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Black Americans are receiving Covid vaccinations at significantly lower rates than white Americans in the first few weeks of the chaotic deployment, according to a new analysis from Kaiser Health News.
So far, about 3% of Americans have received at least one dose of a coronavirus vaccine. But in 16 states that have published data by race, white residents are vaccinated at significantly higher rates than black residents, according to the analysis – in many cases two to three times higher.
In the most dramatic case, 1.2% of white Pennsylvanians had been vaccinated by January 14, compared with 0.3% of black Pennsylvanians.
The vast majority of the first round of vaccines went to healthcare workers and frontline staff of the pandemic – a distinctly racial workforce made up of doctors, hospital cafeteria workers, nurses and others. housekeeping staff.
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If the rollout were to reach people of all races equally, the shares of vaccinated people of known race should vaguely align with the demographics of health workers. But in all states, black Americans have been significantly under-represented among those vaccinated so far.
Access issues and mistrust rooted in structural racism appear to be the main factors that have left black healthcare workers behind in their quest to immunize the nation. The unbalanced adoption among what might appear to be a relatively easy-to-vaccinate workforce does not bode well for the rest of the country’s dispersed population.
Blacks, Hispanics and Native Americans die from Covid at nearly three times the rate of White Americans, according to an analysis by the Centers for Disease Control and Prevention. And black and Asian non-Hispanic healthcare workers are more likely to contract and die from Covid than white workers. (Hispanics can be of any race.)
“My concern now is that if we don’t vaccinate the highest risk population, we’re going to see even more disproportionate deaths in black and brown communities,” said Dr. Fola May, UCLA physician and equity researcher. in health. “It breaks my heart.”
Dr Taison Bell, a University of Virginia health system physician who sits on the immunization distribution committee, pointed out that some blacks’ reluctance to get vaccinated is not monolithic. Nurses he spoke to feared it could harm their fertility, while a black colleague asked him about the safety of the Moderna vaccine, as it was the company’s first product to hit the market . Some pitched conspiracy theories, while other black colleagues just wanted to talk to someone they trusted like Bell, who is also black.
We have to dig deep, go the old-fashioned way with flyers, with neighbors talking to neighbors, with pastors talking to their church members.
But access problems persist, even in hospital systems. Bell was horrified to discover that members of environmental services – housekeeping staff – did not have access to the hospital email. The vaccine registration information sent to the hospital staff was not reaching them.
“This is what structural racism looks like,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “These groups were seen and not heard – no one thought about them.”
UVA Health spokesperson Eric Swenson said some members of the concierge team were among the first to get vaccinated and authorities have taken additional steps to reach those who are not usually by mail. electronic. He said more than 50 percent of the environmental services team had been vaccinated so far.
A failure of the federal response
As the Columbus, Ohio public health commissioner and black doctor, Dr. Mysheika Roberts has a test for any new doctor she sees for care: she makes a point of not telling them she is. doctor. Then she sees if she has spoken or treated with dignity.
This is the level of mistrust she says public health officials must overcome to vaccinate black Americans – a mistrust rooted in generations of abuse and the legacy of Tuskegee’s infamous syphilis study and the experience of Henrietta Lacks.
A high-profile black religious group, the Nation of Islam, for example, is urging its members through its website not to get vaccinated because of what Minister Louis Farrakhan calls “the treacherous story of experimentation.” The group, classified as a hate group by the Southern Poverty Law Center, is well known for spreading conspiracy theories.
Public health messages have been slow to stop the spread of misinformation about the vaccine on social media. The name choice for vaccine development, “Operation Warp Speed,” did not help; it left many feeling that it was all done too quickly.
Benjamin noted that while the nonprofit Advertising Council raised more than $ 37 million for a marketing campaign to encourage Americans to get vaccinated, a government advertising campaign from the Department of Health and Human Services never materialized after being criticized as too political during an election year.
“We were late to start the planning process,” Benjamin said. “We should have started this in April and May.”
And the experts are clear: it shouldn’t just be commercials of famous athletes or celebrities having their picture taken.
“We have to dig deep, go the old-fashioned way with flyers, with neighbors talking to neighbors, with pastors talking to their church members,” Roberts said.
Speed vs fairness
Mississippi state health official Dr Thomas Dobbs said the change announced Tuesday by the Trump administration to reward states that quickly distribute vaccines with more vaccines makes the rollout a “Darwinian process.”
Dobbs fears that black populations who may need more time for awareness will be left behind. So far, only 18% of those vaccinated in Mississippi are black, in a state that is 38% black.
It might be faster to give 100 vaccines in a drive-thru than in a rural clinic, but that doesn’t guarantee equitable access, Dobbs said.
“Those with the time, the computer systems, and the transportation are going to get more vaccines than others – that’s just the reality,” Dobbs said.
In Washington, DC, a digital divide is already evident, said Dr Jessica Boyd, chief medical officer of Unity Health Care, which operates several community health centers. After the city opened vaccine appointments to people 65 and over, the time slots were gone in a day. And Boyd’s staff couldn’t get eligible patients into the system as quickly. Most of these patients do not have easy access to the Internet or need technical assistance.
“If we are to solve inequity issues, we have to think differently,” Boyd said.
Dr Marcus Plescia, chief medical officer of the Association of State and Territory Health Officials, said the limited supply of vaccines should also be considered.
“We are missing the boat on equity,” he said. “If we don’t back down and fix this problem, things will get worse.”
While Plescia is encouraged by President-elect Joe Biden’s willingness to increase the speed of deployment by promising to deliver 100 million doses in 100 days, he fears the Biden administration may fall into the same trap.
And the lack of public data makes it difficult to detect these racial inequalities in real time. Fifteen states publicly provided race data, Missouri did so on request, and eight other states declined or did not respond. Many do not report vaccination numbers separately for Native Americans and other groups, and some lack race data for many of those vaccinated. The CDC plans to add data on race and ethnicity to its public dashboard, but CDC spokesperson Kristen Nordlund said it couldn’t give a timeline for when.
Historical hesitation
One-third of black adults in the United States said they did not plan to be vaccinated, citing the novelty of the vaccine and fears about safety as the main deterrents, according to a December poll by the KFF. (KHN is an editorially independent program of KFF.) Half of them said they feared getting Covid from the vaccine itself, which is not possible.
Experts say this type of misinformation is a growing problem. Inaccurate conspiracy theories that vaccines contain government tracking chips have gained traction on social media.
Just over half of black Americans who plan to get the vaccine said they would wait and see how well it works in others before getting it themselves, compared to 36% of white Americans. This reluctance is found even among health workers.
“We shouldn’t assume that just because a person works in the healthcare industry they will somehow have better information or better understanding,” Bell said.
In Colorado, black workers at Centura Health were 44% less likely to get the vaccine than their white counterparts. Latin American workers were 22% less likely. The hospital system of more than 21,000 workers is developing courier campaigns to close the gap.
“To reach the people we really want to reach we have to do things differently, we can’t just offer the vaccine,” said Dr Ozzie Grenardo, senior vice president and director of diversity and inclusion at Centura. “We need to go further and provide more depth to the resources and to who is carrying the message.”
It takes time and personal relationships. You need people of all ethnicities in these communities, like Willy Nuyens.
Nuyens, who identifies as Hispanic, has worked for Kaiser Permanente Los Angeles Medical Center for 33 years. Working as part of the environmental services staff, he now cleans the rooms of Covid patients. (KHN is not affiliated with Kaiser Permanente.)
In Los Angeles County, 92% of health workers and first responders who died from Covid were not white. Nuyens has seen too many of his colleagues lose their families to illness. He jumped at the chance to get the shot but was surprised to hear that only 20% of his service of 315 were doing the same.
So he set to work to persuade his colleagues, reassuring them that the vaccine would protect them and their families, not kill them.
“I take two employees, I encourage them and I ask them to encourage two more each,” he says.
So far, participation in his department has more than doubled to 45%. He hopes it will soon be over 70%.
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