Launch of vaccines Presentation of states with questions about race and access

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

North Carolina has hired an advertising company to raise awareness of black and Latino communities. New York has convened a working group of clerics, health officials and civil rights advocates to help the process, for example, by ensuring that materials needed for effective conduct – such as cleaning products and syringes – reach in low-income areas.

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

Colorado has written an acknowledgment of systemic racism in its vaccination plan – although officials have not yet said exactly what action the state could take in response. The California plan lists racial and ethnic minority groups among the “critical population” who may receive the vaccine ahead of other groups.

States should focus the first rounds of vaccines on those most at risk, said Georges Benjamin, executive director of the American Public Health Association. It would include minority groups, he said, though he advised not allowing anyone to access the vaccine earlier, simply by race.

Instead, he said, those at highest risk – such as people with pre-existing conditions or living in multigenerational households – should receive the vaccine earlier; in practice, this would benefit racial minorities, who are over-represented in these groups.

“You have to be sensitive to race – you have to make sure you don’t miss people who might be more at risk,” said Dr. Benjamin.

The first challenge, officials in several states said, will simply be to provide vaccine information to minority groups, including those who do not speak English. Blacks, Latinos, and Native Americans receive flu shots 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 has insurance. But a history of discrimination has allowed some minorities to be the first to receive it. In a famous case, the U.S. Public Health Service conducted a study of the effects of untreated syphilis on black men in Alabama since the 1930s. Even after a cure for the disease was discovered, the 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 did not want to receive the vaccine, even though scientists said it was safe. Most white and Hispanic respondents said they would take it.

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

Dr. Duroseau is now part of a campaign to overcome skepticism. Last week, he and another New York medical 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 access to communities of color, Governor Andrew Cuomo said. The plans are awaiting state approval.

Mr Cuomo said on Monday that the state would also turn shipping containers into “community vaccination kits” with all the equipment needed to carry out the shootings. It could be deployed in community centers, churches or public housing projects, he said.

Meanwhile, North Carolina is working with leaders in black and Latino communities – including social media influencers and church pastors – to get the word out 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 encourage those influencers to be seen taking the vaccine … to make sure people feel 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 essential non-health workers, including grocery store officials and teachers.

Although CDC guidance is not mandatory, officials in several states have said that this type of prioritization would benefit racial minorities without explicitly considering race. Racial minorities are over-represented among essential workers and people with pre-existing conditions, which means that minorities would disproportionately benefit from the vaccination of these groups earlier.

In California, some officials are promoting more ambitious goals to get the vaccine to black and Latin American communities.

Richard Pan, a Sacramento physician and state senator, said communities that were most affected by the virus should be vaccinated earlier. “You could go to a neighborhood and prioritize the delivery of the vaccine to certain zip codes or census tracts where we know there are high percentages of people who are essential workers,” said Dr. Pan, a Democrat. “In the end, it helps us all. If rates fall there, they are less likely to spread from their communities to other communities. “

Nadine Burke Harris, California’s general surgeon, said the distribution of vaccines would not involve preferential treatment by race, “where it is, you are this racial group, you are first in line.” However, she said the state was looking at how it could use “equality metrics” to help determine who will have access to the vaccine and when. Already, California has linked reopening in larger counties to the number of Covid-19 cases and positivity rates in the most disadvantaged census tracts.

Noting that black, Latino, and Native Californians died at higher rates than whites, Dr. Burke Harris said, “We absolutely think about the risk of death … when we think about vaccine allocation.”

Write to Ian Lovett at [email protected] and Jimmy Vielkind at [email protected]