States are leaving behind some of the people most vulnerable to contracting or dying from Covid-19 in a quest to quickly administer shots.
The U.S. vaccination campaign that started off slowly has accelerated in recent weeks with online systems to book appointments and mass clinics that immunize thousands of people a day. Yet the pressure to ramp up vaccinations is promoting tactics that favor people with access to technology, transportation and spare time. Others who may be at greater risk of death from Covid are less equipped to navigate systems built for efficiency.
“I don’t think the solution is to move slower so we bring everyone along,” said Shivani Patel, a social epidemiologist at Emory University. “I think the solution is figuring out ways of bringing everyone along.”
Two months into the campaign, the focus on speed highlights the inequities it can create. White and Asian people are generally receiving shots at a higher rate than Blacks and Hispanics in states that collect information on the race and ethnicity of vaccine recipients, according to Bloomberg’s vaccine demographics tracker.
Efforts to hasten vaccination are showing progress: 79% of doses distributed have been used, according to Bloomberg’s vaccine tracker, a significant improvement from the early days of the rollout in December and January. Reaching communities of color, or elderly people less comfortable with technology, could take longer.
The Biden administration has pledged to ensure vaccines get into arms quickly and equitably, and has taken steps to expand vaccination sites and send shots to pharmacies and federally qualified health centers. However, opening vaccination sites in minority and low-income communities doesn’t always mean the shots go to residents.
“The idea that in many places the primary way to sign up for the vaccine has been through the computer, through all these websites, that in itself has been a major barrier, especially for many of our older adults for whom you’re not tied to your phone 24-7,” said Tanjala Purnell, associate director at the Johns Hopkins Urban Health Institute.
In Maryland, 12% of the state’s White population has been vaccinated, compared with about 6% of its Black population, according to Bloomberg’s analysis of state data. In North Carolina, 14% of White residents have received a shot, compared with about 8% of Black residents. The disparities are narrower in some states, including Washington and Oregon, though they still exist.
The scope of racial inequities in vaccinations isn’t fully understood, because the U.S. lacks race and ethnicity data on about half of the people vaccinated. And the reasons are complex: Minority communities in the U.S. experience greater barriers to health care and more hesitancy about vaccination than White people. Yet hesitancy alone doesn’t explain the disparities.
“For somebody to say African-Americans just don’t want to do it, I would be asking them: How many African-Americans have you really sat down and talked to? We have the same concerns as everybody else when it comes to our livelihood,” said Suzette Parham, 61, who has been trying to find vaccination appointments for herself and her husband, Harold, 74, in the Baltimore area; both are Black.
Information Gap
Parham and her husband registered with about half a dozen vaccination sites. They’re eager to be immunized so they don’t have to worry so much about catching the virus, as they have medical conditions that put them at higher risk. But they are struggling to secure appointments.
Online portals have been difficult to navigate for many older adults, said Purnell of Johns Hopkins. She’s working with faith leaders in the Baltimore area to survey people’s feelings about the vaccines. The frustration is evident.
“The transparency of how this process works has been one thing we’ve heard directly, in particular from communities of color, is one area we’re really failing,” she said.