Dr. John C. Cutler, U.S. Public Health Service (center)
For 40 years, the U.S. Public Health Service conducted a study of syphilitic men in Macon County, Ala., to track the disease’s natural arc without revealing the agency’s true intentions.
The massive rollout of the Covid-19 vaccines — meant to render protection against a staggeringly resilient virus — renewed interest in a notorious 40-year federal experiment of Black men in rural Alabama. The infamous study, conducted by the U.S. Public Health Service, came to embody the long history of medical mistreatment and exploitation of African Americans.
Beginning in the early 1930s, public health care workers withheld treatment for hundreds of unsuspecting men infected with syphilis in order to research the arc of the disease.
The toll: Men suffered. Men died. Some transmitted the disease to their wives and children. More than a generation passed before the trials ended in 1972, and only after a news report exposed the study. The exposure eventually resulted in medical research reforms, a presidential public apology and a financial settlement.
But the legacy of the study, initially called the “Tuskegee Study of Untreated Syphilis in the Negro Male,” has endured over the decades, and has sown generational distrust of medical institutions among many African Americans.
Conversations about the study grew amid the distribution of vaccines, sponsored by the government, that are intended to combat Covid-19. For months, Black Americans were far less likely than white Americans to be vaccinated, their hesitancy fueled by a powerful combination of general mistrust of the government and medical institutions, and misinformation over the safety and efficacy of the vaccines.
Again and again, the Tuskegee study was also cited as a reason for their reluctance.
But a wave of pro-vaccine campaigns and a surge of virus hospitalizations and deaths this summer, mostly among the unvaccinated and caused by the highly contagious Delta variant, have narrowed the gap, experts say. So, too, have the Food and Drug Administration’s full approval of a vaccine and new employer mandates.
How the racial gap was narrowed — after months of disappointing turnout and limited access — is a testament to decisions made in many states to send familiar faces to knock on doors and dispel myths about the vaccines’ effectiveness, provide internet access to make appointments and offer transportation to vaccine sites.
Honest conversations about what the Tuskegee study did, and who it harmed, also helped change minds and usher in a fuller, more humane look at the men affected by the research.
“They did not recognize, acknowledge or respect their humanity,” said Omar Neal, a former mayor of Tuskegee and radio show host who often publicly addresses vaccine hesitancy. He had three relatives in the study and wavered before finally getting a Covid-19 vaccine, his mind changed by the rising number of deaths. “They didn’t see them as fully human.”
One national campaign, “It’s Up to You” by the Ad Council and Covid Collaborative, includes a short-form documentary with powerful voices: descendants of the men in the trials. The documentary was designed to dispel lingering myths of the study and to encourage vaccinations in some of the communities hardest hit by a pandemic that has claimed more than 700,000 lives in the United States.
“We don’t want the horror of that study to be used as the reason why people do not get the vaccine to protect themselves,” said Amy Haggins Pack, 73, one of the descendants who appears in the documentary and whose great-uncle was in the study. “Our ancestors were denied treatment. This is the opposite. The vaccine is available for everyone. We want people to take it to protect themselves and others.”
The filmmaker Deborah Riley Draper traveled to Tuskegee, a small mostly Black city of about 8,000, to interview descendants for the documentary. She learned how full their memories were of the men as fathers, grandfathers, brothers and uncles.
“They were ministers and men who had business,” Ms. Draper said. “They weren’t just the singular picture in the singular narrative of these sharecroppers. They owned land. They had wonderfully rich lives. It was their humanity that was important to share — they weren’t just statistics.”
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