Courtney Thornton and Jennifer A. Reich
“Black and brown parents are actually being punished for not being able to afford vaccinations or free time to vaccinate their children on time. CPS (child protection services) intervene due to medical negligence and danger to children, but ytpipo (white people) deliberately choose not to vaccinate their children without any consequences.
This observation was offered by a black mother in an online forum to other black mothers who were worried about childhood vaccines. As the COVID-19 pandemic has shown, the success of public health campaigns, including those related to vaccines, depends on trust. However, as this mother and others like her point out, the state’s efforts to support public health do not necessarily respond to minority communities, such as white families, who question the need for vaccination.
Mothers who refuse to vaccinate their children or delay their vaccinations are more likely to be white, have a higher education (or at least graduate), are married, and have higher household incomes. These mothers describe their decisions to refuse vaccinations as a desire to feel good mothers who are actively making decisions about their children. These mothers perceive vaccines as a personal choice to improve the health of their children. They consider themselves experts of their children who can accept or reject medical advice as they see fit. This practice requires a lot of work and resources and is therefore valued by other mothers and society as a whole. However, white mothers are rarely afraid of state sanctions for the behavior of colored mothers.
Our findings are recent Gender and society The article provides insight into how black mothers who refuse vaccinations of their choice view the importance of their decision, including fears that this could lead to greater state oversight and sanctions. The majority of studies in black children who have not been fully vaccinated have focused on structural barriers to access to vaccines. These children, labeled ‘under-vaccinated’, are more likely to be colored children, have lower-income families, and have no higher education and are more likely to be single. Although structural barriers limit access to health care, the lack of focus on access may ignore the initiative of black mothers and how their decisions reflect negative experiences with health systems. To understand this issue, we analyzed the online discussions for and use of black mothers. We show that while black mothers have the same concerns about vaccines as whites, they find their decisions more risky because they lack the same privileges to protect whites from state oversight and punishment.
Medical racism in its various forms definitely depends on gender. Black women face discrimination, increased supervision of communication with health care providers, and inadequate care, leading to disproportionate illness and premature death. Black women also face gender-based racism in other social institutions that are interrelated in health care, including schools and welfare systems. This experience contributes to the low confidence of black women in public health systems. This often applies to their children and informs their daily parenting strategies.
The women in our study shared frequently cited concerns about the safety and effectiveness of the vaccine. However, unlike white mothers, they saw vaccines as a technology developed without regard for and sometimes against the interests of blacks. Citing unsubstantiated claims that black boys are experiencing severe autism after vaccination, one mother claimed
“It wasn’t us who created it, so so many of our black boys have autism because we react differently … We’ve left a holistic natural way of accepting Western Eurocentric ways at face value.
When black mothers decide to avoid vaccinating their children or delay vaccinating them, they face the state and its actors. The women who posted in these forums discussed how more privileged parents could avoid state oversight and prosecution in ways they could not. These concerns were often related to state laws that require proof of vaccination as a condition of access to schools or childcare facilities. Many mothers have acknowledged that some states are more permissive and allow non-medical exemptions from the vaccine requirements when attending school, but believe that these states can often be hostile to colored families. To illustrate this, one mother weighed the challenges of living in predominantly white areas and the promise to give up vaccinations without losing the opportunity for her children to attend school:
“However, I hear terrible things about Texas and the fact that I am black. Unfortunately, there are many more terrible conservative, racist, sexist politicians in the states / cities where [more] favorable vaccine options ’.
Lower Income Black mothers felt particularly vulnerable to the increased level of screening and loss of privacy they experienced when they were included in state aid programs. Because the Special Supplemental Nutrition Program for Women, Babies, and Children (WIC) is for children’s health, many states require up-to-date vaccine records and regular visits by children to reap the benefits. The women who posted the records worried that WIC staff would report them to CPS and worried about suspicions of medical negligence. They often strategized what information they would share with pediatricians, who often work with WIC case staff. As one mother warned: “Advice not to use government services. Don’t use WIC or prosperity as they will force you. Another mother confirmed the following concerns:
“I am participating in the WIC program. I stopped going because my WIC staff kept talking about my children’s checkups and vaccines. I told her a few times I wasn’t vaccinated.
Widespread stereotypes of black women affect all black mothers, regardless of their class, and force them to manage their interactions with public authorities, including health care, education, and welfare systems, to protect themselves and their children. Unlike white mothers, who are more likely to see doctors as service providers or counselors, the mothers in our study discussed pediatricians as potential threats to reporting their families to government agencies. CPS. Mothers cited this fear as the reason they felt distrust and alienation from health care systems. As one mother explained,
“I try to avoid CPS, so I check every year, lie about the status of vaccinations, etc … As soon as they start to suspect that I am saying delayed vaccinations, I found another doctor.
When black mothers found the freedoms of white mothers online, they drew attention to the ways in which inequality strongly shapes and limits their options, their choices. This study shows how race, class, and gender are inextricably linked to attitudes toward vaccines and the state in general. We don’t think vaccines are irrelevant. On the contrary, the effectiveness of public health campaigns depends on trust in leaders, scientists and medical professionals, as demonstrated by the COVID-19 pandemic. Structural gender-based racism in health care and in contact with the long arms of the state encourages mistrust among black mothers, which determines the medical decisions they make for themselves and their children. The result may be that programs to improve children’s health can actually hurt access for black families. A deeper understanding of these dynamics should help inform public health in color communities and require medical professionals to think more critically about their power as a state of development.
Courtney Thornton has a master’s degree in sociology from the University of Colorado at Denver. Her research interests include the impact of public policies and systems on the health and well-being of families and the intersecting impact of structural gender and racial oppression on the lives of black women.
Jennifer A. Reich is a professor of sociology at the University of Colorado at Denver. Her research examines how individuals and families weigh information and strategize their interactions with the state and service providers in the context of public policy, especially when it comes to health care and well-being. She is the author of Repairing Families: Parents, Power, and the Child Welfare System and Calling the Shots: Why Parents Reject Vaccines, and is the editor of Reproduction and Society (with Carole Joffe) and The Status of Families.
