Black Americans are less likely than white Americans to say they plan to get a flu vaccine this year, and significantly less likely to say they'll take a first-generation coronavirus vaccine, according to numbers from the latest edition of the Axios-Ipsos Coronavirus Index.

Why it matters: Black Americans have suffered disproportionately from COVID-19, which means they also stand to benefit from a successful vaccine. But a legacy of medical mistreatment, systematic racism in health care and targeted efforts by anti-vaxxers means that a wide trust gap needs to be closed first.

Details: 49% of Black Americans say they are somewhat or very likely to get a flu shot this year, compared 65% of white Americans and 60% of Hispanics.

• That gap is significantly larger when it comes to willingness to take a first-generation COVID-19 vaccine. Just 28% of Black Americans say they would be willing to do so, compared to 51% of white Americans and 56% of Hispanics.
• Altogether, 62% of those surveyed say they are somewhat or very likely to get a flu shot, while 48% say they'll take a first-generation COVID-19 vaccine.

How it works: Experts say that Black Americans' vaccine reluctance is due largely to racism, both past and present.

• During the 1930s, hundreds of Black men were recruited into what became known as the Tuskegee Syphilis Experiment, where doctors permitted the disease to progress without treatment.
• A 2016 study indicated that Black patients were routinely under-treated for pain compared to whites, in part because many white doctors believed in inaccurate differences between races, including the erroneous idea that Black patients have less sensitive nerve endings.
• Just 5% of active physicians identify as Black, compared to more than 13% of the total U.S. population.
• "History absolutely plays a role as to why communities of color are hesitant to get the vaccine," says Patrice Harris, the former head of the American Medical Association. "We need to earn their trust."

Context: Anti-vaxxers have alsobegun specifically targeting Black communities and Black Lives Matter events in an effort to spread misinformation about vaccine safety.

• "That predominantly white, privileged group of people has finally figured out that there is another group of people with real, legitimate grievances against public health and health care," says Joe Smyser, the CEO of the Public Goods Project. "And they can exploit that for their own cause."

The bottom line: Black Americans desperately need an effective coronavirus vaccine, but if the medical establishment is going to close the gap in trust, it needs to engage to directly engage with the Black community before a vaccine is made available.

Methodology: This Axios/Ipsos Poll was conducted August 21-24 by Ipsos’ KnowledgePanel®. This poll is based on a nationally representative probability sample of 1,084 general population adults age 18 or older.

• The margin of sampling error is +/- 3.3 percentage points at the 95% confidence level.