Another reason why some Black Americans may have been vaccine hesitant

 Last update: Monday 10/4/21

During the first few months of 2021, coronavirus vaccination rates among Black Americans were substantially lower than the rates for White and Asian Americans. One reason often cited for this hesitancy was Black awareness of the CDC's unethical Tuskegee syphilis experiment, an awareness that might make some Black Americans more distrustful of new medications endorsed by the CDC. Another oft cited reason was the inadequate access of many Black Americans to adequate health care. Lack of access would provide fewer opportunities to learn about the safety of the coronavirus vaccines. This note suggests one more reason why even the best informed, best educated Black Americans might be hesitant. 

Google's Black American gorillas

Many readers may recall the famous failure of Google's face detection algorithms in 2015 to correctly identify a couple of Black American faces. The algorithms determined that the subjects in the photos were gorillas. 

• "Google Mistakenly Tags Black People as ‘Gorillas,’ Showing Limits of Algorithms", Alistair Barr, Wall Street Journal, 7/1/15
  

An extensive discussion of a wider range of errors, but with the same conclusions, is presented in the following article. Algorithms developed by Google, Microsoft, Facebook, and Amazon make more errors in identifying the faces of people with darker skin ... and for the same reasons. The algorithms were trained on zillions of photos of White Americans, but on far fewer photos of people of color.

• "Bias persists in face detection systems from Amazon, Microsoft, and Google", Kyle Wiggers, VentureBeat, 9/3/21
  
  

The U.S medical establishment's Black American gorillas

Whereas Google's algorithms failed because they were overfitted to photographic data that was preponderantly White, the data used to train American doctors is also preponderantly White, more specifically White males. Indeed, Congresswoman Patricia Scott Schroeder, a prominent feminist, led a successful drive to reduce systemic racism and gender bias in the clinical trials sponsored by the National Institutes of Health (NIH), a drive that culminated in the passage of the NIH Revitalization Act of 1993 Public Law 103-43, just 28 years ago. Here are a few of its key provisions:

"INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH

"SEC. 492B. (a) REQUIREMENT OF INCLUSION.—

"(1) IN GENERAL.—In conducting or supporting clinical research for purposes of this title, the Director of NIH shall, subject to subsection (b), ensure that—

"(A) women are included as subjects in each project of such research; and

"(B) members of minority groups are included as subjects in such research.

"(2) OUTREACH REGARDING PARTICIPATION AS SUBJECTS.—The Director of NIH, in consultation with the Director of the Office of Research on Women's Health and the Director of the Office of Research on Minority Health, shall conduct or support outreach programs for the recruitment of women and members of minority groups as subjects in projects of clinical research.

Think about this for a moment. The vast majority of all of the medical research conducted before 1993 did not involve women or people of color. This would suggest that current medical knowledge may be overfitted to White males and may lead to less effective treatments for diseases and other maladies when applied to Blacks and others who are not White males. For example:

• Blacks may require higher (or lower) doses of some meds than prescribed for Whites
• Blacks may experience more unpleasant side effects than Whites.
• And, hopefully only in rare outlier cases, medications that cure Whites may cause more severe illness or even death when prescribed for Blacks.

It would be difficult for the average Black American to detect inappropriate medical diagnoses and treatments. 

• Some Black Americans might become disenchanted with prescriptions that did not work as well as advertised. As consequence, they might develop a "show me" attitude about new prescriptions, as in, "Doctor, I won't take these meds unless you can show me some other Black people that you or I know who have been cured by these meds without serious side effects". In such cases vaccine hesitancy is not vaccine refusal; it's just a reluctance to be vaccinated until they learn about other Black people who have been vaccinated, but experienced no debilitating side effects.
  
  
• Outliers, by contrast, are a small percentage of Black Americans who have experienced severe negative consequences from the usual prescriptions.
  
  

Full disclosure #1 -- The author of this note is an 80 year old Black American with a PhD from one of the nation's top ranked universities and certificates in data science from Johns Hopkins University and Data Camp.

Full disclosure #2 -- The author comes from a family of outliers. All of his closest blood relatives have suffered catastrophic consequences of misdiagnoses of their ailments, i.e., his father, mother, sister, nephew (son of his sister), his two daughters, and himself. The occurrence of so many outliers in one family is a logical consequence of their sharing the same pool of genes, thereby sharing the same critical differences from the White males who were the subjects of most medical research. In other words, the author has had close encounters of the worst kind with the limits of American medical knowledge.

Full Disclosure #3 -- The author received his third ("booster") shot on 10/1/21. He would have preferred to have had data about the effectiveness of the first two shots on Black American males over 65 before receiving his third shot, but he has been unable to locate this information on the CDC's website -- assuming, of course, that Pfizer included enough older Black American males in their clinical trials to enable a calculation that was statistically significant.

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Related notes on this blog:

•  "Policy junk -- Old COVID policies overcome by new data" -- Last update: 9/30/21