The age-adjusted mortality rate from COVID-19 is more than three times higher for Black and Indigenous people than it is for white people and more than two times higher for Pacific Islanders and Latinos. By the end of April, 90 percent of predominantly Black communities were affected by COVID-19; by the end of June, 31 percent of Black Americans personally knew someone who had died of coronavirus. In this time of hyper-visible conversations around health equity and racial justice, a persistent question remains: As we move with unparalleled speed toward a COVID-19 vaccine, will Black and brown people be left behind? Both our history and our present have set us on a trajectory to fail to deliver a vaccine to communities that need it most, through a combination of scientific abuses, systematic exclusion from both research and clinical care, and structural barriers to access to even basic health care. The shadow cast by unethical human experimentation on communities of color is very long. From the unconscionable withholding of treatment from 600 men in the Tuskegee Syphilis trial to the exploitation of Henrietta Lacks in research, racism is built into the U.S. biomedical enterprise. And while these examples have become relatively well known, there are many others that have escaped the mainstream; further, racial inequities are not solely in our past. African Americans make up about 13 per of the U.S. population but on average make up 5 percent of clinical trial participants; Hispanic or Latinos make up approximately 18 percent of the population and only 1 percent of clinical trial participants.