “Never, never again would we allow the federal government, the state government or any other government to come into our community and take advantage of our people.”
One year after civil rights attorney Fred Gray filed suit against the U.S. government on behalf of the Tuskegee victims, Congress passed the National Research Act aimed to protect human subjects from scientific exploitation. Yet, the unintended consequences of the infamous study persist.
Researchers found that after the government’s malpractice had been exposed, life expectancy for middle-aged Black men fell by up to 1.5 years. Some coined the mistrust the study fostered in Black Americans the “Tuskegee effect,” but the U.S.'s exploitative relationship with people of African descent is longstanding, evading both limit and geography.
As the first rounds of the COVID-19 vaccine are shipped to medical centers across the country, the impacts of structural racism and exploitation have again placed Black people at the nexus of suffering.
Not only have African Americans been disproportionately impacted by coronavirus due to health disparities, access to care and employment, a recent survey from the Kaiser Family Foundation reported 49% of Black respondents said they would not get the Covid-19 vaccine if it were determined to be safe by scientists and it was free. Only 9% of Black adults felt “very confident” that a vaccine would be properly tested or distributed fairly.
Many Black people may feel that they can’t trust the government, but Ford and leading Black medical experts are asking them to trust in science.
“We don’t want Black Americans or anyone using the Tuskegee Study, as they call it, as an excuse not to trust the doctors,” Ford said. “We’re dying more than anyone else.”
Some historically Black colleges and universities, including Morehouse College and Xavier University of Louisiana, partnered with the National Institutes of Health to address confusion around the virus and vaccine, and increase Black participation during trials. Still Black people represented only 3% of subject participants.
Advocates have pointed to prominent Black doctors and medical experts involved in research and development, most notably Dr. Kizzmekia Corbett who was one of the lead scientists on Moderna’s vaccine. The head of the NIH’s National, Heart, Lung and Blood Institute is an African American physician, and the president of the historically Black Meharry Medical College sat on the advisory committee that reviewed decisions on Pfizer's vaccine research before it went before the FDA for a final decision.
“Unlike in the 1930s when there was Tuskegee … we are under the tent, in the bubble, in the game and we will absolutely be advocating for our community,” said Dr. Reed Tuckson on a virtual call with journalists in November. Tuckson is D.C.’s former commissioner of public health and founder of the Black Coalition Against COVID-19.
Yet, a perceived lack of leadership in Washington has mired efforts to inspire more confidence in Black Americans.
When asked about his greatest apprehension related to the vaccine, Tuskegee resident Charlie Hardy cited a lack of confidence in outgoing President Donald Trump and the Republican administration, rather than medical maleficence.
“One of the things that he doesn’t have is emotional intelligence, which is essential for sound leadership. It doesn’t allow him to build trust, which is the foundation of all of this,” said Hardy. “I need to feel that you care, that you have a genuine interest in something of mutual concern. And it’s your responsibility as a leader to convey that.”
For some Black Americans, Trump’s early lax attitude toward the virus and proposed health precautions coupled with his inflammatory rhetoric, have tainted their view of the vaccine and its dispersal.
The importance of building trust between African Americans and the medical establishment was at the heart of the formation of Tuskegee Institute’s National Center for Bioethics in Research and Health Care. The Center’s Director Dr. Reuben Warren was a member of the Tuskegee Legacy Committee that formed in 1996 to press the federal government for a formal apology (which they received in 1997), and the funding to create a center focused on public health ethics to prevent these atrocities from occurring again.
The stigma of Tuskegee and present anxieties over the COVID vaccine is not a biological comparison, Warren posits.
“It’s a comparison around fairness, around ethics. It’s a comparison around institutional racism. [There’s] a history of abuse in every system that Black people have engaged; the health care system, the educational system, the employment system, the legal system — it’s not an issue of a problem in a particular instance or event. It’s a system barrier,” he said.
Medical experts and community leaders have put forward a host of ideas to increase Black confidence in the Pfizer and Moderna vaccines. These include engaging community anchors: churches, fraternities, sororities and civil organizations; and ensuring Black people are visibly engaged in the process. One of the first front-line workers to receive the vaccine publicly was a Black nurse in New York City.
Ford, the former eight-time Tuskegee mayor, said he wants to take his shot in the town square to help assuage those who still have concerns.
While Warren, who spent two decades at the CDC, is confident in scientists’ capabilities, he said the government had failed to provide the public with proper assurances.
"Vaccinations are one of the most effective public health strategies to prevent disease and promote health in the world — and nothing’s perfect. We’re not looking for the perfect answer, but we’re looking for some assurances. ... If I don’t have health insurance and we find five years down the line there’s been some long-term effect of the vaccine, then I’m completely vulnerable. I don’t have a way to resolve it. There has to be some assurances of care equity for those who are uninsured,” said Warren.
A cruel irony of the Tuskegee Study was that researchers had reportedly hoped to use their findings to justify the medical treatment of syphilis in Black communities, as racism had informed a prevalent belief among white physicians that the disease was simply endemic to African Americans.
In 1974, the U.S. government settled its case with Pollard and the surviving victims of its unethical study out-of-court. By that time 128 of the participants had died of syphilis or related complications, 40 wives had been infected and 19 children were born with the disease.
The survivors were awarded $10M and life-long medical care (and later health care). The Tuskegee Health Benefit Program was expanded to include the wives, widows and children of the study’s participants a year later. Today, 11 living descendants continue to receive that care.
Contact Montgomery Advertiser reporter Safiya Charles at (334) 240-0121 or SCharles@gannett.com