Medical apartheid and COVID-19 vaccinations

See updates through April 4, 2021, at end of post.


I go in today for my second shot of the Pfizer vaccine against COVID-19. I had symptoms, all pretty much on the list of side effects, with the first shot, and I’ve heard that the second shot is worse,[1] so I’m taking this one seriously, expecting to take the day off sick.

I hadn’t really considered the vaccine a matter of white privilege.

But Blacks in particular seem hesitant to get the vaccine. I, along with just about everyone else not of color, had assumed it was because of a horrific history of medical “experimentation.”[2] They point to the Tuskegee syphilis experiments, that left Black men untreated for syphilis as it took a toll on their bodies over time.[3] I knew that Tuskegee was barely a tip of the iceberg of a legacy that makes Josef Mengele, the similarly-motivated infamous doctor at Auschwitz who performed medical “experimentation” on prisoners, look tame.[4] But they just point to Tuskegee.[5]

We’re all wrong,[6] but the way many other folks not of color are wrong diminishes that legacy to a single experiment the same way that current medical practice discounts Black symptoms (much as I’ve heard women say doctors discount their symptoms).

As a prime example of the unequal treatment Black people receive, they point to the recent Facebook Live video of Dr. Susan Moore.

When Moore, a geriatrician and family medicine physician from Indiana, got COVID-19, she filmed herself from her hospital bed, an oxygen tube in her nose. She told the camera that she had to beg her physician to continue her course of remdesivir, a drug that can speed recovery from the disease.

“He said, ‘Ah, you don’t need it. You’re not even short of breath.’ I said ‘Yes, I am,’” Moore said into the camera. “I put forward and I maintain, if I was white, I wouldn’t have to go through that.”

Moore died two weeks later.[7]

And it isn’t just medical practice. It’s where pharmacies are located—a problem recognizable in form as similar to that of “food deserts”—and about the hoops, hoops that seem to have been less problematic for well-off whites, people have had to jump through to even find an appointment to get a vaccine. It’s about access and a lack thereof that alienates Blacks from modern medicine.[8] And though these vaccines are available for free, alienation is surely at least in part about affordability, the refusal of the United States to ensure access to health care as a human right.[9]

“[Tuskegee is] a scapegoat,” [Karen] Lincoln said. “It’s an excuse. If you continue to use it as a way of explaining why many African Americans are hesitant, it almost absolves you of having to learn more, do more, involve other people — admit that racism is actually a thing today.”

It’s the health inequities of today that Maxine Toler, 72, hears about when she asks her friends and neighbors in Los Angeles what they think about the vaccine. As president of her city’s senior advocacy council and her neighborhood block club, Toler said she and most of the other Black seniors she talks with want the vaccine but are having trouble getting it. And that alone sows mistrust, she said.

Toler said the Black people she knows who don’t want the vaccine have very modern reasons for not wanting it. They talk about religious beliefs, safety concerns or a distrust of former President Trump and his contentious relationship with science. Only a handful mention Tuskegee, she said, and when they do, they’re fuzzy on the details of what happened during the 40-year study.[10]

This, by the way, is in line with what I’ve heard from passengers in my car in Pittsburgh. It amounts to a modern medical apartheid.[11] And I don’t have an immediate answer for that any more than I have for the legacy of torture in the name of medical “experimentation.”[12]

But while some of this is just out-and-out racism, the problem of access is largely about capitalist decision-making that may itself also be racist, at least systemically. I don’t really have an answer for this either. I’m getting my shot because the fewer people who get their shots, the more opportunity there is for more lethal and more contagious variants of COVID-19 to arise.[13]

And as I take the afternoon and evening off, I might spare a thought for others who, like me or to an even greater extent, really can’t afford to take that time off.


Update, March 30, 2021: Because the COVID-19 vaccine rollout has been so uneven around the globe, in part due to drug manufacturers’ insistence on preserving their intellectual property ‘rights,’[14] new, deadlier, and more contagious variants of the novel coronavirus[15] will require new vaccines within a year.[16] This is apparently without even considering vaccine hesitancy in countries that have access to the vaccine.[17]


Update, April 4, 2021: I’ve pulled together a more complete compilation of citations for my concern about more contagious or more lethal variants of the novel coronavirus[18] and corrected the footnoting accordingly, including in the update for March 30, 2021.

  1. [1]Centers for Disease Control and Prevention, “Possible Side Effects After Getting a COVID-19 Vaccine,” March 16, 2021, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html
  2. [2]I use scare quotes because this “experimentation” was not really about inquiry. Benefits, if any, were dubious at best: Harriet A. Washington, Medical Apartheid (New York: Doubleday, 2006).
  3. [3]April Dembosky, “It’s not Tuskegee. Current medical racism fuels Black Americans’ vaccine hesitancy,” Los Angeles Times, March 25, 2021, https://www.latimes.com/science/story/2021-03-25/current-medical-racism-not-tuskegee-expls-vaccine-hesitancy-among-black-americans
  4. [4]Harriet A. Washington, Medical Apartheid (New York: Doubleday, 2006).
  5. [5]April Dembosky, “It’s not Tuskegee. Current medical racism fuels Black Americans’ vaccine hesitancy,” Los Angeles Times, March 25, 2021, https://www.latimes.com/science/story/2021-03-25/current-medical-racism-not-tuskegee-expls-vaccine-hesitancy-among-black-americans
  6. [6]April Dembosky, “It’s not Tuskegee. Current medical racism fuels Black Americans’ vaccine hesitancy,” Los Angeles Times, March 25, 2021, https://www.latimes.com/science/story/2021-03-25/current-medical-racism-not-tuskegee-expls-vaccine-hesitancy-among-black-americans
  7. [7]April Dembosky, “It’s not Tuskegee. Current medical racism fuels Black Americans’ vaccine hesitancy,” Los Angeles Times, March 25, 2021, https://www.latimes.com/science/story/2021-03-25/current-medical-racism-not-tuskegee-expls-vaccine-hesitancy-among-black-americans
  8. [8]April Dembosky, “It’s not Tuskegee. Current medical racism fuels Black Americans’ vaccine hesitancy,” Los Angeles Times, March 25, 2021, https://www.latimes.com/science/story/2021-03-25/current-medical-racism-not-tuskegee-expls-vaccine-hesitancy-among-black-americans
  9. [9]I think here of Robert Terrell, my formerly favorite professor at California State University, East Bay, who seemed convinced that the reason the U.S. does not have universal health care is that such care would include Blacks.
  10. [10]April Dembosky, “It’s not Tuskegee. Current medical racism fuels Black Americans’ vaccine hesitancy,” Los Angeles Times, March 25, 2021, https://www.latimes.com/science/story/2021-03-25/current-medical-racism-not-tuskegee-expls-vaccine-hesitancy-among-black-americans
  11. [11]I am borrowing this term from the title in Harriet A. Washington, Medical Apartheid (New York: Doubleday, 2006).
  12. [12]Harriet A. Washington, Medical Apartheid (New York: Doubleday, 2006).
  13. [13]Josie Ensor, “New coronavirus mutation could be evolving to get around mask-wearing and hand-washing,” Telegraph, September 24, 2020, https://www.telegraph.co.uk/news/2020/09/24/new-coronavirus-mutation-could-evolving-get-around-mask-wearing/; Natalie Grover, “What do we know about the fast-spreading Covid variant in UK?” Guardian, December 20, 2020, https://www.theguardian.com/world/2020/dec/20/fast-spreading-covid-variant-in-england-uk; Melissa Healy, “California’s coronavirus strain looks increasingly dangerous: ‘The devil is already here,’” Los Angeles Times, February 23, 2021, https://www.latimes.com/science/story/2021-02-23/california-homegrown-coronavirus-strain-looks-increasingly-transmissible-and-dangerous; Sarah Kaplan and Joel Achenbach, “Researchers hypothesize that a highly contagious strain of the coronavirus is spreading, but other experts remain skeptical,” Washington Post, May 5, 2020, https://www.washingtonpost.com/health/researchers-hypothesize-that-a-highly-contagious-strain-of-the-coronavirus-is-spreading-but-other-experts-remain-skeptical/2020/05/05/db90d790-8ee7-11ea-9e23-6914ee410a5f_story.html; Sarah Kaplan and Joel Achenbach, “This coronavirus mutation has taken over the world. Scientists are trying to understand why,” Washington Post, June 29, 2020, https://www.washingtonpost.com/science/2020/06/29/coronavirus-mutation-science/; Christopher Rowland, Emily Rauhala, and Miriam Berger, “Drug companies defend vaccine monopolies in face of global outcry,” Washington Post, March 20, 2021, https://www.washingtonpost.com/business/2021/03/20/covid-vaccine-global-shortages/; Zeynep Tufekci, “The Fourth Surge Is Upon Us. This Time, It’s Different,” Atlantic, March 30, 2021, https://www.theatlantic.com/health/archive/2021/03/fourth-surge-variant-vaccine/618463/; Ralph Vartabedian, “Scientists have identified a new strain of the coronavirus that appears to be more contagious,” Los Angeles Times, May 5, 2020, https://www.latimes.com/california/story/2020-05-05/mutant-coronavirus-has-emerged-more-contagious-than-original
  14. [14]Christopher Rowland, Emily Rauhala, and Miriam Berger, “Drug companies defend vaccine monopolies in face of global outcry,” Washington Post, March 20, 2021, https://www.washingtonpost.com/business/2021/03/20/covid-vaccine-global-shortages/
  15. [15]Josie Ensor, “New coronavirus mutation could be evolving to get around mask-wearing and hand-washing,” Telegraph, September 24, 2020, https://www.telegraph.co.uk/news/2020/09/24/new-coronavirus-mutation-could-evolving-get-around-mask-wearing/; Natalie Grover, “What do we know about the fast-spreading Covid variant in UK?” Guardian, December 20, 2020, https://www.theguardian.com/world/2020/dec/20/fast-spreading-covid-variant-in-england-uk; Melissa Healy, “California’s coronavirus strain looks increasingly dangerous: ‘The devil is already here,’” Los Angeles Times, February 23, 2021, https://www.latimes.com/science/story/2021-02-23/california-homegrown-coronavirus-strain-looks-increasingly-transmissible-and-dangerous; Sarah Kaplan and Joel Achenbach, “Researchers hypothesize that a highly contagious strain of the coronavirus is spreading, but other experts remain skeptical,” Washington Post, May 5, 2020, https://www.washingtonpost.com/health/researchers-hypothesize-that-a-highly-contagious-strain-of-the-coronavirus-is-spreading-but-other-experts-remain-skeptical/2020/05/05/db90d790-8ee7-11ea-9e23-6914ee410a5f_story.html; Sarah Kaplan and Joel Achenbach, “This coronavirus mutation has taken over the world. Scientists are trying to understand why,” Washington Post, June 29, 2020, https://www.washingtonpost.com/science/2020/06/29/coronavirus-mutation-science/; Christopher Rowland, Emily Rauhala, and Miriam Berger, “Drug companies defend vaccine monopolies in face of global outcry,” Washington Post, March 20, 2021, https://www.washingtonpost.com/business/2021/03/20/covid-vaccine-global-shortages/; Zeynep Tufekci, “The Fourth Surge Is Upon Us. This Time, It’s Different,” Atlantic, March 30, 2021, https://www.theatlantic.com/health/archive/2021/03/fourth-surge-variant-vaccine/618463/; Ralph Vartabedian, “Scientists have identified a new strain of the coronavirus that appears to be more contagious,” Los Angeles Times, May 5, 2020, https://www.latimes.com/california/story/2020-05-05/mutant-coronavirus-has-emerged-more-contagious-than-original
  16. [16]Natalie Grover, “New Covid vaccines needed globally within a year, say scientists,” Guardian, March 29, 2021, https://www.theguardian.com/world/2021/mar/30/new-covid-vaccines-needed-within-year-say-scientists
  17. [17]April Dembosky, “It’s not Tuskegee. Current medical racism fuels Black Americans’ vaccine hesitancy,” Los Angeles Times, March 25, 2021, https://www.latimes.com/science/story/2021-03-25/current-medical-racism-not-tuskegee-expls-vaccine-hesitancy-among-black-americans; Elizabeth Dwoskin, “Facebook steps up campaign to ban false information about coronavirus vaccines,” Washington Post, December 3, 2020, https://www.washingtonpost.com/technology/2020/12/03/facebook-covid-vaccine/; Benjamin Wallace-Wells, “The Vaccine Resisters,” New Yorker, March 5, 2021, https://www.newyorker.com/news/annals-of-populism/the-vaccine-resisters; Hannah Wiley, “‘No masks. No vaccines.’ Battle is brewing over coronavirus immunizations in California,” Sacramento Bee, June 26, 2020, https://www.sacbee.com/news/politics-government/capitol-alert/article243381501.html
  18. [18]Josie Ensor, “New coronavirus mutation could be evolving to get around mask-wearing and hand-washing,” Telegraph, September 24, 2020, https://www.telegraph.co.uk/news/2020/09/24/new-coronavirus-mutation-could-evolving-get-around-mask-wearing/; Natalie Grover, “What do we know about the fast-spreading Covid variant in UK?” Guardian, December 20, 2020, https://www.theguardian.com/world/2020/dec/20/fast-spreading-covid-variant-in-england-uk; Melissa Healy, “California’s coronavirus strain looks increasingly dangerous: ‘The devil is already here,’” Los Angeles Times, February 23, 2021, https://www.latimes.com/science/story/2021-02-23/california-homegrown-coronavirus-strain-looks-increasingly-transmissible-and-dangerous; Sarah Kaplan and Joel Achenbach, “Researchers hypothesize that a highly contagious strain of the coronavirus is spreading, but other experts remain skeptical,” Washington Post, May 5, 2020, https://www.washingtonpost.com/health/researchers-hypothesize-that-a-highly-contagious-strain-of-the-coronavirus-is-spreading-but-other-experts-remain-skeptical/2020/05/05/db90d790-8ee7-11ea-9e23-6914ee410a5f_story.html; Sarah Kaplan and Joel Achenbach, “This coronavirus mutation has taken over the world. Scientists are trying to understand why,” Washington Post, June 29, 2020, https://www.washingtonpost.com/science/2020/06/29/coronavirus-mutation-science/; Christopher Rowland, Emily Rauhala, and Miriam Berger, “Drug companies defend vaccine monopolies in face of global outcry,” Washington Post, March 20, 2021, https://www.washingtonpost.com/business/2021/03/20/covid-vaccine-global-shortages/; Zeynep Tufekci, “The Fourth Surge Is Upon Us. This Time, It’s Different,” Atlantic, March 30, 2021, https://www.theatlantic.com/health/archive/2021/03/fourth-surge-variant-vaccine/618463/; Ralph Vartabedian, “Scientists have identified a new strain of the coronavirus that appears to be more contagious,” Los Angeles Times, May 5, 2020, https://www.latimes.com/california/story/2020-05-05/mutant-coronavirus-has-emerged-more-contagious-than-original

2 thoughts on “Medical apartheid and COVID-19 vaccinations

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.