Does the Tuskegee Experiment Really Explain Black Vaccination Rates?

Yves here. It is bizarre to see the press keep repeating the myth that the Tuskegee syphilis experiment is the big reason blacks are lagging other groups in vaccination. But it is also proof of how removed the press and our nominal betters are from the struggles of individuals and families at the lower end of the income spectrum.

Many people who have gotten the Covid shots are pretty ill for a half a day to two days. Many of our readers have confirmed that happens, and blown that off as if it’s no big deal. It’s not if you can’t afford to miss any shifts, or worse, might lose your job if yo call in sick.

To put it another way, “What about precarity don’t you understand?”

Perhaps I am overthinking things, but I also wonder if the Tuskegee experiment rings “Bad Bubba!” bells, which makes it even more appealing to those who want to assign blame for low vaccinations to retrograde whites. Even though the Tuskegee study was a Federal initiative, run by the United States Public Health Service and the Centers for Disease Control, it was managed by the then Tuskegee Institute, and recruited poor black sharecroppers in Alabama. In other words, even if the top brass might not have been from the South, the front line staff and immediate managers were.

Oddly, I have yet to see someone who tries assigning blame to the Tuskegee study highlight the CDC’s role, and play out a possible thought process: “The CDC was behind that atrocity. And they are headquartered in Atlanta, in the Deep South. How can we trust them?” Is it that the CDC is now “the science” and can’t be seen as responsible for past mistakes, no matter how horrific?

Matt Breunig doesn’t get into alternative explanations but simply demonstrates that the popular account doesn’t hold up to scrutiny.

By Matt Bruenig. Originally posted at his website

Black vaccination rates lag the rest of the country, according to data from the Census Household Pulse Survey and other similar sources.

One common explanation for this in the discourse is that black people are skeptical of the vaccine because of prior historical events in which they were abused and experimented upon by the US government and healthcare authorities. The main incident brought up in this explanation is the Tuskegee Experiment. In that experiment, black people with syphilis were told they were receiving drugs to treat the disease but they were actually given placebos while the researchers studied the effects of untreated syphilis.

This theory checks off certain boxes that make it resonate well within current discourse frameworks, but it doesn’t really make a lot of sense. If the coronavirus vaccines were only being given to black people, then you could see how someone might reason that it is a trick. But they are being given to everyone, including over 100 million white people. Are we meant to think that black people who aren’t getting the vaccine believe that the government is poisoning 100 million white people because the government has a racist history of poisoning black people? The racial analysis here would tell you that there is no way the white supremacist government would do such a thing and so the vaccine must be safe!

Perhaps more compelling than this abstract reasoning is the breakdown of the black vaccination rate by education level.

As with the population in general and every other racial group, black vaccination rates climb in lockstep with educational attainment. Educational attainment of course is also a decent proxy, on average, for income, wealth, and other socioeconomic indicators.

I would guess that awareness of the Tuskegee Experiment and black history more generally is greater among those with higher education than those with lower education. If this guess is right, then knowledge of historical racist medical abuses is actually strongly correlated with getting the vaccine.

One of the reasons I am bringing this up because it seems to me that this just-so story about black vaccine hesitancy is actually very unhelpful when it comes to trying to getting black people and the population more generally vaccinated. It’s soothing to a certain mindset that is prevalent in the discourse, but it’s totally detached from reality and papers over the much more significant socioeconomic factors.

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  1. cocomaan

    Yes, I agree with the post. And what evidence is there that this is an explanation? Has someone actually said that Tuskegee is their reason?

    Maybe someone in the media or whoever is pushing the meme could ask a black person. You know, talk a living, breathing human being about why they’re not getting vaccinated.

    The reporter would have to turn off twitter for 5 seconds to pretend to listen to the answer, though.

    It reminds me of the Paul Mooney bit on Chappelle Show, “Ask A Black Dude,” this one featuring Stephen King:

  2. Noone from Nowheresville

    so what people numbers do these percentage equate to?

    US population is about 330 million.

    Let’s say those identifying themselves as White is around 60%. Approx. 180 million.

    Let’s say those identifying themselves as Black is around 13%. Approx. 43 million.

    Those starting numbers are very different but I assume the 30-50 age percentage distribution would be similar. I might even assume that the 13% difference vaccination status means that the real citizens / residents for those identifying as whites and unvaccinated are still greater (perhaps significantly greater given the starting numbers) than those identifying as blacks.

    I’d also want to know what the education percentage numbers mean in terms of actual people identifying as black equates to.

    The articles’ percentages are kind of useless without a frame of reference. Or knowing how the census bureau surveyed people on the vaccinations. I do know I didn’t receive a vaccination survey.

    And sorry, but I’m too lazy at the moment to traipse through the census data to try to figure it out. That’s on me.

    If the unvaccinated real people identifying as white numbers are much greater than the unvaccinated as the identifying as black numbers in this age group even with the 13% point difference, then what’s our purpose in concentrating on blacks?

    1. Noone from Nowheresville

      adding the underlying premise of this article seems to be if only we had better messaging or PR in order to reach the unvaccinated for their own good. Yeah, it is pretty soft compared to the nightly news and personal ER doc / nurse story scolding in online publications (preaching to themselves / choir). What’s interesting to me about bringing up the Tuskegee Experiment is that all of us, vaccinated / unvaccinated, within the rural and urban areas of all fifty states plus the rest of the global population are in fact participating in an experiment. I’d say great opportunity for data given all the different approaches.I, for one, am very interested in learning the results once they are known with the caveat that the data is already known to be corrupted. Still…

      1. Yves Smith Post author

        Wow, you really do make shit up, don’t you? Your comment about the premise of the article is a total straw man. I said at the top, in the clearest possible terms, that the biggest explanation for people not getting vaccines was rational, that they could not afford the economic consequences of a routine “bad reaction”.

        I have no tolerance for bad faith argumentation. Keep this up and you will not be allowed to comment here again.

      2. Zakiya Alake

        I live in Roxbury, a Boston neighborhood and I am African American. I took the vaccine, reluctantly as I do not trust government to protect the people from Big Pharma. BP has a demonstrated track record of rushing unsafe products to market.
        Re education level, I finished two years of the late Antioch School of Law’s program for radical lawyers in the late ‘70s.

        That said, at least five African American nurses aids of three of our biggest EDs (Emergency Departments) warned me of large numbers of patients presenting with complaints, particularly following the second jab. I was struck with malaise for close to two months which of course can’t be proved a consequence of the vaccine. One of these nurses aids remains unvaccinated to date.
        I suggest these front line workers have a lot of influence in their networks. In public spaces such as bus or train stations and beauty salons and barber shops in African American communities Tuskegee Experiment is still referenced regularly as well as more recent experiences with medical negligence even during this pandemic.

    2. Yves Smith Post author

      Because the reports on the ground from Texas and Florida are that the people showing up in ERs are ~85% black and Hispanic. These in the states derided in the media the epicenters of Trump-loving whites.

      1. anEnt

        So to use the language of the woke that the PMC have fallen in love with, the PMC are “erasing” PoC and “ignoring the lived experiences” of PoC to assuage their guilt and dunk on the white rubes of the other party. Sounds like the PMC are “racist.” I guess they’ll have to spring for some more PMC CRT training from Robin DiAngelo to “adequately center the needs of the oppressed races.”

        1. Yves Smith Post author

          That is a much crisper statement of what I was groping to say. Thanks.

          More generally, and Lambert and I have been discussing this for some time, the PMC are remarkably fearful and feel it necessary to demonize any perceived threats to their authority.

          1. anEnt

            Thanks. Had I been in full snark mode, I’d have said “ignoring the lived (and death) experiences.”

            I don’t know how many of the PMC are self conscious enough to recognize their own precarity and thus realize they’re feeling internal existential fear vs fear of the other which they consume. Not all of the PMC produce the propaganda, and trust in credentials is high, leading to uncritical and self-reassuring consumption of propaganda. It feeds their needs, so they don’t look too closely at it.

            1. Left in Wisconsin

              In my (lifetime of) experience, the needs, fears, confident pronouncements, and lack of understanding of the PMC all originate in the same place. The PMC life is a fear-inspired desperate treadmill of blinkered overwork supported by a never-to-be-challenged narrative that it’s not that but something more infinitely satisfying and meaningful.

              1. anEnt

                It must be absolutely soul killing to be in a job that only exists because of needlessly complex legislation that itself only really exists for the purpose of creating said job. Doubly so when one isn’t allowed to do that job well or God forbid help the people the legislation was ostensibly written to help because cost must be minimized (except of course for the cost of one’s job.)

            2. Gulag

              I would submit that there may be something else going on as well–that a significant proportion of the PMC are now participating in constructing a new religious faith (the woke phenomenon) with such items as its own metaphysics of truth, its own hierarchy of virtues and its own self-abusing rituals (white privilege).

              I would place this faith squarely within the Christian tradition with its supposed concern about the weak and victimized and its emphasis on atonement. In addition the more secular social justice warriors within this congregation are using critical race theory and intersectional identity as new sources of authority.

              It may, in fact, be the case that no functioning culture can exist without some kind of sacred dimension and the woke church is simply a striking representation of a vast spiritual hunger.

              The current crisis in our country now extends far beyond satisfying only material needs.

            3. Aumua

              I think it’s dangerous to lump people into categories, The word often tends to become just a catch-all for “behaviors we don’t like”, and then every person in that group or whatever becomes guilty of those behaviors, en masse. I don’t know but I’m pretty sure that a good portion of NC’s readership either is or has been at some point a member of the Notorius PMC.

            4. Harry

              In my limited experience I think most of them have a good sense of their precarity, but its not considered either polite or good form to discuss it.

              My wife has relatives that have done well buying real estate. Its how they fund their country club memberships. Many of their fellow golfers would be in a difficult spot if a system of rent control was implemented. But luckily, this type of horrific socialism cant happen in a God fearing country like America.

              1. anEnt

                I’m sure there’s some variety, but I was also being charitable. In any case, socially censuring a thing is one way of not looking at it.

          2. KLG

            YMMV, but this! I am a paid-up member of the PMC but come from a thoroughly pre-Neoliberal (i.e., pre-Jimmy Carter-yes, he and Alfred Kahn started it) working class background. Based on 40+ years of fieldwork, the PMC knows the Man is coming for them, too, and they simple cannot understand why this must be so. Explaining the underlying political economy to them is like teaching a border collie to solve differential equations, the occasional spark but never a flame. Neither verbal nor nonverbal cues work. I used the term “neoliberal” with one of my physician colleagues who is two years younger, and he had to look up the word. Most of my contemporaries, late Baby Boomers, are hanging on for the time being, worried about outliving their money. However, they see nothing but precarity in their children’s future…This all makes them crazy, and they take it out on the Deplorables (my oldest friends and most of my remaining family) who refuse to listen to PMC reason. Which, of course, is the only kind.

          3. Lois

            I see an amazing amount of comments on twitter where people absolutely refuse to grant this issue. Like f*** em for getting sick, everyone has had a chance to get a shot by now! And when someone brings up low income people and paid time off, they just refuse to believe it. I honestly thing PMC types don’t want become conscious of information that shows that exploited classes exist (I say this as a PMC level type who totally *does* get this and gets weird looks from friends when I explain I will never use Uber Eats, Doordash, Instacart, etc.)

            1. drumlin woodchuckles

              I am beginning to wonder if the concept of PMC is over-fascinating and over-dominating analysis of various social problems because of its newness and appearance of flashing brilliance. There is a risk of it becoming an omni-pan-hammer for hitting all conceptual nails.

              Just a cautionary thought . . .

            2. Louis

              I see an amazing amount of comments on twitter where people absolutely refuse to grant this issue. Like f*** em for getting sick, everyone has had a chance to get a shot by now! And when someone brings up low income people and paid time off, they just refuse to believe it.

              Some refuse to believe in the existance of jobs that don’t have sick-leave–yes they exist, and there are a lot of them–but I’ve also seen other comments saying to take OTC medications and work (deal with it basically).

              Try coming to work sick in a job where you are on your feet all day and get flak from customers–abuse might be a better description for some cases–often about stuff you have no control over, and then get back to me on how it’s no big deal.

      2. Grumpy Engineer

        The people showing up in ERs are ~85% black and Hispanic.

        Holy cow. That’s an extreme asymmetry in the statistics. Texas and Florida are both over 70% white.

        In addition to lack of vaccination, I wonder if Vitamin D deficiency is a factor. People in Texas and Florida (of all colors) are spending as much time indoors as possible right now to hide from the summer heat. This means less exposure to sunlight, and people with heavily pigmented skin need more sunlight to produce adequate Vitamin D. So it wouldn’t be a surprise if blacks and Hispanics were more heavily Vitamin D deficient than whites.

        And when you throw in the effects of poverty, I’d expect that a lower percentage of blacks and Hispanics are getting their levels of Vitamin D tested and taking supplements if necessary. My last Vitamin D test cost me $200. The insurance company doesn’t cover it.

  3. Arizona Slim

    ISTR reading a comment by one of our NC stalwarts. Said commenter was listening to a rap show, I believe it was on a Philadelphia radio station, and the DJ was asked about taking the vaccine.

    DJ said he wouldn’t take it, and his reason was that he didn’t have Obama money if something happened.

    The “something happening” part is very real to just about everybody. In my circle, I know a mother who got vaccinated and darn near ended up in the hospital. One of her sons, who also was vaxxed, got sick for three weeks.

    Although the shots are free, treatment for the reactions throws you right into the tender loving arms of the for-profit healthcare system. And a lot of Americans steer clear of that system because of its cost.

      1. Arizona Slim

        Thank you! I thought it was your comment, but I didn’t use your name because I wasn’t sure.

  4. Ezmack

    I’m not sure I buy the economic explanation either tbh. The arguement is basically: can’t take time off to get the shot, can’t take time off to deal with side effects. However appointments are so easy to get at this point it’s quite possible to schedule a vaccine after work on a Friday and deal with the side effects on the weekend ( or whatever your schedule is).

    How many people are actually working 16 hour shifts 7 days a week where that’s not possible? I never went to college I know those people exist, I was one of them, but are we honestly saying that 60% of black people who didn’t go to college are working like that? I’m doubtful.

    Even if that is the case, if you were stuck in that situation prior to covid and you got sick what did you do? You go to work sick! Right?

    1. Yves Smith Post author

      Wow, your PMC privilege is showing. I suggest you get to know low income workers before opining. Our aides work weekends and 6-7 days a week between their work for us and other clients or medical centers. One is desperate for all the hours she can get because her car was totaled by drunks with no insurance, so drunk they weren’t clear on who was driving, expired license, expired tags, as in absolutely no money. She is working 60 hours a week.

      Our past yardman worked an erratic schedule because if it rains, he has to work a different day. That’s true for guys in construction too, when they can work is weather dependent. Our new yardman works full time during the week and for us on the weekend. Needs the hours because he is a single dad. McDonalds is famous for a having staff on call, so they never know their hours. We ran stories on how many retail stores operate this way too. Low income workers are often working multiple part time jobs and juggling hours.

  5. Louis Fyne

    “Perhaps I am overthinking things,”

    No, you are not overthinking things.

    Additional anecdote…for all of the media talk about “equity,” in the spring, when the vaccination roll-out began, my ostensible very liberal big city-county didn’t even bother to open its vaccination centers during the weekend or past 5:30pm on the weekdays—-virtually guaranteeing that workers with non-traditional schedules would be excluded.

    And now that vaccine supply can meet demand, do people even know that they can get free vaccinations at any pharmacy? (obviously pharmacy access is another thing as well) All of the PSAs that I’ve seen have “aspirational messaging” about beating the virus as if the PSA was selling Starbucks and not concrete information of who-what-when-where re. vaccination.

    Seemingly the most successful outreaches have been when vaccine clinics were held in conjunction with local churches.

    As seeming with so many things nowadays, the professional management class sees the world through their eyes, lack any ‘walk a mile in their shoes” empathy, and seemingly can’t get their heads out of their 35,000-feet level powerpoint slides.

    1. Erelis

      Same thing in my area. The local government had centralized vaccinations into one “convention center” requiring an appointment. Open same hours as the local art museums. And closed on weekends. (Depression era reference.) The next big center was a drive through clinic at local airport parking lot requiring of course an appointment and a car–which had back up for hours. As for pharmacy distribution, well, one one near offered limited time the J&J which I got because I luckily walked into the place for some meds just as they put up their signs. Otherwise, no pharmacy around me (middle to lower class area) offered any. Now distribution has been decentralized with a few walk in clinics in medical centers.

      The point being is that unless you had time and resources knew English and had access to the internet, it was physically difficult to get one dose forget out two. (Just read the Michael Tracey essay about social class differences in vaccination rates and he and his letter writer totally miss the point about mere physical access to vaccines as a factor in vaccine uptake.)

      I know people in Russia and they had walk in vaccination centers in almost every shopping “mall”. All free and no prior registration required. Sorta strange though, the second dose of the Sputnik V vaccine had to be done at an established medical clinic.

  6. Tom67

    I beg to differ from both the “official” discourse (Tuskegee) and from Yves Smith explanation. I am German and live in a small town in Germany which thanks to Covid I have gotten to know pretty well as my business – tourism – is dead. To understand the following first let me state that here in Germany, like everywhere else, the mass media are propagating vaccination by all means available and dissenting voices are silenced. The further you are up in the food chain and the more educated you are the more you believe in the “system” and in the mass media. After all you profit from the way things are and have grown up to believe that this is the best of all possible worlds.
    People more at the bottom of the pile tend to be much more sceptical. They also have much more common sense. The latter you can easily proof by looking at history. In 1914 it were the young well to do who were thrilled to go to war and in 1939 dock workers in Hamburg refused to listen to one more speech by Hitler if they weren´t paid for it. The latter I have read in a Gestapo report. I am sure if you visited a well to do household in 1939 in Hamburg you would have found much more readiness to listen to the Fuehrer.
    The people at the bottom of the pile become sceptical if the powers that be want to ram something down their throats. They don´t know whether they are being lied to but they are pretty sure that whatever their betters are planning, they don´t have their best interests at heart.
    So back to my small town: the last (small) farmer of the area and all of his friends will not take the vaccine. Nor will the local baker and the people that work for him. Nor will most of the non Germans who do the dirty and heavy work. It is mostly the well to do and highly educated who whole heartedly believe in the vaccine.
    To my mind the vaccination campaign is a result of regulatory capture and will have the same result that regulatory capture had in the financial crisis: a catastrophy.
    I´ll never forget how I stayed as a guest at the house of a vice president of the world bank in washington for several weeks and how all my doubts regarding the way things were going in finance were belittled. One day I went downtown to a k-mart to buy some batteries. One of the employees was an elderly black man and we started talking about the state the US was in. Although being totally uneducated he was sure there would be a disaster as to many people were taking out “liar loans”. “They will all be robbed of their houses by the banks”. That is how he put it and I never forgot it. Black people in the US might be badly educated and poor but when they smell a rat you better listen. At least that is my experience.

  7. Tom Stone

    The rage ( and it is rage) of three well educated women of my acquaintance startled me when I questioned “The Science”.
    The rage is focused on “Bubba”, “Trumpsters” and “The Science” is whatever Fauci and the CDC are saying this week.
    One a retired RN, one a retired environmental lawyer and one a Real Estate appraiser.
    All with advanced degrees.
    They are people who have benefitted from trusting Authority their whole lives and they are terrified of what’s coming down the pike.
    So they double down on what has worked for them in the past because if they CAN’T trust the CDC they know that they and their loved ones will be tossed over the side just like “Those People” have been for decades.
    It’s much safer and easier to blame the powerless..
    BTW, two of those three informed me that they never intend to speak to me again.

  8. Tom Stone

    I’ll add that one of the three very angrily asked me how I could attribute my sudden increase in pain to the Moderna vaccine.
    When I told them I knew my body and that the adverse reactions started within thee days of my first shot and got worse immediately after the second shot she was dismissive, to put it nicely.
    My primary care physician ( New, the old one retired) took me seriously enough that I’ll be seeing a neurologist on 8/18.
    Anger and fear do not lend themselves to good decision making.

    1. Tom67

      Wow. Another continent same story. My own sister won´t talk to me as I refuse to get vaccinated.

  9. NoBrick

    While mind-readers are often wrong, they are seldom in doubt, like the “experts”,
    the PMC, you name it. Systematic irrationality seems old as dirt.
    Emerson: I am ashamed to think how easily we capitulate to badges and names,
    to large societies and dead institutions.

  10. Carolinian

    Gee I don’t know–why would black people distrust while people? You don’t need a Tuskegee.

    And here’s suggesting that a lot of white people don’t trust some white people either. Vaccine hesitancy could be as simple as “you’re not the boss of me”–particularly when it comes to my health and my body. Funnily enough it turns out that this distrust is entirely justified as the vaccine proves to be less effective than was almost universally (by the MSM) claimed. Naturally the thought bubble becomes “what else are they not telling us?” The harder and more authoritarian Biden pushes the more suspicions grow. His latest is to force all armed forces members to get the shot.

    The PMCs are go along to get along conformists and can’t process this sort of defiance. After all they achieved their comfortable status in life by doing as they are told. I’d say this also accounts for much of the hysteria over Trump. It all comes from a lack of respect for their fellow Americans and the assumption that those without degrees must be stupid and backward and uncivilized–the classic authoritarian excuse. To me it looks very dangerous indeed and not from Covid.

    1. Arizona Slim

      Speaking of “you’re not the boss of me,” there was this protest outside a Tucson hospital. Happened yesterday. Note the prevalence of health care workers in the photo and the story:

      The protestors chose Campbell Avenue, one of the busiest streets in Tucson, for their event. Talk about high visibility. The Campbell and Elm intersection has a traffic light that takes its sweet old time, meaning that thousands of people had a chance to pause and contemplate what these health care workers were saying.

    2. Yves Smith Post author

      I agree that monocausal explanations for large populations are at best oversimplified. Monocausal explanations often don’t work at the individual level.

      The reason for even talking about Tuskegee, and Bruenig looks to have assumed his readers (heavily Beltway and media) didn’t need a setup-intro, is that Tuskegee is an idee fixe among large swathes in DC and blue city opinion leaders. That’s why sensible efforts to improve vaccine “access,” like bringing vans into communities with few pharmacies and/or short pharmacy hours, have been slow to get going. They would have been prominent had the officialdom understood some of the issues impeding getting vaccinated.

      And as we’ve said, there’s been virtually no willingness to compensate hourly workers for the time needed to get the shot and possible sick time. The assumption is workers are malingerers and would put in for time whether they needed it or not. Of course, given how mean-spirited most employers of hourly workers are, malingering is an entirely sensible response.

  11. John Wycliffe

    First, I am black, live in a city that is 44% black, and largely votes Democrat. We have a high Covid-19 test rate and vaccination rate across all “racial” groupings for several reasons.
    Early in the pandemic, the Black Doctors Coalition started neighborhood based, 6-day/wk, barrier free testing for everyone. They used major Abrahamic churches to get the word out, in addition to having a great website and being on the list of City approved sites. When the vaccines became available, BDC continued its neighborhood strategy AND set up a large scale, easily accessible site for weekends, vaccinating ~4000 people during one winter weekend. At the same time, they held education sessions throughout the city.

    In addtion, the city and hospital systems established vaccination sites around the area. The city mass site was centrally located, accessible by public transportation. There are/were about 14 hospital sites; appointments on-line or call-in. 311 was beefed up to get people quickly scheduled. The site I used, in a mixed neighborhood, was packed with elderly black people and staffed by black nurses. Which was fortunate as so many elderly were confused about which vaccine, which dosage, and what to do. Everything was run smoothly, was digitally efficient, and sympathetic.

    Second. numerous black scientists and healthcare professionals have commented in mainstream and social media about using Tuskegee as an excuse (search “stop blaming Tuskegee”). And I’ve drubbed a couple of articles in the Conversation for such nonsense. But who listens. Which leads me to…

    One of the “perils of race reductionism,” as Adolph Reed has named it, is that analysis using race obscures, actually covers up, the real issues and challenges. In the case of Covid-19 and vaccines, we are obscuring questions of access, quality and affordability– that is all the issues raised in the Commonwealth Fund Report cited in today’s links. Unfortunately, collectively we’ve developed a kind of stupidity we can ill afford.

    1. Yves Smith Post author

      That is great that your city undertook such a full bore, multi-front effort. It’s a shame that it hasn’t been better publicized.

      We didn’t mention here, but other posts have, other barriers in low income neighborhoods like few pharmacies and poor public transportation, that it is time consuming just to get a shot. Those are other financial/time costs.

    2. Basil Pesto

      Thanks for this report. BDC’s effort in your city sounds like American grassroots action at its best.

    3. fajensen

      One of the “perils of race reductionism,” as Adolph Reed has named it, is that analysis using race obscures, actually covers up, the real issues and challenges.


      And, IMO, This is why we have “Races” to begin with and now the whole gender-ism -debacle; Diversion and Obfuscation are features, not bugs.

  12. kareninca

    Just as an aside, there were also the Guatemala experiments:
    “The Guatemala syphilis experiments were United States-led human experiments conducted in Guatemala from 1946 to 1948. The experiments were led by physician John Charles Cutler who also participated in the late stages of the Tuskegee syphilis experiment.” “Doctors infected soldiers, prostitutes, prisoners and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects.” (

  13. JohnnyGL

    Thanks for this write up.

    NPR throws around the Tuskegee reference like it’s a matter of fact when it’s a story that’s not particularly well known. I suppose they realized how ridiculous it sounds, so now they’ve muddied the waters by using a more vague characterization of the “ugly history of the medical establishment with the black community” or something like that.

    It’s also entirely rational to disbelieve when you’re told “the vaccine is free” because #1, we all know free usually isn’t really free. #2, that’s 2x true when it comes to health care and medical billing. I’ve definitely gotten random bills for my “free” annual checkups.

    So, if I were to summarize and supplement Bruenig’s very good piece on factors inhibiting vaccine uptake, I’d say.

    1) can’t take time off work and risk being out sick
    2) can’t deal with risk of random bills
    3) Me, or people I know have already been infected and they got through it okay. It’s somewhat low risk, and worth taking because of items 1) and 2).

  14. David

    Not an expert on the issue but I wonder if this doesn’t perhaps illustrate a wider problem that the conceptual tools we have available to understand a problem are limited to those which we know about, are those which we are able or allowed to use.
    So a Marxist, for example, would be more or less obliged to analyse everything in terms of economic class interests. Here, I wonder whether what we’re seeing isn’t the soft-wokeism so prevalent in the PMC simply rendering people incapable of thinking of any explanation for any difference which can’t be reduced to oppression of one group by another.

  15. LAS

    I agree with the thrust of the article in that active precariate existance factors are likely more the actual barrier to vaccination than differential distrust. For goodness sake, we all have doubts. However, some of us have more resources/supports protecting us and simplifying our lives.

    I think the precariate mediators are many and include more than the work consideration. These barriers are often underappreciated by the public health decision makers who have never been poor and aspire to institute mass actions at a high level, like vax mandates, and underappreciated by that part of the general public who has never been poor or had a darker skin. There are so many daily traumas, insults, and threats that people who are poor experience, and risks they have to tolerate, that it becomes difficult to suddenly prioritize a vaccination.

    Poor people have these issues: Is it safe to go in and out of your apartment with the rising crime in my development? Many have cited travel to innoculation sites as a barrier; it costs money and puts you among an unfamiliar group of people. Also, where am I going to find money for laundry detergent so I present clean and am not looked down on? What are they going to do with my information they collect with the vaccine b/c of me being behind on some payments, or being undocumented, or having an undocumented relative, or subletting a room in my apartment? Considering my asthma, can I tolerate the side effects? Considering I still have to refill those hypertension meds, are they going to ask about that? Will someone be there who speaks my language? Have they really tested this on people like me? Etc. etc.

    Racism is an issue, too. Many white people do not appreciate the degree of unsafe many Black people feel b/c of the way our society operates in systemically dismissing systemic effects. It gets hard to say which health threat is the greater, and getting a vaccine might justifiably diminish in priority.

    In NYC, many precariate do choose to get vaccinated with only a little patience and community level interest.

    By middle class people it’s perceived as incremental time/expense to do outreach in poor neighborhoods, but actually since the neighborhoods are subject historically and presently to chronic disinvestment, it is not incremental expense. Perception gaps and myths prevail nonetheless.

  16. Soredemos

    I thought the whole “many black people are refusing to get vaccinated because of Tuskegee” claim would surely fall about after about five seconds of thinking. Turns out it simply isn’t true. I’m shocked. /s

  17. Desert Sasquatch

    One thing to keep in mind: Education rates may also be a proxy for whether someone has learned, as Noam Chomsky once put it, to “play well with others.”

    It’s a bit like the Stanford Marshmallow Experiment, but backwards: Those who learn that following the rules brings rewards will naturally tend to trust the system more. Those whose environments are less ordered, where a dollar today is truly better than two tomorrow (because the two dollars may never show up) will, by extension, tend to trust authorities less.

    To make it through college you must trust that an education is worth delaying gratification until later. You must also trust life and your circumstances enough (and they must in turn be trustworty and stable enough) to allow you to finish your education.

    Furthermore, if you don’t have a great deal of education and get a low-paying job, I suspect you’ll also get a constant lesson in just how little the system actually cares for you.

    So I imagine there are a lot of reasons why education level may correlate with vaccination rates other than “dumb folks don’t get vaccinated”–which I know the article didn’t say, and was not the point of the article. Still, given the argument that was presented, it seems like a worthy addendum.

  18. Basil Pesto

    This explanation always strained credulity when you consider that the collective American historical memory barely extends beyond 4 years, let alone 49.

  19. John

    Regarding Tuskegee, no one remembers the ground breaking polio vaccine work done at Tuskegee Institute. (See R. Skloot’s “The Immortal Life of Henrietta Lacks,” and “Development of the Polio Vaccine: A Historical Perspective of Tuskegee University’s Role in Mass Production and Distribution of HeLa Cells,”
    Timothy Turner, PhD) Instead we focus on the salacious.
    ‘Nough said.

    1. marym

      If people and their institutions want to avoid being remembered for the evil that they do they should first do no harm. Henrietta Lacks’s contribution to medical progress was also without her knowledge or consent.

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