Launch of vaccines featuring states with questions about race and access

Blacks and Latin Americans were killed by the coronavirus at more than twice the rate of white residents. Now, states are committing themselves to ensuring that the most affected minority groups have equal – or, in some cases, prioritized – access to the vaccine.

But as the first doses of the Pfizer and Moderna vaccines are being administered across the country, states are still struggling to know how and when the vaccine will be made available to affected communities.

Some states say they are focused on outreach, hoping to ensure that people of color are not left behind while the vaccine is distributed more widely.

North Carolina hired an advertising company to conduct outreach activities for black and Latino communities. New York has assembled a task force made up of clergy, health officials and civil rights defenders to assist in the process, for example, by ensuring that materials needed for effective implementation – such as cleaning products and syringes – reach low-income people. areas.

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Other states are taking a step further, saying that groups most affected by the virus should have faster access to the vaccine.

Colorado wrote an acknowledgment of systemic racism in its vaccination plan – although officials have yet to say exactly what measures the state can take in response. The California plan lists racial and ethnic minority groups among the “critical population” who could receive the vaccine before other groups.

States should focus the first rounds of the vaccine on those most at risk, said Georges Benjamin, executive director of the American Public Health Association. That would include minority groups, he said, although he advises against allowing anyone to have access to the vaccine earlier on the basis of race alone.

Instead, he said, those most at risk – such as people with pre-existing illnesses or living in multigenerational families – should get the vaccine earlier; in practice, this would benefit racial minorities, who are overrepresented in these groups.

“You have to be sensitive to race – you need to make sure you don’t leave out people who may be at greatest risk,” said Dr. Benjamin.

STATES SPENDED MORE THAN $ 7B ON VIRUS SUPPLY COMPETITION BEFORE

The first challenge, officials in several states said, will simply be to bring information about the vaccine to minority groups, including those who do not speak English. Blacks, Latinos and Native Americans receive flu vaccines at lower rates than whites or Asians, according to a report by the Centers for Disease Control and Prevention, in part because they are more likely to be uninsured.

Coronavirus vaccines will be free, regardless of whether someone is insured. But a history of discrimination made some minorities afraid to be the first to understand it. In a famous case, the United States Public Health Service conducted a study of the effects of untreated syphilis on black men in Alabama from the 1930s. Even after a cure for the disease was discovered, men were not treated.

A study by the Kaiser Family Foundation in August and September found that about half of black Americans said they probably or definitely would not like to receive the vaccine, even if scientists determined it was safe. Most whites and Hispanics interviewed said they would accept.

“We have a significant problem in communities of color where people are reluctant to get vaccinated because of historical issues left behind in terms of experimentation,” said Yves Duroseau, president of emergency medicine at Lenox Hill Hospital-Northwell Health in Manhattan.

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Dr. Duroseau is now part of the campaign to overcome this skepticism. Last week, he and another New York health care worker, both black, received the first doses of the vaccine in the state during press events. Major state hospitals are developing vaccination plans, which will include partnerships with community organizations to ensure outreach to communities of color, said Governor Andrew Cuomo. The plans are pending state approval.

Cuomo said on Monday that the state would also transform containers into “community vaccination kits” with all the equipment needed to distribute vaccines. They could be deployed in community centers, churches or public housing projects, he said.

In the meantime, North Carolina is working with leaders in black and Latin communities – including social media influencers and church pastors – to spread the word that the vaccine is safe and available.

“It’s about building trust,” said Goldie Byrd, director of the Maya Angelou Center for Health Equity at Wake Forest University, which co-chaired the North Carolina Vaccine Advisory Committee. “In some cases, we are encouraging these influencers to be seen taking the vaccine … to ensure that people feel that the vaccine is safe.”

On Sunday, the CDC released guidelines for phases 1b and 1c of the vaccine launch, which would give priority to the elderly; those with pre-existing high-risk medical conditions; and non-essential health workers, including store clerks and grocery teachers.

While the CDC’s guidance is not binding, officials in several states have said that this type of prioritization would benefit racial minorities without explicitly taking race into account. Racial minorities are overrepresented among essential workers and people with pre-existing illnesses, which means that minorities would disproportionately benefit from vaccinating these groups earlier.

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In California, some officials are promoting more ambitious goals to bring the vaccine to black and Latino communities.

Richard Pan, a physician and state senator from Sacramento, said communities most affected by the virus should be vaccinated earlier. “You could go to a neighborhood and give priority to delivering the vaccine in certain postal codes or census sectors where we know that there are high percentages of people who are essential workers,” said Democrat Pan. “In the end, it really helps all of us . If rates fall there, it is less likely to spread from your communities to other communities ”.

Nadine Burke Harris, a surgeon general in California, said the vaccine would not involve preferential treatment by race, “where it is as if you are that racial group, you are first in line.” But she said the state is studying how it can use “equality metrics” to help determine who will have access to the vaccine and when. California has already linked the reopening in larger counties to Covid-19 case numbers and positivity rates in the most disadvantaged census sectors.

Noting that blacks, Latinos and Californian natives died at higher rates than whites, Dr. Burke Harris said, “We are absolutely considering the risk of death … when we think of vaccine distribution.”