Why Vaccine Hesitancy Has a History
Black History Month is a time to honor both the progress and the pain that define the relationship between Black communities and medicine. While public health has made huge advancements, including the development of life-saving vaccines, it also carries a legacy of unethical practices that shaped deep mistrust toward medical institutions.
Vaccine hesitancy in Black communities is often dismissed as misinformation or resistance to science. However, framing it this way overlooks an important reality: hesitancy is frequently rooted in historical and ongoing injustice. To understand vaccine confidence today, we must understand the history that informs it.
Historical Roots of Medical Mistrust
Medical mistrust did not arise overnight. It is rooted in a long record of exploitation and inequity. A central example is the Tuskegee Syphilis Study (1932-1972) conducted by the U.S. Public Health Service. In this study, nearly 400 Black men with syphilis were deliberately denied treatment without informed consent, even after penicillin became available as a standard of care treatment. This contributed to long-term distrust in public health institutions and government-led health initiatives.
The story of Henrietta Lacks — whose cervical cancer cells were taken in 1951 and used for scientific research without her knowledge or consent — further illustrates how Black patients’ rights and autonomy were routinely disregarded. Her cells created the immortal “HeLa” cell line which revolutionized biomedical science, yet her family remained uninformed and uncompensated for decades.
These are not isolated incidents. They represent patterns of exclusion and exploitation that forged a generational memory of distrust toward health institutions.
Their Modern Impact
The legacy of segregated healthcare systems and unequal access to treatment continues to shape health behaviors today. Black communities face a number of contemporary health disparities including higher maternal mortality rates, nearly three times greater than those of White women, and disproportionate burdens of chronic disease such as hypertension, diabetes and COVID-19 mortality. . These inequities continue to reinforce concerns that the healthcare system often fails to protect Black lives equally.
Reframing Vaccine Hesitancy
Vaccine hesitancy is opposition to science. It can represent a call for transparency, accountability, and respect. For many, caution around vaccines reflects a rational reaction to past and present injustices rather than a rejection of medical knowledge.
Reframing hesitancy allows public health leaders to move from blame to understanding. Trust must be fostered through community-led, culturally responsive, and historically informed approaches. Trusted messengers, peer education, and youth leadership are especially powerful tools in rebuilding confidence in vaccines. When information comes from individuals who share lived experience and cultural understanding, it resonates differently.
Next Steps
Black History Month reminds us that progress in health equity demands truth-telling, empathy and shared responsibility. Rebuilding vaccine confidence is not solely about providing information. It is about earning trust through partnership.
Empowering young people to become informed, trusted voices in their communities is one way to bridge gaps in trust. By equipping adolescents with knowledge and leadership skills, we can help create a future where trust in public health is earned, sustained, and shared.
Resources:
PMC article (multi-study review on vaccine hesitancy):
Brumbaugh, K., Gellert, F., & Mokdad, A. H. (2025). Understanding vaccine hesitancy: Insights and improvement strategies drawn from a multi-study review. Vaccines (Basel), 13(10), 1003. https://doi.org/10.3390/vaccines13101003
CDC “About the Untreated Syphilis Study at Tuskegee” page:
Centers for Disease Control and Prevention. (2024, September 4). About the Untreated Syphilis Study at Tuskegee. U.S. Department of Health & Human Services. https://www.cdc.gov/tuskegee/about/index.html
Johns Hopkins Medicine – Henrietta Lacks page:
Johns Hopkins Medicine. (2026). The legacy of Henrietta Lacks. https://www.hopkinsmedicine.org/henrietta-lacks
