For some, the only effective argument for a COVID vaccine is the death of a loved one

A man I didn’t know held out a shovel, seeking an interested taker, so I offered a hand. I stabbed the tool into the ground, scooped up a pile of dirt and rock, and dumped it onto my friend’s casket before the gusting East Bay winds had a chance to blow it off the spade.

I helped bury my good friend at a cemetery in Livermore in August after he lost a monthlong battle with the coronavirus, a victim of institutional mistrust and our pitiful acceptance of it as unsolvable. A lot of young and healthy people brush off COVID because it is less likely to kill them. Yet there I was, watching a young and healthy person’s coffin disappear into his grave, one scoop of dirt at a time.

My friend’s wife was one of my fiancee’s oldest friends, so our relationship started with grown-man playdates. We initially connected over soccer, poker and the misery of the Sacramento Kings. But we forged a tight bond independent of our better halves over late nights joking and talking about life. We partied on birthdays and traveled abroad together. When he and his wife suffered a brutal series of personal hardships, they leaned on us for support or a night out to escape.

The last time I saw him alive was on my back patio in April. I vaguely remember laughing about his stock portfolio and which cryptocurrencies we thought were the best get-rich-quick scheme. The one thing I know we didn’t talk about was his plan for getting vaccinated, because as it turned out, he never did.

He had been spending time with people who downplayed COVID and didn’t want to get vaccinated. Some would call them bad influences. I viewed them as traumatized immigrant outsiders.

They were mostly refugees of the Bosnian War of the early 1990s, which displaced 2.7 million people. Yugoslav-backed Serbian separatists murdered more than 8,000 Muslim men and boys and sexually assaulted thousands of women in a campaign of ethnic cleansing.

Barely one generation removed, I can understand why the Bosnian American community doesn’t trust the U.S. government, or any government for that matter.

Many Black Americans were also reluctant to get the COVID vaccine because of their own suspicions of government. The most commonly cited grounds were the despicable Tuskegee experiment, in which public health workers promised free medical care to Alabama sharecroppers with syphilis but instead gave them a placebo for decades, even after an effective treatment was adopted.

Discussions about such distrust peaked this year as the pandemic’s racially disparate 2020 death rates were supplanted by unequal vaccination rates. Talk of “equity” surged as public officials and community leaders tried to persuade nonwhite skeptics to get the jab.

By September, similar shares of white, Black and Latino adults had finally received at least one vaccine dose, according to the Kaiser Family Foundation. But journalists and experts had already developed a bad habit of citing institutional mistrust as a good reason for vulnerable communities and ethnic enclaves to shun vaccination. Rather than seizing on the pandemic as a chance to start reversing decades of inequitable health outcomes, the cause of the disparities was becoming an excuse to accept them.

Once my friend was hospitalized, everyone he knew who had scoffed at COVID suddenly woke up to the threat and got vaccinated. In the absence of stringent vaccine requirements across public life, a front-row seat to the consequences of hesitancy often serves as the most compelling argument for getting vaccinated.

I never imagined that my friend’s COVID case would end with bedside goodbyes at a hospital where his life was too briefly preserved by an orchestra of beeping machines. We swapped texts and snaps for a few weeks before his death, and my fiancee and I actually joked about how much grief we’d give him once he got out. Then the messages became shorter and infrequent. Then he stopped replying altogether.

Roughly 39 million Americans are unvaccinated, and many remain defiant as infections once again spike nationwide. Pandemic fatigue, complacency and even acceptance are spreading as fast as omicron.

Vaccination rates do rise when variants surge. Unfortunately, that may be because burying loved ones is one of the few things that can overcome deep institutional suspicions.

A previous version of this story misstated how the subjects of the Tuskegee experiment contracted syphilis.

This story was originally published December 29, 2021 at 5:00 AM.