Peter J. Hotez
Submitter: Jacelyn Peabody Lever | jpeabody@uab.edu
Authors: Jacelyn Peabody Lever, Michele Bamgartner, Ihuoma Njoku, Ayushi Aggarwal, Monica Verduzco-Guiterrez
University of Alabama at Birmingham
Published May 7, 2021
Dear Editor,
We were very interested in reading Dr. Hotez's viewpoint on America's deadly flirtation with antiscience and the medical freedom movement. His recount of the deep-rooted medical freedom movement within our nation artfully demonstrated how such an obstinate culture of medical mistrust and antiscience persists today. Doubt in the scientific process and deaths from the vaccine-preventable disease are modern travesties resulting from mainstream response to recent medical missteps like the retracted Wakefield paper falsely linking vaccines to autism and built upon a complicated backstory including the heinous "Tuskegee Study of the Untreated Negro Male."
The internet and social media undoubtedly contributed to disseminating misinformation and fueling an anti-vaccination movement. The historical targeting of racial and ethnic groups and the current COVID-19 pandemic is particularly interesting. Anti-vax groups leverage existing mistrust in medicine, especially in Black communities, with false equivalence for vaccination and the unethical experimentation in Tuskegee {Jaiswal 2019 DOI: 10.1080/08964289.2019.1619511}. The last Tuskegee study participant died in 2004, and there are still 11 offspring receiving benefits from the reparation {https://www.cdc.gov/tuskegee/timeline.htm}. This atrocity remains in recent memory, especially in BIPOC communities.
For example, a federally funded poll by the Alabama Department of Public Health to better understand COVID-19 vaccine reluctance among BIPOC persons showed that speed of development, lack of trust in government research, and general skepticism of vaccines were drivers of vaccine hesitancy {Landers 2021 https://www.alabamapublichealth.gov/news/2021/03/26.html}. Additionally, focus groups revealed that African Americans are sensitive to feeling "targeted," Hispanics were disproportionately worried about being deported, and African Americans, Hispanics, and Tribal Nations were all concerned about not being insured and the price of vaccination. Lack of minority representation in vaccine trials is also concerning and fodder for distrust {Flores 2021 doi:10.1001/jamanetworkopen.2020.37640}. Social determinants of health, including race or ethnicity, can potentiate vaccine reluctance {Kelly 2021 doi.org/10.1186/s12879-021-06023-9}.
We propose a call to action by the physician-scientist community to expand our local and virtual community engagement to help squelch antiscience narratives and increase the representation of diverse, expert voices. As BIPOC communities have been particularly affected by the rising COVID-19 death toll, they must hear from individuals with a similar background. In conclusion, we should follow Dr. Hotez's example and utilize our platforms to reach people at risk from antiscience disinformation. It is of utmost importance that we amplify women's voices and BIPOC experts to better reach vulnerable populations with vaccine hesitancy.