When viewing immunizations and vaccine hesitancy from a health equity lens, it is important for MIHP home visitors to examine historical underpinnings of vaccine hesitancy. Understanding the historical impact of vaccine hesitancy allows home visitors to acknowledge the complexities that shape experiences and belief systems, including those related to vaccines.
Health care systems in the United States (U.S.) developed during the 18th, 19th, and 20th centuries were fundamentally shaped by dominant societal norms and systems of power including white supremacy, capitalism, and patriarchy.
Human experimentation in the U.S. has been shaped by the same dominant social narratives about race, social class, and gender as the rest of the health care system.
Inhumane human experimentation, forced sterilization, and other atrocities committed against historically underrepresented and underserved populations are documented throughout history and represent valid roots of distrust in the health care system in this country.
Unfortunately it was common practice for physicians to purchase or borrow enslaved Black people to conduct experiments to avoid inflicting harm on white people.
Since enslaved people had no rights to consent or reject any health procedures or experiments, they were forced to endure harmful and painful experiments that were designed to advance medicine in the 18th and 19th centuries.
Unethical and abusive human experiments, particularly those sponsored and funded by the U.S. government, have contributed to communities of color experiencing a great deal of distrust and mistrust in the medical system.
When populations have been harmed at a systemic level, it is critical to acknowledge the role that this plays in how, why, or even when they may access services such as vaccines.
Understanding the history of racism in medicine and how it may influence the care people receive, specifically around vaccines is vital for respectful and productive conversations.35
Home visitors have the opportunity to engage with families, gather a shared understanding of the family's acceptance of vaccines, and offer information and support in accessing health care and vaccines.
By using a health equity lens to address such barriers, we uplift our focus on families to be protected from vaccine-preventable disease. For more information regarding Using a Health Equity Lens, visit the CDC.36
