ARI SHAPIRO, HOST:
A lingering mistrust of the medical system makes some Black Americans more hesitant to sign up for COVID-19 vaccines. The early data show a stark disparity in who is getting shots in this country, more than 60% going to white people and less than 6% to African Americans. The mistrust is rooted in history, including the infamous U.S. study of syphilis that left Black men in Tuskegee, Ala., to suffer from the disease. NPR's Debbie Elliott traveled to Tuskegee to see how that 20th-century tragedy affects the vaccine rollout today.
DEBBIE ELLIOTT, BYLINE: Cheryl Owens says she grew alarmed talking with family and friends and elderly relatives in Tuskegee who told her they were afraid to get a COVID vaccine.
CHERYL OWENS: So I asked, why? And it was like, well, you remember that Tuskegee syphilis study; that's why.
ELLIOTT: Officially named the Study of Untreated Syphilis in the Negro Male, the U.S. Public Health Service, working with the Tuskegee Institute, recruited hundreds of rural Black men in 1932, offering free meals and checkups, but never explaining that they'd be human subjects in a study designed to deny them medical treatment.
OWENS: They had local leaders, church leaders, medical people to convince them to become involved with this study.
ELLIOTT: Owens is a nurse at the Central Alabama Veterans Health Care System and grew up in Tuskegee, a city of about 8,000. It has a storied African American history as home to the Tuskegee Airmen, and Booker T. Washington and George Washington Carver were educators here.
But the syphilis study also looms large in Tuskegee's collective memory. Owens, who is 59, says she remembers hearing about it in elementary school, so she understands why people in this nearly all-Black community are skeptical when the government says take a shot.
OWENS: And they felt that the government was - really wanted to inject something in their bodies and they were going to eventually die from that.
ELLIOTT: To help dispel that notion, Owens penned an op-ed in the local newspaper, including a picture of her getting the shot. Health officials are up against a powerful sentiment as they try to ramp up vaccinations.
AMIR FAROOQI: I think a part of the challenge is that there's still a lot of anxiety about the vaccine.
ELLIOTT: Amir Farooqi is director of the Central Alabama VA.
FAROOQI: It's unfortunate because it's a really great tool to help people protect their personal health as well as the public health.
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UNIDENTIFIED PERSON: Thank you for choosing to protect yourself from the coronavirus by being vaccinated today.
ELLIOTT: In a large auditorium at the VA's Tuskegee campus, an informational video explaining just what to expect plays on an overhead screen as people wait their turn for a shot.
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UNIDENTIFIED PERSON: ...Muscle fatigue, joint pain, swollen glands...
ELLIOTT: Seventy-eight-year-old Vietnam veteran Douglas Terry is masked up and ready to get one.
DOUGLAS TERRY: With this, there's hope.
ELLIOTT: Nurse Pamela Bell gives him his first jab.
PAMELA BELL: That's it.
TERRY: You through?
BELL: Yes, sir.
BELL: Didn't feel it?
TERRY: Not at all.
ELLIOTT: Terry says he intends to spread the word that he and his wife got the injection.
TERRY: After they hear us doing it, that's the reason why we want to do it - so to give them courage to do it also.
ELLIOTT: That's what VA officials want to hear. They've set up a selfie station at the clinic and hand out stickers proclaiming you've been vaccinated. The VA's infectious disease physician, Dr. April Truett, says that word of mouth will be key to overcoming reservations about the shot.
APRIL TRUETT: The more people hear about the vaccine, the more they know someone else who's received the vaccine, the more they see how well they did, the more comfortable they become with the vaccine.
LUCENIA WILLIAMS DUNN: It's the biggest PR project to get Black people to take that vaccine.
ELLIOTT: Lucenia Williams Dunn is the former mayor of Tuskegee and runs a local community development organization. She's not convinced. Even though she's been watching the pandemic's devastating and disproportionate impact on African Americans, she still questions the rapid development of the vaccine. And then there's the history.
WILLIAMS DUNN: You cannot separate the experience of the past with what we believe in the present. I mean, people say, well, you know, y'all ought to not to be worried about that syphilis study. Yeah, we do - because that's part of our experience.
ELLIOTT: The vaccine rollout has sparked a conversation among descendants of the men involved in the syphilis study. Among them is Theilene Williams of Tuskegee. She says her grandfather died before knowing the truth about the study.
THEILENE WILLIAMS: Grandfather - his name was Willie Fitzpatrick. He was a good man, a family man, a farmer.
ELLIOTT: She says there's a difference between what's happening now and what the government did to her grandfather and the other men.
WILLIAMS: They didn't know what they were getting into.
ELLIOTT: Williams, who is 72, says she was able to talk with her doctor about the vaccine.
WILLIAMS: I went on and got it, the first shot 'cause we knew about it. We've been hearing and talking about it. It's not like, come on, we're going to do this - nobody know anything about it like they did.
ELLIOTT: Her grandfather is among those now memorialized at the Tuskegee History Center on a large tile circle in the middle of the museum.
FRED GRAY: And around here in alphabetical order, you have the names of all 623 men.
ELLIOTT: That's Tuskegee civil rights attorney Fred Gray, who represented the men when the truth came out about the study in the 1970s, 40 years after it began. Participants were not injected with syphilis, but those who already had it were left untreated, even once penicillin was available.
GRAY: Not only did they withhold treatment from it, but they sent these men's names to the various doctors in the area and told them if they came to their office, not to treat them for syphilis.
ELLIOTT: Gray won a $10 million settlement for the men and later secured this apology from President Clinton in 1997.
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BILL CLINTON: What the United States government did was shameful. And I am sorry.
ELLIOTT: Gray, who is 90 years old now, takes issue with people citing the syphilis study as a reason not to get vaccinated.
GRAY: Individuals, if they elect not to take the vaccine for whatever reason, but they shouldn't put it, is because of what the government did to the men in the Tuskegee syphilis study because they're altogether different situations.
ELLIOTT: A January poll from Kaiser Family Foundation found that more than half of Black adults surveyed said they did not have immediate plans to get vaccinated. Forty-three percent said they were going to wait and see how well it's working. That hesitancy is to be expected, says Rueben Warren, director of the National Center for Bioethics in Research and Health Care at Tuskegee University, established and funded by the federal government as a result of the syphilis study. He says the mistrust of the health care system among African Americans is twofold.
RUEBEN WARREN: It's both historical and current - and not either/or but both/and.
ELLIOTT: Dating to slavery and continuing through the eugenics movement, he says, Black bodies have been medically abused. Now, he says, the coronavirus pandemic and its disparate impact on people of color have exposed the shortcomings of the U.S. health care delivery system. For instance, there's no hospitals serving the general public in Tuskegee, and COVID testing was hard to come by here early on.
WARREN: So it's not just historical, but it's current. So the combination of that makes folks pause.
ELLIOTT: Warren says seeing the mayor and community leaders getting vaccinated is not the kind of assurance that people need. What they need to know, he says, is that the health care system will deliver for them in the future.
Debbie Elliott, NPR News, Tuskegee, Ala.
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