Why are Black, Asian and other ethnic minorities hesitant to take the Covid-19 vaccine?
Language barriers and the deep seated suspicion against healthcare professionals due to the historical roots of discrimination and racism against Black and Asian individuals contribute to distrust.
Although translators have become widely available for patients who don’t speak English as their first or even second language, there have been many instances, which I have personally observed due to my Kurdish family, where healthcare professionals often raise their voices in order to be understood clearer by patients. Whilst this is an attempt at building rapport with non-English speaking patients, these efforts can often be misconstrued and seen to be not only patronising, but dehumanising.
A new generation of medical staff are rising up to this challenge, a generation which is more diverse and socially aware, thus combating the issue of representation. Feeling safe and understood by your doctor, especially if you are a non-English speaking immigrant, is of paramount importance for building trust.
Much of the anti-vaccination discourse taking place on social media platforms has referanced multiple instances of discrimination against Black people by medical establishements. The Tuskegee trials is one example of this. Beginning in 1932 and continuing until 1972, the focus of the trial was to see if Black men were more significantly affected than their White counterparts with syphilis. Unethically, the men weren’t told that they had syphilis nor that they could transmit it through sexual intercourse. The men were followed until their deaths and all treatment was halted. Penicillin was denied even after it became available in the mid-1940s, which was in direct violation of government legislation. In the name of ‘medical research’, hundreds of Black men were abused and consequently died due to purposeful medical negligence.
The case of Henrietta Lacks’ HeLa cells is also really important to explore here. Lacks was diagnosed with cervical cancer in 1951, a small biopsy was taken from her cervix in order to diagnose her. Dr Grey found that her cells were able to survive in vitro, even after seven decades the HeLa cells have been vital for studying diseases- including Covid-19.
However at what cost did these magical HeLa cells come to existence? Dr Grey was responsible for supplying the cells to scientists worldwide, whilst making profit as well as taking credit. It was only in 1973, when Lacks’ family were made aware of this, and even this was for personal gain, researchers wanted blood samples from her children. In 2013, the European Molecular Biology Laboratory published the HeLa genome. Without obtaining consent of the family.
Whilst her family now sit on the committee and are able to regulate the use of the cells, now more than ever the historic medical exploitation of Black people may prevent individuals from taking the Covid-19 vaccine.
Efforts to tackle misrepresentation of Black, Asian and other ethnic minorities within healthcare
Steps are being taken to combat bias against Black and Asian patients. Malone Mukwende, a 3rd year medical student and his team, recently created the “Mind the Gap: A handbook of clinical signs on Black and Brown skin”. This was created to raise awareness on how symptoms of diseases can present differently on darker skin. Especially during the Pandemic emergency services often ask if the Covid patient has become “pale” or if their “lips are turning blue” when describing these varying signs and symptoms. The biggest danger is that these descriptors compromise the care of Black and Asian patients receive.
Following the investigations of SAGE, it was found that more than 40% of Pakistani and Bangladeshi people say they are unlikely to get the Covid-19 vaccine, while more than 20% of Indian individuals don’t want the jab, either. In an attempt to combat this, the BBC Asian Network has debunked various vaccine myths in 5 South Asian languages in order to combat the spread of misinformation which constituted claims such as how the vaccine may contain animal products which aren’t halal or cause infertility.
The Jamia Ghausia mosque in Sheffield has set up a pop-up vaccination centre. It was concluded that the area has the highest number of Black, Asian and Other minority ethnic group patients in the city. This effort has been a success. By taking the vaccine in a familiar environment, individuals can feel safe and secure and this is a huge encouragement to the wider community to get vaccinated.
Future steps in order to build trust and and establish rapport with BAME patients
Medical professionals are taught to empathise with patients and communicate effectively. However, with a changing patient demographic whose first, or even second, language may not be English, these rules of communication need to be modified. We may never see another pandemic again, but distrust and miscommunication between doctors and patients will persist, regardless. Even with the use of translators patients feel the division between them and their doctor, thus barriers are established.
This issue needs to be tackled on a larger scale. Teaching inclusively, on a range of skin colours and ethnicities, needs to be integrated into Medical schools’ curriculum. Perhaps if these measures had pre-existed, the government wouldn’t be racing to ensure BAME individuals trust medical professionals enough to get vaccinated, so that the whole population can gain protection.