The omicron variant has brought COVID-19 vaccine inequality to the media forefront.  Soon after the pandemic began, experts encouraged richer nations to share the world’s finite vaccine supply with poorer nations.  Not only would unvaccinated populations be more vulnerable to the disease, but it would increase the risk of the virus mutating into a vaccine-resistant form that could devastate the world.

But wealthier nations hoarded vaccines anyway.

While many wealthier countries bought too many vaccines, billions around the world living in low- to middle-income countries, many of which are in Africa, have yet to receive one.  But vaccine inequality is not just about wealth; it is also about white supremacy.  Vaccine deserts are another result of colonialism (together with imperialism), and racism, which continue to intentionally perpetuate the oppression of Black populations worldwide.  But this time, white supremacy will harm white people, too.

Because although white people can discriminate, the rapidly spreading variant does not.

Access to vaccines has been an issue since the pandemic began, but vaccine inequality is largely talked about as a wealth issue—a poverty issue.  Black Americans are more likely to live in vaccine deserts, areas further from places like hospitals or clinics that offer vaccines, because they are poorer than white Americans.  When vaccines initially rolled out in the U.S., Black Americans were left behind with only 5% receiving vaccinations.  This was largely blamed on poverty, lack of healthcare access, and vaccine hesitancy.  Ironically, white Americans from richer neighborhoods gladly used their privilege to commute into these poorer, Black neighborhoods, inundating clinics to take vaccines for themselves.

Globally, only 6.6% are fully vaccinated in the entire continent of Africa.  Yet, South Africa, the country with the highest population of white people in Africa, has one of the top vaccination rates in Africa.  Although white South Africans have greater vaccine hesitancy than Black South Africans, they are more likely to be vaccinated than their Black peers, suggested to be the result of increased access to private clinics offering the vaccine.

But, discussing global wealth and vaccine distribution without mentioning European colonialism leaves out a large part of the story, but white people dominate public discourse, so perhaps the truth hurts.

Black Americans are on average poorer than white Americans because white supremacy designed it to be that way.  Centuries of racist laws were crafted to benefit white people at the expense of Black people, beginning with African enslavement, a jumpstart to generational wealth for European colonizers residing on stolen Indigenous lands renamed as America.  But, African countries continue to suffer from the downstream effects of colonialism, too, and some experts maintain that the economic oppression of Africa is linked to European exploitation and stealing of resources.  But colonialism was not just about accruing wealth, it was the birthplace of white supremacy.

The concept of race was created by the Portuguese in the 1400s to justify enslaving African people.  Whiteness was synonymous with superiority and civility, and Blackness with inferiority and deviance.  We learn about Jewish concentration camps during World War II, but we don’t learn that one of Germany’s first concentration camps was forged after their colonization and annihilation of the Herero people of modern-day Namibia.  We don’t learn that German geneticists performed heinous experiments on African people to prove their racial inferiority.

European colonialist experimentation reared its ugly head in COVID-19 discourse, too.  When vaccines were still under development, two French physicians sparked outrage when they suggested that African individuals be used as clinical trial subjects.  The French have a long history of medical experimentation on African people, so this statement opened wounds.

One example occurred from 1921 to 1956, when French colonial governments forced millions of Africans to test the efficacy of injected medications, which caused severe side effects such as gangrene, blindness, and death.

To be sure, participation in COVID-19 vaccine trials is a good thing, but not in the context of such statements.  Indeed, African countries along with other low to middle income resourced countries, did host COVID-19 vaccine trials.  Yet, these same African countries ended up receiving less vaccines than richer, whiter countries once they were deemed effective.

The hoarding of vaccines by wealthier, whiter countries and the consuming of Black vaccine resources by white Americans are classic moves from the white supremacy playbook.  The greed and entitlement of white supremacy results in the entire world being worse off, as vaccine deserts abound, and variants, like omicron, form and infiltrate wealthy and poor nations alike.  So, if we want to fix vaccine inequality and stem the spread of this disease, then we need to fix white supremacy.

Amanda J. Calhoun, MD, MPH (@amandajoymd) is an Adult/Child Psychiatry Resident at Yale Child Study Center/Yale School of Medicine.   Carmen Black, MD is an Assistant Professor in the Yale Department of Psychiatry at Yale School of Medicine.  Both are Op Ed Project Fellows at Yale University.