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PORTLAND, Ore. (AP) – The role that race should play in deciding the priority of the COVID-19 vaccine was put to the test Thursday in Oregon, but people of color will not be the focus of the ‘attention in the next phase of state deployment as tensions around equity and access gunshots are emerging nationwide.
An advisory committee making recommendations to Governor Kate Brown and public health officials discussed whether to prioritize racial minorities, but decided to choose a wide range of other groups: those under 65 suffering chronic diseases, essential workers, inmates and people living in groups.
The 27-member panel from Oregon, a Democratic-led and predominantly white state, said people of color were likely to be from other priority groups and expressed concerns about legal issues if race was at the center of the issue. ‘Warning. Its recommendations are not binding but offer key advice on vaccine distribution.
The committee was formed with the goal of keeping equity at the heart of vaccine deployment in Oregon. Its members have been chosen to include racial minorities and ethnic groups, from Somali refugees to indigenous peoples.
“Our system is not yet ready to focus and reveal the truth about structural racism and how it unfolds,” said Kelly Gonzales, Cherokee Nation of Oklahoma member and health disparities specialist on the committee.
The group included a statement in its plan recognizing the impact of structural racism and saying it had considered the needs of minority communities.
The virus has disproportionately affected people of color. Last week, the Biden administration reiterated the importance to include “social vulnerability” in state immunization plans – with race, ethnicity and rural-urban divide at the fore – and called on states to identify “pharmacy deserts” where it is will be difficult to receive gunfire.
Overall, 18 states included ways to measure equity in their original vaccine distribution plans last fall – and more likely have done so since the vaccines started arriving, Harald Schmidt said, a medical ethicist at the University of Pennsylvania who has extensively studied vaccine fairness.
Some, like Tennessee, have offered to set aside 5% of its allocation for “highly disadvantaged areas,” while states like Ohio plan to use social vulnerability factors to decide where to distribute the vaccine, he said. he declares. California has developed its own metrics to gauge a community’s level of need, and Oregon does the same.
“We told a fairly simple story: ‘The vaccines are here’. Now we need to tell a more complicated story, ”said Nancy Berlinger, who studies bioethics at the Hastings Center, a non-partisan and independent research institute located in Garrison, New York. “We need to think about all the different overlapping risk areas, rather than the group we belong to and our personal network.”
Attempts to address inequalities in access to vaccines have already provoked negative reactions in some places. Dallas officials recently reversed their decision to prioritize the most vulnerable zip codes – primarily communities of color – after Texas threatened to cut the city’s vaccine supply. This type of setback is likely to become more pronounced as states delve deeper into deployment and grapple with difficult questions about supply needs and scarcity.
To avoid legal challenges, almost all states that look at race and ethnicity in their immunization plans are turning to a tool called a “social vulnerability index” or “disadvantage index”. Such an index includes more than a dozen data points – ranging from income and education level to health outcomes and car ownership – to target disadvantaged populations without specifically citing race or ethnicity.
In doing so, the index includes many minority groups due to the impact of generations of systemic racism while picking up socio-economically disadvantaged people who are not people of color and avoiding “very, very tough and poisonous ”on the breed, Schmidt said.
“The point is not, ‘We want to make sure the Obama family gets the vaccine before the Clinton family.’ We do not care. They can both wait safely, ”he said. “We want the person who works in a meat packing plant in a crowded situation to receive it first. It is not a question of race, but of race and disadvantage.
In Oregon, health executives are working on a Social Vulnerability Index, including looking at U.S. Census data and then overlaying it on things like work status and income levels, Rachael Banks said, director of the public health division of the Oregon Health Authority.
This approach “goes beyond an individual perspective and more of a community perspective” and is better than asking one person to prove “how they fit into any demographic group,” he said. she declared.
This makes sense to Roberto Orellana, professor of social work at Portland State University, who has launched a program to train his students to find contacts in Hispanic communities. Data shows Hispanics have an approximately 300% higher risk of contracting COVID-19 than their white Oregon counterparts.
Orellana hopes that her students, who are interning in public agencies and organizations, can use their knowledge both for contact tracing and for vaccine promotion in migrant and farm worker communities. Vaccination of essential workers, prisoners and people in multigenerational households will reach people of color and put them at the heart of the immunization plan, he said.
“I don’t want to take myself away from any other group. This is a difficult and difficult question, and each group has valid needs and concerns. We shouldn’t be going through this, ”Orellana said. “We should have vaccines for everyone – but we’re not here.”
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Associated Press / Report for America Statehouse News Initiative, Body Member Sara Cline, contributed to this report. Follow Flaccus on Twitter at http://www.twitter.com/gflaccus.
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