America’s largest cities face racial inequalities in vaccine distribution

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And as the vaccine is rolled out across the country, these communities are being vaccinated at rates far lower than white Americans.

These inequalities are evident in some of the country’s largest metropolitan areas, where demand for vaccines far exceeds supply. While experts have raised concerns about vaccine reluctance among black and Hispanic adults, disparities in vaccination rates also indicate that appointments are not sufficiently accessible to underserved groups.

“As we look at how to ensure equity in immunizations, a set of key factors will be to ensure that all people can access vaccines regardless of their circumstances,” said Samantha Artiga, Equity Program Director race and health policy at the Kaiser Family Foundation. .

Artiga said increased demand can lead to a “first come, first served” system, creating an environment where those with internet access and a vehicle are more likely to be able to sign up for a vaccine.

CNN analysis of five of the largest metropolitan areas in the United States shows that while each faces city-specific challenges, all face supply shortages, difficult registration processes, and high dropout rates. disproportionately low vaccination among the groups hardest hit by the pandemic.

In Houston, distribution inequalities in predominantly Hispanic regions

The Covid-19 pandemic has disproportionately affected Hispanic residents of Harris County, but data released by Texas shows vaccination rates among the Hispanic population are lagging behind.

In Harris County, 44% of residents are Hispanic but accounted for 60% of new Covid-19 infections in the first week of February.

The disparity is also present in immunization rates – only 19% of vaccines in the county were given to Hispanic residents, while 43% went to white residents.

Only a small percentage of the county’s vaccine providers are predominantly Hispanic zip codes. There are fewer providers in rural areas, leading some Texans to travel long distances to get vaccinated. The whiter, wealthier areas of the county have a higher concentration of vendor locations.

The state recently announced that it will deploy several Covid-19 vaccination centers, including six in Harris County. At a press conference on Saturday, Houston Mayor Sylvester Turner criticized the lack of dose distribution to the county’s smaller clinics, many of which are located in under-vaccinated areas and may be easier to access. by public transport.

“Mass distribution sites are good for numbers, but when it comes to people who are disproportionately affected, they’re not good for fairness,” he said. City and state officials have since asked Gov. Greg Abbot to provide more vaccines to small health clinics and pharmacies.

Disproportionate number of white residents vaccinated in Chicago

The equitable distribution of vaccines in Chicago was one of the first concerns of health officials, who feared the city’s pharmaceutical deserts could worsen the disparate effects.

Hispanic residents account for the largest share of the city’s Covid-19 cases – 35%. And 38% of those who have died from the disease are blacks.

Distribution sites are clustered in predominantly white areas of the city and are more scattered in the southern and western sides of the city, where most residents are black or Hispanic. Despite the higher rates of Covid-19 infections for black and Hispanic Chicagoans, they received a total of 38% of vaccine doses, while white residents received almost half. The city’s population is 29% Hispanic, 30% black, and 33% white.

Chicago is also one of the few cities to release postal code vaccination data, revealing that far fewer residents received a dose of the vaccine on the city’s south and west sides than in predominantly white areas.

Their communities are deserted by pharmacies. Advocates fear this will lead to inequitable access to vaccines
These disparities have been evident from the first phase of the deployment, which focused on health workers, and became more pronounced as the vaccine became available to other essential workers and people over 65. . A shortage of doses and appointments caused confusion, an influx of fraudulent calls and led a Chicago doctor to liken the process of dispensing the immunization to “playing the Hunger Games.”

Lack of data in Atlanta creates challenges for accountability

Georgia’s public health department has not released county-level demographic data on cases or vaccinations. But statewide, black residents account for 25% of confirmed cases while constituting 33% of the population. There are fewer vaccination sites in the predominantly non-white areas of DeKalb and Fulton counties than in the predominantly white areas, and appointments have been difficult to secure.
Atlanta, which is 51% black, was identified as a particular concern for access to vaccines in a study by the University of Pittsburgh School of Pharmacy, which looked at areas of the country where black residents were. more likely than white residents to live longer. within a mile of the nearest vaccinator.

But the lack of available data makes it difficult to identify and correct disparities.

“Data limitations … limit the extent to which we are able to get a full picture of immunization equity,” Artiga said. “Data is essential for understanding the gaps and making an effort to fill those gaps.”

Confusion over availability in Los Angeles

Los Angeles County, the first U.S. county to report more than one million cases of Covid-19, released its first batch of vaccine demographics on Monday. The county entered a new phase of its vaccination program on Jan.20, which allows people 65 years of age and older to sign up for a vaccine.
While most of the county’s vaccination sites are in predominantly non-white areas, officials said only 7% of black seniors and 14% of Hispanic seniors received a first dose of the vaccine, despite the disproportionate rates. to which these communities have been affected by the pandemic.

Vaccination rates among other groups of seniors are higher – 17% of whites, 18% of Asian Americans, and 29% of native Hawaiians / Pacific Islanders received a first dose of the vaccine.

Barbara Ferrer, director of the county’s public health department, said in a Monday briefing that she was “alarmed” by the data and expressed the urgent need for better awareness.

“This early data shows us that we need to facilitate the vaccination of Native American, Black and Latin American residents and workers in their communities by trusted providers,” she said.

The county’s vaccination efforts have been hampered by confusing messages and an inconsistent amount of doses administered to the county each week, making it difficult to deliver the two-dose schedule that current vaccines require.

Public health officials have announced that the county-run sites will primarily administer second doses this week as they face a supply shortage, which has left many confused as to whether the first doses were. available on sites managed by the city. The messaging left the city-run vaccination site at Dodger Stadium with thousands of unused first-dose appointments available for seniors on Tuesday. But the next day, Los Angeles Mayor Eric Garcetti said city-run sites would be temporarily closed at the end of the week due to a lack of doses.

New York has fewer vaccination sites in hardest-hit areas

New York City has faced fierce criticism for its vaccine rollout, which campaigners and healthcare advocates have decried as ineffective and unfair.

The city has tried to increase the speed of vaccinations, including opening a large hub at Yankee Stadium, but some of its hardest hit areas still have the fewest vaccine distribution centers. Sites in these neighborhoods face the dilemma of who to vaccinate. A predominantly Hispanic Washington Heights site, which has the highest infection rate in Manhattan, was criticized last week for vaccinating large numbers of whites who came to the clinic from other neighborhoods.

Vaccination site to serve hard-hit Latino neighborhood in New York City instead served more whites in other areas

Staten Island and Queens, among the hardest hit boroughs, have 11 and 28 sites, respectively. Even in areas where a site is available, residents must navigate a complicated registration process requiring Wi-Fi access, email, and often a good measure of luck.

A path to equitable access

As state and local governments receive more doses of the vaccine, health officials and activists are sounding the alarm about the need for better planning and awareness in vulnerable communities.

Monica Spoch-Spana, senior researcher at the Johns Hopkins Center for Health Security, said that even if jurisdictions wait for more doses to arrive, they can plan how best to reach underserved areas. Spoch-Spana and other Johns Hopkins researchers released a report Tuesday highlighting how state and local governments can work with communities of color to ensure greater equity in vaccine distribution.

“There may be a shortage of products,” she said, “but there is no shortage in terms of opportunities to connect with organizations that have roots in these communities to jointly develop a delivery system that will work for these segments of society. . ”

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