How can racial equity in coronavirus vaccinations be achieved?

Mike Bebernes
·Senior Editor
·5 min read

“The 360” shows you diverse perspectives on the day’s top stories and debates.

What’s happening

People of color have experienced a disproportionate amount of suffering during the coronavirus pandemic in the United States. Black, Hispanic and Indigenous Americans make up an outsized share of COVID-19 cases and face substantially greater risk of hospitalization and death than white people when they do become infected.

But several weeks into the rollout of life-saving vaccines, white people are being vaccinated at a significantly higher rate than people of color, according to limited data from the states that share racial breakdowns of vaccine recipients. In some states, the vaccination rate for white people is double or even triple the rate for Black people. In New Jersey, for example 6 percent of the state’s white population had received at least one dose as of last week, compared to 1.7 percent of Black residents.

These disparities exist even though people of color make up more than 40 percent of health care workers and more than half of long-term care workers, two groups that have been prioritized in the first stages of vaccine distribution. Experts fear that if these imbalances aren’t corrected, the already stark racial divide in coronavirus deaths will become even wider as a larger share of the population becomes vaccinated.

Why there’s debate

Experts say there are two main factors driving the wide racial disparity in vaccinations: Lack of access and lack of trust. The lower rates of vaccinations among people of color are a reflection of the broader inequities in the American health care system, many argue. To fix this imbalance, public health officials must ensure that vaccination sites are in the communities where people of color live, advocates say. Community groups and houses of worship can also play a significant role in helping marginalized people set up and attend vaccination appointments. Some have suggested taking a more direct approach by specifically prioritizing people of color over white people in vaccine eligibility.

Vaccine skepticism exists among all racial groups but is especially pronounced among Black people, polls show. Overcoming this hesitancy means addressing the deep level of mistrust that many Black Americans hold — mistrust informed both by historical events like the Tuskegee syphilis experiment and lived experience with the inequities of the modern health care system, many argue. A similar dynamic is prevalent among Native Americans. Vaccine skepticism can be combated by ensuring that people of color, who are much more likely to garner trust among their racial peers, are at the center of outreach efforts, experts say.

There are other, more pragmatic, steps that can help improve vaccine equity. While speeding up distribution is important, it cannot come at the expense of fairness, some argue. Others say poor data collection practices are severely hampering the effort to distribute the vaccine fairly. Health officials can’t tell which strategies work if they don’t have enough reliable information, they say.

Perspectives

Vaccines must be administered in places where vulnerable people can reach them

“The problem is mainly about access. … Car keys, computer access, and commercial insurance coverage shouldn’t be prerequisites for COVID-19 vaccinations, but the current hospital-focused vaccination system often limits access to folks with these advantages.” — Brian Haile, Tennessean

Historical and modern reasons for vaccine hesitancy must be addressed

“To create equitable vaccine programs, we must go beyond addressing historical trauma and account for the traumas people experience in the here and now. Racial trauma is like other forms of trauma: Its impact is widespread, it is intergenerational, and it can have severe social, physical, and psychological consequences.” — Julian L. Watkins, STAT

Members of vulnerable racial groups should be prioritized for vaccines

“It makes sense to protect those who are most vulnerable, whether the vulnerability is social or health-related. So if the evidence indicates that Black, Latino or Native American people have a higher risk of dying from the virus, they should be offered the vaccine ahead of others of the same age who are at lower risk because they are white or Asian.” — Bioethicist Peter Singer to New York Times

Better data practices are needed to track what’s working and what isn’t

“This lack of information makes it very difficult to be able to track performance, to be able to identify specific locales of concern, to target resources. And above all, it speaks to a lack of either organizational competence or willful disregard for the importance of ensuring that programs meet the goals of equity, fairness and justice.” — Health equity advocate Reed Tuckson to Washington Post

Speed of vaccinations shouldn’t come at the cost of fairness

“While efficiency is a laudable goal, it cannot occur by sacrificing equitable distribution.” — Dr. Sadiya S. Khan, USA Today

People of color should be the faces of vaccine outreach campaigns

“Spokespeople for the vaccination need to be a diverse group. Dr. Tony Fauci is fantastic, but every state needs to find the leading health care experts that represent the diversity in their own state, whether it’s Native American, African American or Latino.” — Public health expert Mark Kittleson to ProPublica

Age-based eligibility will make vaccine disparities worse

“In the past couple of weeks, many states opened eligibility to a wider group of older people and more front-line workers, which could be further depressing the relative share of Black people getting vaccinated. The nation’s over-65 population is more heavily white than other age groups.” — Carla K. Johnson, Angeliki Kastanis and Kat Stafford, Associated Press

Vaccine equity must be part of a broader campaign to improve widespread health disparities

“Coronavirus relief must be a twin priority alongside coronavirus vaccination. People need to know how the administration will tackle other upstream issues, like food insecurity, access to safe and thriving communities, equitable opportunities in education and jobs, and high-quality, affordable housing — all the factors that made outcomes associated with Covid-19 worse for certain groups. All of this is part of the ecosystem upon which public trust, and thus public health, is nurtured or eroded.” — Chris T. Pernell, MSNBC

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