A Shot In The Dark : Code Switch As the rollout of coronavirus vaccines unfolds, one big challenge for public health officials has been the skepticism many Black people have toward the vaccine. One notorious medical study — the Tuskegee experiment — has been cited as a reason. But should it be?
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A Shot In The Dark

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A Shot In The Dark

A Shot In The Dark

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GENE DEMBY, HOST:

I'm Gene Demby.

SHEREEN MARISOL MERAJI, HOST:

I'm Shereen Marisol Meraji. And this is CODE SWITCH.

DEMBY: ...From NPR. So, Shereen...

MERAJI: Yes.

DEMBY: ...Not too long ago, my mom got her first dose of the COVID vaccine.

MERAJI: Congratulations, Ms. Jeanette.

DEMBY: Yeah, I was very happy for her. It was like - it calmed my nerves a lot. And she got it after standing in a long line at Temple University, which is in North Philly. She was in this long line, and a dude near the front of the line saw her, you know, this 70-something-year-old Black woman waiting for the COVID vaccine shot just before they closed down that line at the end of the day. And so he saw her standing there, and he was like, yo, come with me. And he told the people giving up the shot that this lady, who he didn't know, who was my mom, that she was his plus-one.

So first, to the brother who got my mom out of the line, I appreciate you for that. Thank you very much.

MERAJI: Yes.

DEMBY: That's a big relief.

MERAJI: That's wonderful.

DEMBY: The flip side of that is like, yo, isn't this kind of haphazard? Like I felt, you know, like some type of way about the way that was organized. Right? Like, this can't be the way we're doing this, right?

MERAJI: Well, I have an anecdote, too, that kind of shows the haphazardness of all of this. Nico and I - that's my husband. We - you know that, Gene, but for those of you who don't - we got this text a couple of weeks ago from a friend who had heard from a volunteer at a vaccine site or a vaccination site that extra vaccines were being given away that couldn't be re-refrigerated.

DEMBY: Right.

MERAJI: So we rushed down there. And we got there, and we were just like, what is the deal? There's this really long line. What's happening? And we were told that the vaccines were specifically for community members over the age of 65. This is a Black and Latino neighborhood, but nearly everyone in that long line to get those extra doses was white and young. I kid you not. And I was like, Nico, this isn't right. This doesn't feel right at all. I don't want any part of this mess. We got to go home. So we didn't get the vaccine.

DEMBY: Yeah. And such a weird part of this is people have to make these kind of individual decisions about their ethics, you know what I'm saying? Like...

MERAJI: Yeah.

DEMBY: ...Because, you know, this vaccine rollout is this huge logistical undertaking, like unlike anything we've seen in the history of this country. So in order for this country to have herd immunity to COVID, public health officials are saying that something like 240 million people need to get this shot or shots in their arms at some point. Some of those vaccines have to be kept at -94 degrees Fahrenheit. Like, what even is that number?

MERAJI: Yes. What is that number?

DEMBY: Yeah.

MERAJI: Very, very cold.

DEMBY: Extremely cold. So just transporting the vaccine and keeping them viable is a challenge unto itself. And another thing that's become clear over the last year, though, is that Black folks have been among the hardest hit by the coronavirus along with Indigenous people on reservations. You know, Black folks are more likely to contract the virus and more likely to die when they do contract it.

MERAJI: Yeah. And these inequities, they're showing up in who gets the vaccine, too. At the end of January, the Centers for Disease Control and Prevention released a report from the 17 states and two cities that made their vaccination data public. And they found that in all of those places, Black people were not being vaccinated for COVID-19 in numbers consistent with their populations. And in some places, they were way behind.

DEMBY: And the AP pointed out, when the information came out, that this was true, even though Black folks are overrepresented among health care workers who, you know, were pushed to the front of the line for the vaccines when these rollouts began. So...

MERAJI: So yeah, what is going on? Yeah.

DEMBY: That's a...

MERAJI: What is going on here? I mean, obviously, part of it is about unequal access to health care, which we've talked about before on the podcast. But if you just give a listen to some of the things that listeners told our producer Alyssa Jeong Perry, you're going to notice another theme.

UNIDENTIFIED PERSON #1: I'm a 37-year-old Black woman, so I'm hesitant to take the COVID-19 vaccine because of the way the medical industry has treated Black people since the start of this country.

UNIDENTIFIED PERSON #2: I identify as Black and Latino. My wife has described me as vaccine hesitant. I can't really argue with that, although I tend to think of it as more of an acute lack of enthusiasm.

UNIDENTIFIED PERSON #3: I will absolutely not get the COVID vaccine. History has demonstrated how the use of Black bodies for medical research is not off limits.

UNIDENTIFIED PERSON #4: I'll be quite honest. As a person of color, you know, if we get sick, we're not going to get the same care as everybody else.

(SOUNDBITE OF MUSIC)

MERAJI: Back in December, the Pew Research Center found that 83% of Asian respondents, 63% of Latinos and 61% of white people said they'd get the COVID vaccine.

DEMBY: Wow.

MERAJI: But only 42% of Black Americans said the same thing.

DEMBY: Only 42% - oh, my God. But if you've listened to or read any of the news or conversation about Black people and the distrust of the COVID vaccine, there's one place name that you've probably heard invoked a whole lot.

(SOUNDBITE OF MONTAGE)

UNIDENTIFIED REPORTER #1: The Tuskegee experiment...

UNIDENTIFIED REPORTER #2: The Tuskegee syphilis study...

UNIDENTIFIED REPORTER #3: The Tuskegee syphilis experiment...

UNIDENTIFIED REPORTER #4: The Tuskegee exper (ph)...

UNIDENTIFIED REPORTER #1: Fear over the coronavirus and other vaccines is common among African Americans. One reason why is the Tuskegee experiment.

MERAJI: Tuskegee, Ala. - the epicenter of a four-decade-long experiment called the Tuskegee Study of Untreated Syphilis in the Negro Male. It was one of the most notorious medical experiments in the history of the United States. And as you heard, it's often cited as a key reason why Black Americans are reluctant to trust the medical establishment. But is it really?

DEMBY: As you would say, Shereen, it's complicated - like, real complicated.

MERAJI: And in order to unpack all of this, we need to talk about just what this study was.

DEMBY: And just a heads-up - like, this is going to get kind of dark. So...

MERAJI: Very.

DEMBY: ...First we need to explain that syphilis, which is a venereal disease, is very, very bad in its early stages. Syphilis begins with sores often. But as it progresses, years down the line, it can come with, like, an endless range of horrible symptoms that can cause strokes and blindness, deafness, a loss of feeling in your hands and your joints and dementia. And it can ultimately be fatal.

MERAJI: Starting in 1932, white government researchers and doctors at the U.S. Public Health Service, which later became the Centers for Disease Control and Prevention, they wanted to test out a theory that syphilis, if left untreated, would unfold differently in Black people's bodies. So these scientists decided to follow hundreds of Black men from the rural South who had been diagnosed with the disease. Their findings on it were published in academic journals. And so certain people knew what was going on, but not the men in the study. They weren't even told they had syphilis.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

UNIDENTIFIED REPORTER #5: Recently, it was revealed that a group of Alabama Blacks had been involved in a syphilis study run by the government, which left some of them untreated for years. The government is investigating the conditions under which the study was conducted.

DEMBY: And so here we are again in this moment in 2021, when the medical establishment and the U.S. government are again working in concert and specifically doing this outreach to Black folks. And unsurprisingly, Tuskegee is back in the news. So we thought it probably made sense to talk to somebody who had to deal with the direct fallout of the Tuskegee syphilis study to talk through how he was thinking about this moment. And his name is Roosevelt Baums.

ROOSEVELT BAUMS: Roosevelt Baums.

MERAJI: Reverend Roosevelt Baums.

BAUMS: Reverend - I'm a pastor.

DEMBY: Oh, you right. My bad. Sorry, Rev. Sorry, Rev. Reverend Baums talked to our producer, Alyssa Jeong Perry, over the phone.

BAUMS: I am 75 years young. I grew up in Tuskegee, Ala., with my grandfather.

MERAJI: Reverend Baums is the oldest of eight children. And when he was young, he was sent to live with his grandfather, a man named Albert Davis, in Tuskegee. This was rural Macon County, Ala., and they were crushingly poor. Albert Davis had almost no formal education. He couldn't read or write. And Reverend Baums says his grandfather didn't even get his first pair of shoes until he was 23 years old.

BAUMS: My grandfather worked on a farm. Not only did he work on a farm as a sharecropper, also he was an overseer for a plantation.

DEMBY: Reverend Baums told us that his grandfather learned some of his farming techniques from George Washington Carver, which I thought was interesting. Also, that's the obligatory George Washington Carver cameo for Black History Month, so just had to get that in there. Anyway, Rev. Baums' grandfather, Albert, he was like a physically strong man. And he kind of had to be 'cause he was a sharecropper. He was doing all this backbreaking work - picking cotton, hauling cotton in the Alabama sun. So it was just real hard on his body.

(SOUNDBITE OF MUSIC)

MERAJI: And all that pain made his grandfather a difficult person to be around. He was controlling, and he refused to let him go to school.

BAUMS: He was more concerned about working on the farm than he was concerned about me and my education.

MERAJI: When Reverend Baums was a child - when he was young Roosevelt Baums - he remembers that every once in a while, a nurse came around to meet with his grandfather and other Black men in Macon County.

BAUMS: She had a little black car, and she used to come out and pick them up and and take them to a location.

DEMBY: That nurse, by the way, was a Black woman named Eunice Rivers, and she is a fascinating and confounding figure in the larger story of the Tuskegee syphilis study. She was the only person involved in the study for the entire time that it was running. She probably deserves her own deep dive.

MERAJI: She does.

DEMBY: But anyway, it was this nurse, Eunice Rivers, who was driving that black car and ferrying these Black men to these appointments.

BAUMS: They went to a location out on the United States forest down in Tuskegee, and also they went to Shiloh Missionary Baptist Church and also Rising Star Baptist Church.

DEMBY: On these trips, these appointments, the men would meet with doctors from the county and other people from the Tuskegee Institute, which is the nearby historically Black college. And the doctors, they would feed them. And the reverend said those men looked forward to it. Like, it was a respite from the grueling labor that they were doing.

BAUMS: Like, more like fun thing for them - you know, they'd go. They'd take off. They'd go to the church, and they gather. And they talking to their friends and everything like that - drinking soda and having whatever they provided for them.

DEMBY: The doctors and workers who saw those men poked them and prodded them with weird instruments. They gave them these tonics and these pills that the doctor said, you know, they would help them with their various aches and pains. And a lot of those men counted themselves fortunate because, you know, this is the Jim Crow South. And especially in more rural places like Macon County, it was just real hard, if not impossible, for Black people to see a doctor.

BAUMS: He was thinking that he was getting health care. In other words, they told them that if anything happened - oh, he told them they had bad blood.

MERAJI: Bad blood - that was the way these sessions were pitched to the men who climbed into Eunice Rivers' car. We'll treat you for your bad blood.

BAUMS: That's why they gave them - when they ablations (ph) on their body, they gave them that liniment kind of rub to rub their bodies and stuff like that.

DEMBY: Those liniments, those rubs - I mean, they didn't do anything. And the doctors knew that they didn't do anything. They were just placebos. Sometimes it was stuff like aspirin, but what it absolutely wasn't was a cure for syphilis.

MERAJI: Some of the Black men in Macon County were in a control group. They didn't have syphilis. But the men in the other group, they did. Albert Davis, Roosevelt Baums' grandfather, was in that second group.

DEMBY: And what these researchers did was they actively prevented the men in the study from seeing other doctors who might reveal to them that they were infected, who might treat them with penicillin, which by the 1940s was like everywhere and had been developed as an effective treatment for syphilis. And so for the next 40 years, all these Black men unwittingly spread this disease to their wives and to their partners. And since the disease can be congenital, they'd pass it down sometimes to their children.

Meanwhile, the organizers of the study, you know, they moved on over the years. They went on to bigger and better government jobs. They passed on the study to new directors to run it. And all the while, they were keeping this whole thing as quiet as possible.

MERAJI: It wasn't until 1972 when all of this finally hit the mainstream press, and Reverend Baums found out the sick truth of the syphilis study along with the rest of the country.

BAUMS: We didn't know that he had it because they didn't discuss those kind of things around the family. When the thing broke on the national news, I was in the service at the time when I read it in - Ebony magazine had a story about it.

DEMBY: People were - I mean, not surprisingly - outraged. But the researchers who ran it, you know, they continued to defend it. They said it was scientifically necessary. But by the time the study became public, most of the men who were tricked into the experiment to begin with, they had already died. Albert Davis, Reverend Baums' grandfather, was still alive. But by then, Roosevelt said he had lost his hearing. He'd lost most of his sight. And his family didn't know for sure that he'd even been involved in any of this.

MERAJI: It wasn't until much later, actually, after Albert Davis passed - long after Albert Davis passed, that the reverend visited the CDC headquarters in Atlanta and the details of what happened to his grandfather became clear.

BAUMS: We was able to go in there to the archives and look in their records and see some of the things that was in the records.

MERAJI: And in those records was all sorts of personal information about the test subjects, including how much money they got as a part of a government settlement.

BAUMS: We was told that he received $37,500.

MERAJI: As far as those settlements went, that was relatively big money, and those bigger payouts were given to the families of people who had the disease.

BAUMS: That's why we knew that he had syphilis, because the fact of the amount of money that he was awarded.

MERAJI: Reverend Baums said this experiment destroyed his family's faith in the white medical establishment.

DEMBY: So yeah, if anybody had occasion to not want to participate in a vaccine rollout overseen by the CDC, it'd probably be somebody like Reverend Roosevelt Baums.

MERAJI: Mmm hmm.

DEMBY: So - you know, how does the reverend feel about the COVID vaccine?

BAUMS: I'd rather have the shot than wait and see whether I'm going to fall dead.

MERAJI: I bet you all had no idea that's where this was going.

DEMBY: That's not where I thought it was going. He explained it to us this way. The Tuskegee study had this long, long shadow, you know, that reverberated throughout the medical field, not the least of which was that, you know, it introduced this whole field of bioethics. It led to the institution of all sorts of rules and guidelines about medical consent and medical procedure. And he said, unlike when his grandfather was being denied treatment, there are legal avenues that people can pursue now for wrongdoing from doctors.

MERAJI: Yeah. But the thing about suing a doctor is that you can only do it after you've suffered some harm. It's not necessarily preventative.

DEMBY: Right, right, right. That's true. But yeah, that's the way Rev. explained it. He's actually kind of an evangelist of the vaccine - that's not a reverend joke - to help spread the word about the vaccine to President Biden offering his support on behalf of the descendants of the Tuskegee subjects.

BAUMS: Dear President Joseph R. Biden Jr., I would like to offer my service to your COVID-19 plan as an encourager to tell the true story so that others will understand the facts and truth.

Yes, I sent that to him, you know, and he should have it. I sent it to 1600 Pennsylvania Avenue Southwest Washington, D.C.

DEMBY: So this experiment is held up as a reason for people mistrusting the vaccine, but Reverend Baums told us that it's because of this experiment and the fallout from it that he's all for it.

(SOUNDBITE OF MUSIC)

MERAJI: After the break, we're going to hear from a researcher who thinks the media's hyperfocus on Tuskegee misses a much bigger issue.

HARRIET WASHINGTON: We're dealing with an untrustworthy health care system, and we're dealing with people's reaction to that health care system, which is, unfortunately, a logical reaction.

DEMBY: Stay with us.

(SOUNDBITE OF MUSIC)

DEMBY: Gene.

MERAJI: Shereen.

DEMBY: CODE SWITCH.

(SOUNDBITE OF MUSIC)

MERAJI: So before we go further with this, we need to underscore that public health experts and scientists are encouraging everybody who can get the COVID vaccine to get the COVID vaccine. That's the way they say we're going to get this pandemic under control.

DEMBY: One of the major practical hurdles to this vaccine rollout, though, is the skepticism we've been talking about among Black Americans in particular toward the vaccine. So in our deep diving on this, we asked a scholar named Harriet Washington if the hesitance to get the vaccine was part of this long shadow of Tuskegee we've been talking about. And she basically shut all that right down.

WASHINGTON: No, because it's the wrong question.

DEMBY: OK, and so asking the right questions about medicine - that's kind of Harriet Washington's bailiwick.

WASHINGTON: I most often write about medicine, and I focus on the ethics of medical research for the most part.

MERAJI: And she told us about a study by a researcher at Johns Hopkins which looked at Black people's concerns. And that study found...

WASHINGTON: People who have never heard of Tuskegee are more likely than others to distrust medical research.

DEMBY: Which, you know, kind of makes sense when you think about it.

WASHINGTON: You know, people may not have - know the encyclopedic history noted in my book, but they do know that their own families and the families of their friends and many people they know have, over generations, been abused in the medical research arena.

MERAJI: Harriet is the author of "Medical Apartheid: The Dark History Of Medical Experimentation On Black Americans From Colonial Times To The Present." And it won the National Book Critics Circle Award for nonfiction in 2007. It also brought to light a long history of medical abuse toward Black people, a history which Tuskegee was only a small part. It's a history that stretches all the way back to slavery.

WASHINGTON: It's well documented that physicians would steal the bodies of African Americans, either from the hospitals or from the graveyards, use them exclusively to do anatomical dissection. And then they would take the bodies of African Americans themselves and do things like amputate the legs and arms of slaves in order to show medical students how the practice was done.

DEMBY: And Black people, of course, knew about all this mistreatment. They talked about it with each other. They told each other what was going on. And today, people are sharing contemporary stories of mistreatment and neglect. You know, these are things that are happening at the doctor's office or the ER, like, last week, you know? So when we're talking about this moment...

WASHINGTON: In reality, we're dealing with two things here. We're dealing with an untrustworthy health care system, and we're dealing with people's reaction to that health care system, which is, unfortunately, a logical reaction. It's regrettable. I wish people were more willing to get the vaccine. But no one can say it's illogical given the history and the present of health care delivery in this country.

MERAJI: We've talked on this podcast quite a bit about the way racism plays out in health care. And just a few weeks ago, we took you all to this hospital near Compton and Watts in LA on the front lines of this fight against COVID-19. That hospital replaced a different hospital called King/Drew that had such a bad reputation in the community that it was nicknamed Killer King.

DEMBY: We did a whole episode about how Black mothers are more likely to die during or after childbirth. And just in the news, Serena Williams, like, made headlines not that long ago after talking about how she almost died after she gave birth because doctors didn't believe her complaints about pain that turned out to be related to a blood clot in her lung.

WASHINGTON: Serena Williams is someone we know about because she's one of the best athletes, if not the best athlete on the planet, and she's rich.

DEMBY: There was that doctor - you might remember this, Shereen. She was in the video that went viral last month. Her name was Susan L. Moore (ph).

MERAJI: Yeah.

DEMBY: And she was talking about the fact that the doctors in the hospital where she was being treated for COVID were not treating her pain, right? And not long after that, she died.

MERAJI: This is happening to Black people up and down the income ladder.

WASHINGTON: Look at the data. They tell us that African Americans who make $50,000 or $60,000 a year, who are, you know, solidly middle class by most standards, they are far more likely to be exposed than are whites who earn only $10,000 a year, which is profoundly poor. Profoundly poor whites are less likely to be exposed to environmental toxins than are African Americans who are middle class. So you can't rely on socioeconomic data to find disease risk.

MERAJI: So there's two things at play here. Black people are coming to the doctor, and they're getting there sicker regardless of socioeconomic status, and they're being untreated or they're being mistreated regardless of socioeconomic status. And Harriet's point is people can come to this logical conclusion that bad things may happen at the doctor without ever needing to name-check Tuskegee.

WASHINGTON: In 2016, we read the latest of many reports on how African American pain is treated in hospitals. And they all say the same thing. They've been saying the same thing for decades. Caregivers, health care providers, experts, and physicians specifically do not believe African American reports of pain. Blacks are sent away with Tylenol and castigated as drug-seeking.

DEMBY: Here's a weird side to that (ph), Shereen. Turning to another public health crisis, there was a study a year ago that found that Black communities were hit less hard by the opioid crisis than they probably should've been because doctors were just so much less likely to prescribe painkillers to treat the chronic pain of Black patients, you know, for all the reasons that Harriet just described, because doctors assumed that Black folks were addicts. So, you know, make of that what you will.

MERAJI: This distrust we've been talking about, it's a real public health crisis for everybody because it could have huge consequences for when we get the pandemic under control. But also, we need to remember people who distrust the medical establishment - they've arrived here honestly.

DEMBY: Yeah. Harriet says, you know, the best way to mitigate the fact that people feel this way is making the health care system more just, you know, more accessible, more responsive to the people, to the Black people who have to interact with it. These problems with trustworthiness, or, I guess, untrustworthiness, these are problems that Black folks can't fix. The medical establishments, however, they can. That reckoning can't really happen if these ongoing broader problems are explained away simply as, this is about Tuskegee.

WASHINGTON: It's not only lazier, but it's a lot easier to simply invoke Tuskegee, but it's simply not true, and it's not scientifically rigorous. Frankly, we know better, and we need to stop saying that.

(SOUNDBITE OF MUSIC)

MERAJI: That's our show. You can follow us on Twitter and Instagram. We're @NPRCodeSwitch. And subscribe to our newsletter at npr.org/newsletters.

Coming up later this week on CODE SWITCH...

ERIKA ALEXANDER: "The Big Payback" is a podcast about two people - one Black woman, me, and Whitney Dow, a white man, talking about race and slavery and America inside the conversation of reparations.

MERAJI: ...We're ending Black History Month the way we started it, talking about reparations. And if you're a fan of the actress Erika Alexander...

DEMBY: Maxine Shaw, Esquire - what?

MERAJI: That's right. You don't want to miss this. Erika spent the last two years working on a documentary and podcast about reparations with filmmaker Whitney Dow from the Whiteness Project.

ALEXANDER: He's also a proxy for all the things that I think that I can't say to white men or white women.

MERAJI: That's later this week.

DEMBY: This episode was co-reported and produced by Alyssa Jeong Perry. She did a lot of the heavy lifting with this episode. Shoutout to Alyssa.

MERAJI: It was edited by Steve Drummond and Leah Donnella, and it was fact-checked by our intern, Summer Thomad.

DEMBY: And we got to shout out the rest of the CODE SWITCH massive - Karen Grigsby Bates, Kumari Devarajan, Jess Kung, Natalie Escobar and LA Johnson. I'm Gene Demby.

MERAJI: And I'm Shereen Marisol Meraji.

DEMBY: Be easy, y'all.

MERAJI: Peace.

(SOUNDBITE OF MUSIC)

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