The Historical Impact of the Tuskegee Syphilis Study on Modern Vaccination Efforts

Ever since the “Tuskegee Study of Untreated Syphilis in the Negro Male” was uncovered by the Associated Press, the study has become a go-to point in history for people who are skeptical or oppose scientific research. Skeptics of academic and scientific institutions are justified if one looks at the study in a vacuum and without historical context. The study started in 1932, before the era of antibiotics, and continued into 1972. But what was the study about? And how does it influence modern vaccination efforts?

The Study

The study was conducted by the United States Public Health Service (USPHS) in association with the Tuskegee Institute in Macon, Alabama. The goal of the study was to observe the natural progress of syphilis to better understand it. In an era where laws and regulations for the protection of human subjects did not exist, researchers failed to fully inform the men participating in the study of all of the study’s aims. Worse yet, they failed to fully inform the men on how to avoid syphilis altogether. By this time, it was well-established that disease was communicable, that it was caused by bacteria, and that it was avoidable.

Even with the advent of penicillin in the 1940s, the researchers failed to provide appropriate therapy to the participants. According to reports, men in the study were discouraged from seeking help for the disease. For thirty more years after penicillin, researchers continued the study, observing men go through the different phases of syphilis, often with bad outcomes. By the time the study was ended, there were no criminal indictments of any of the researchers or their staff. Only a $9 million settlement was obtained by the surviving men in the study, and President Bill Clinton formally apologized for the study in the 1990s.

The Echoes of the Study

Today, many People of Color point to the study as an example of how “the government” can use and abuse citizens for scientific research. One misconception that continues to thrive is that the researchers infected the men on purpose in order to watch them die. That was not the case. The men acquired syphilis and were observed, treatment was withheld, and they were discouraged from seeking treatment elsewhere. The men in the study were not fully informed.

A study like the Tuskegee syphilis study would likely not be done today because of all of the safeguards put into place in the last 50 years, especially after the Nazi war crimes in human experimentation were discovered. Federal and state laws for the protection of human subjects have been adopted. Academic and scientific research institutions, and pharmaceutical companies, are all heavily regulated and often include members of the public in their review boards of all studies.

Nevertheless, the Tuskegee syphilis study has become a talking point for people skeptical of the COVID-19 vaccines. That has not stopped efforts to vaccinate people in that part of the country. As NPR reported:

“In the broader community, elected officials in Tuskegee have also posted videos getting shots, and some residents say they’ve gotten letters from the presidents of historically Black universities encouraging inoculation.
“It’s the biggest PR project to get Black people to take that vaccine,” says Lucenia Williams Dunn, a former mayor of Tuskegee who now runs a local community development organization. She’s 77 years old and has high blood pressure, but she’s not convinced to get the vaccine.
Even though she’s been watching the pandemic’s devastating and disproportionate impact on African Americans, she still questions the rapid development of the vaccine. And then, there’s the history.
“You cannot separate the experience of the past with what we believe in the present,” Dunn says. “People say, ‘well, you know, y’all ought not be worried about that syphilis study.’ Yeah, we do, because it’s part of our experience.””

Outreach and Conversations

One big outreach push is from the Ad Council, and it includes this mini-documentary on the Tuskegee study which showcases survivors and their descendants talking about the study and the need for vaccines in the modern era:

When talking about vaccines — especially with African Americans — it is important to put all the facts in historical perspective. Yes, there was abuse in the Tuskegee study, much of which has not been fully dealt with at a societal level. Yes, there were scientists who were lacking in their ethics and morals, and may have even committed crimes in how they treated the subjects in the study. And, yes, People of Color have often been on the receiving end of inequity in healthcare.

Even if the Tuskegee Syphilis Study was not directly involved in the science and development of vaccines, the effects on the public image of science and researchers has had a tangible impact in the uptake of vaccination by the communities the study affected. Other similar studies conducted in developing nations around the world have had similar effects on populations who trace their roots to those countries. It is therefore necessary to put these historical events in context and explain exactly what happened, and what — if anything — has changed since then.

Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: Feel free to follow me on Twitter: @EpiRen