In this study, data shows in the State of Louisiana, Blacks make up 32 percent of the population, 34 percent of COVID cases, 39 percent of COVID-related deaths yet only 13 percent of the recipients in the state who have received the vaccine.
As of Feb. 10, 2021, according to the Centers for Disease Control and Prevention (CDC) COVID Data Tracker, over 43 million vaccines had been administered thus far in the United States. According to American Public Media, when adjusted for age, Black Americans are 2.1times more likely to die of coronavirus compared to White Americans. These sobering statistics are borne out repeatedly in numerous epidemiologic reports. To further compound this inequity, Blacks who are disproportionately affected by the virus, are hit with another obstacle: they now face barriers to obtaining the vaccine which research has shown can reduce hospitalizations and deaths.
Multiple public health data reports and analyses show that Black Americas are still far behind their white counterparts in receiving the coronavirus vaccine relative to their percentage of the population. Public health advocates have been sounding the alarm regarding disparities in vaccination coverage among Black Americans and other communities of color. Even when health policy advocates have attempted to target communities of color to receive the vaccine, it has been demonstrated in some instances that the wealthy have benefited from receiving this coveted vaccine allocated for poorer neighborhoods.
Anticipating the need to focus on health equity related to the current pandemic, the Biden-Harris Administration assembled a COVID-19 Health Equity Task Force and on January 20, 2021, the Biden-Harris Administration issued an Executive Order ensuring an equitable pandemic response and recovery. One of the many goals of this Executive Order is to mitigate health inequities causes by the COVID-19 pandemic. Unfortunately, one of the barriers to ensuring equitable distribution of the vaccine inequity is the lack of data regarding race/ethnicity of vaccine recipients. Without sufficient robust data, policymakers cannot have accurate information on the percentage of Blacks and other communities of color who have actually received the vaccine. As Dr. Marcella Nunez-Smith, chair of the Biden-Harris Administration’s COVID-19 Health Equity Task Force, stated during a Kaiser Family Foundation (KFF) briefing regarding the lack of health data related to race/ethnicity: “We cannot address what we cannot see. We are making a choice every time we allow poor-quality data to hinder our ability to intervene on racial and ethnic inequities.”
Moreover, there are only a fraction of states that collect and report race/ethnicity health related data. A recent study by the KFF revealed that in only 23 states where race and ethnicity demographics were available, there was a consistent pattern of Black and Hispanic people receiving smaller shares of vaccinations compared to their shares of cases and deaths and compared to their shares of the total population. For example, in this study, data shows in the State of Louisiana, Blacks make up 32 percent of the population, 34 percent of COVID cases, 39 percent of COVID-related deaths yet only 13 percent of the recipients in the state who have received the vaccine.
In an effort to curtail some of this inequity, on February 9, 2021, the White House announced plans to directly ship vaccines to local community health centers to reach the most vulnerable communities in need of this vaccine. Although the government has indicated that the COVID-19 vaccine will be made available at no cost, it will be important for people to know how they can access it for free in order to decrease concerns related to cost particularly for people who are uninsured.
Some states have made equity a guiding principle or focus of their pandemic response to coronavirus. Many health policy advocates have applauded Governor John Bel Edward’s effort in April 2020 to launch the Louisiana COVID-19 Health Equity Task Force. Despite this, there still exists a myriad of factors contributing to vaccine inequity in our state and throughout the nation, such as:
• Continued vaccine hesitancy or mistrust of the health system within the Black community and other communities of color
• Historical layers of inequity to access healthcare within our nation that subsequently renders many without access to the vaccine
• Lack of broadband internet and WIFI access to make online appointments in jurisdictions that require residents to make online appointments to receive the vaccine
• Work schedules without flexibility or paid time off to allow persons to obtain the vaccine during the limited designated hours that the vaccine is administered
• Lack of health data regarding race makes it difficult to track which racial groups have actually received the vaccine—which in turn provides a challenge for health policy experts to accurately quantify the racial inequities in vaccine administration
• Lack of transportation and other societal factors affecting access
Here are some proposed solutions to the vaccine inequity to ensure everyone who wants the vaccine obtains the vaccine:
• State and local governments can illicit the help of trusted local community groups and leaders with shared backgrounds and experiences to conduct outreach efforts and provide information on the protective benefits of the vaccine to decrease vaccine hesitancy
• Bring the vaccine to these vulnerable communities. State and local leaders should utilize trusted community sites such as churches and schools and implement the use of mobile vaccination units with flexible hours of vaccine administration in both urban and rural communities.
• The federal government could partner with states and deploy its US Public Health Service Corps Ready Reserve Units to administer the vaccines in these mobile vaccination units and in other areas where their assistance is needed
• State and local governments can work with local leaders and organizations to identify individuals and groups who are at risk of not receiving the vaccine—homebound, elderly, homeless, uninsured, etc.
• Each state and local municipality should have policies or goals that focus on eliminating vaccine inequity
• Use of the CDC’s Social Vulnerability Index (SVI) by local public health officials and policy makers to target vulnerable communities that have the greatest need for resources and assistance during public health outbreaks, pandemics, or other health emergencies.
This global pandemic has further exacerbated and exposed the layers of inequity and health disparities that previously existed throughout the U.S. healthcare system. If we want to further decrease the toll that this pandemic has on communities of color and our nation as a whole, then prioritizing vaccine equity should be a focus for all health policy leaders, community activists, and stakeholders.
Constance M. Gistand, MD, MPH, FACP
Adjunct Assistant Professor of Clinical Medicine
LSU School of Medicine