Black Americans are receiving Covid vaccines at dramatically lower rates than white Americans in the first few weeks of the chaotic launch, according to a new analysis.
About 3% of Americans have received at least one dose of the coronavirus vaccine so far. But in 16 states that released data by race, white residents are being vaccinated at significantly higher rates than black residents, according to the analysis – in many cases two to three times more.
Incorporation of KHN
In the most dramatic case, 1.2% of Pennsylvania whites had been vaccinated by January 14, compared with 0.3% of Pennsylvania blacks.
The vast majority of the initial round of vaccines went to health professionals and teams on the front lines of the pandemic – a workforce that is typically racially diverse, made up of doctors, hospital cafeteria workers, nurses and janitorial staff.
If the launch was reaching people of all races equally, the share of vaccinated people whose race is known should vaguely align with the demographics of health professionals. But in all states, black Americans were significantly underrepresented among those vaccinated until now.
Issues of access and mistrust rooted in structural racism seem to be the main factors that leave black health professionals behind in the nation’s quest for vaccination. The unbalanced absorption among what may 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 are dying from Covid at a rate almost three times that of white Americans, according to an analysis by the Center for Disease Control and Prevention. And black and Asian non-Hispanic healthcare professionals are more likely to contract Covid and die from it than whites. (Hispanics can represent any race or combination of races.)
“My concern now is if we don’t vaccinate the most at-risk population, we will see even more disproportionate deaths in black and brown communities,” said Dr. Fola May, a doctor at UCLA and a health equity researcher. “It breaks my heart.”
Dr. Taison Bell, a physician at the University of Virginia Health System who serves on the vaccination distribution committee, emphasized that hesitation among some blacks about getting vaccinated is not monolithic. The nurses he spoke to were concerned that it could harm his fertility, while a black co-worker asked him about the safety of the Modern vaccine, as it was the first such product on the market. Some have suggested conspiracy theories, while other black coworkers just wanted to talk to someone they trusted like Bell, who is also black.
But access problems persist, even in hospital systems. Bell was horrified to find that members of the environmental services – the janitorial staff – had no access to the hospital’s e-mail. The vaccine registration information sent to the hospital staff did not reach 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 – nobody thought about that.”
A spokesman for UVA Health, Eric Swenson, said that some members of the janitorial team were the first to receive the vaccines and that authorities have taken additional steps to contact those who are not usually emailed. According to him, more than 50% of the environmental services team has been vaccinated so far.
Like the public health commissioner in Columbus, Ohio, and a black doctor, Dr. Mysheika Roberts has a test for any new doctor she seeks: she makes a point of not telling them that she is a doctor. Then, she sees if she was treated with dignity or hit.
This is the level of distrust she says public health officials must overcome to vaccinate black Americans – which is rooted in generations of abuse and the legacy of the infamous study of syphilis in Tuskegee 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 be vaccinated because of what Minister Louis Farrakhan calls a “tricky experimentation story”. The group, classified as a hate group by the Southern Poverty Law Center, is known for spreading conspiracy theories.
Public health messages have been slow to stop the spread of misinformation about the vaccine on social networks. The choice of the name for the development of the vaccine, “Operation Warp Speed”, did not help; left many feeling that everything was done very quickly.
Benjamin noted that while the nonprofit advertising board raised more than $ 37 million for a marketing campaign to encourage Americans to get vaccinated, a government health and human services government advertising campaign never materialized after be considered too political during an election year.
“We were late to start the planning process,” said Benjamin. “We should have started in April and May.”
And the experts are clear: it shouldn’t just be ads for famous athletes or celebrities receiving the photos.
“We have to dig deep, follow the old path with pamphlets, neighbors talking to neighbors, with pastors talking to members of their churches,” said Roberts.
Speed v andquality
Mississippi state health officer Dr. Thomas Dobbs said the move announced by the Trump administration to reward states that deliver vaccines quickly with more injections makes the launch a “Darwinian process”.
Dobbs worries that black populations who may need more time for outreach are left behind. Only 18% of those vaccinated in Mississippi so far are black, in a state that is 38% black.
It may be faster to administer 100 vaccines at a drive-thru site than at a rural clinic, but that does not guarantee equal access, said Dobbs.
“Those with the time, computer systems and transportation will get more vaccines than other people – that’s the reality,” said Dobbs.
In Washington DC, a digital divide is already evident, said Dr. Jessica Boyd, medical director of Unity Health Care, which runs several community health centers. After the city opened vaccination appointments for people aged 65 and over, vacancies ran out in a day. And Boyd’s team couldn’t get eligible patients into the system that fast. Most of these patients do not have easy access to the internet or need technical assistance.
“If we’re going to solve the inequality problems, we need to think differently,” said Boyd.
Dr. Marcus Plescia, medical director of the Association of State and Territory Health Officials, said that limited vaccine supply should also be considered.
“We are missing out on equity,” he said. “If we don’t go back and fix it, it will get worse.”
Although Plescia is excited by Joe Biden’s promise to administer 100 million doses in 100 days, he fears that the Biden government 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 racial data, Missouri did so on request and eight other states refused or did not respond. Several do not report vaccination numbers separately for Native Americans and other groups, and some do not provide racial data for many of those vaccinated. The CDC plans to add race and ethnicity data to its public panel, but a CDC spokeswoman, Kristen Nordlund, said she could not give a timetable for when.
Historical Hesitation
A third of black adults in the United States said they do not plan to get vaccinated, citing the vaccine’s novelty and fears about safety as the main obstacles, according to a December KFF survey. (KHN is an editorial program independent of KFF.) Half of them said they were concerned about 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 space on social media.
Just over half of black Americans planning to get the vaccine said they would wait to see how it works on other people before taking it themselves, compared with 36% of white Americans. This hesitation can be found even in the health workforce.
“We shouldn’t assume that just because someone works in healthcare, that person will somehow have better information or better understanding,” said Bell.
Willy Nuyens saw many of his environmental service colleagues at the Kaiser Permanente Los Angeles medical center lose family to Covid. He took the chance to get the vaccine and has encouraged them to do the same.
In Colorado, black workers at Centura Health were 44% less likely to receive the vaccine than their white colleagues. Latino workers were 22% less likely. The hospital system of more than 21,000 employees is developing messaging campaigns to bridge the gap.
“To reach the people we really want to reach, we have to do things differently, we cannot just offer the vaccine,” said Dr. Ozzie Grenardo, senior vice president and director of diversity and inclusion at Centura. “We have to go deeper and provide more depth to resources and whoever is delivering the message.”
This requires time and personal connections. It takes people of all ethnicities within these communities, like Willy Nuyens.
Nuyens, who identifies himself as Hispanic, has worked for the Kaiser Permanente Los Angeles medical center for 33 years. Working on the environmental services team, he is now cleaning Covid’s patient rooms. (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 saw many of his co-workers lose their families to the disease. He took the chance to get the vaccine, but was surprised to hear that only 20% of his department of 315 people was doing the same.
Then he started to work persuading his co-workers, assuring them that the vaccine would protect them and their families, would not kill them.
“I take two employees, encourage them and ask them to encourage two more each,” he said.
So far, absorption in your department has more than doubled to 45%. He expects to reach more than 70% soon.
KHN (Kaiser Health News) is a non-profit news service that covers health issues. It is an independent KFF (Kaiser Family Foundation) editorial program that is not affiliated with Kaiser Permanente.