In New York City, location is everything. It matters for schools, homes and hot-dog carts. Now, it defines access to Covid-19 vaccines.

Among the starkest divides is a swath of Manhattan that starts on the Upper East Side, where 36% of adults had received at least one dose as of Tuesday. Blocks north in Harlem, that number is just 17%. In general, the parts of Harlem that are less wealthy and White are also less likely to have vaccinated residents, city data show.

“The fact that we knew where the hardest-hit communities were and didn't set aside shots for them or prepare for that is just frustrating and mind-boggling,” said Diana Ayala, a City Council member representing East Harlem and the South Bronx who hasn’t been able to secure a vaccine herself despite being eligible.

Mayor Bill de Blasio and Governor Andrew Cuomo pledged the nation’s most equitable distribution, but shots are going to White New Yorkers at a much greater rate than minority, poor and immigrant communities.

“We're among the most cases and deaths. How does it happen that we're so many weeks into this and it's still such a grueling process to get a vaccine?” said Ayala, who's been walking door to door to sign up senior citizens. “The city says to be patient, that we need more supply. But it's really difficult to explain away.”

De Blasio got elected with a pledge to make New York “the fairest big city in America.” Months into the pandemic, it was clear he hadn’t achieved his goal. Covid hospitalizations and deaths were disproportionate in lower-income neighborhoods, and remain so. Job losses followed.

When vaccines arrived in December, de Blasio pledged to direct them to the neediest places first. But the nation’s largest city still lags behind other parts of the U.S. in equitably distributing the vaccine. At least a dozen states, including Oregon, Rhode Island and Kansas, are reaching a relatively more equal share of people of different races and ethnicities, according to the Bloomberg Vaccine Tracker.

Vaccine Mismatch
New York City Health Commissioner Dave Chokshi said the city disclosed ZIP code data to highlight efforts to remedy inequities. It's a “road map,” he said, noting a majority of city vaccine sites are in 33 vulnerable neighborhoods.

“Equity is at the heart of the city’s vaccination effort,” said de Blasio spokesman Bill Neidhardt.

Some disparities can be chalked up to higher proportions of older residents, or concentrations of health-care workers and first responders. But some of the least-vaccinated ZIP codes, including in Harlem, have some of the highest rates for diabetes, obesity and and other underlying health conditions that qualify residents for shots.

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