PORTLAND, Oregon (PA) – The role that the breed should play in deciding who gets priority for the COVID-19 vaccine in the next phase of launch is being tested in Oregon as tensions around equity and access photos appear nationwide.
An advisory committee advising the Oregon governor and public health authorities will vote Thursday on whether to prioritize people of color, target people with chronic conditions, or focus on combinations of groups at higher risk of coronavirus. Others are taken into account, such as essential workers, refugees, detainees and people under the age of 65 living in groups.
The 27-member committee in Oregon, a Democratic-led state that is overwhelmingly white, was formed to keep fairness at the heart of its vaccine launch. Its members were selected to include racial minorities and ethnic groups, from Somali refugees in the Pacific islands to tribes. The committee’s recommendations are not binding, but provide a critical input for Governor Kate Brown and guide health officials drafting the launch.
“It’s about revealing structural racism that remains hidden. It influences the disparities we experienced before the pandemic and exacerbated the disparities we experienced during the pandemic, ”said Kelly Gonzales, a member of the Cherokee Nation in Oklahoma and a health disparity expert on the committee.
The virus has disproportionately affected people of color. Last week, the Biden administration reaffirmed its importance to include “social vulnerability” in the state’s vaccination plans – with race, ethnicity and the rural-urban division at the forefront – and called on states to identify “pharmacy deserts” that would be difficult to pull off.
Overall, 18 states have included ways to measure equity in their initial vaccine distribution plans last fall – and more have probably done so since vaccines began to arrive, said Harald Schmidt, a medical ethicist at the University of Pennsylvania, which has fully studied the correctness of vaccines.
Some, such as Tennessee, have proposed reserving 5 percent of its allocation for “high-disadvantaged areas,” while states like Ohio plan to use social vulnerability factors to decide where to distribute the vaccine, he said. California has developed its own values for assessing the level of need of a community, and Oregon does the same.
“I told a pretty simple story: ‘The vaccines are here.’ Now we have to tell a more complicated story, ”said Nancy Berlinger, who is studying bioethics at The Hastings Center, an independent and independent research institute in Garrison, New York. “We need to think about all the different overlapping areas of risk, rather than the group we belong to and our personal network.”
Attempts to address inequalities in access to vaccines have already caused adverse reactions in some places. Dallas authorities recently overturned a decision to prioritize the most vulnerable zip codes – primarily communities of color – after Texas threatened to reduce the city’s vaccine supply. This type of push is likely to become more pronounced as states move deeper into the struggle and struggle with difficult questions about need and lack.
To avoid legal challenges, almost all states that look at race and ethnicity in their vaccination plans use a tool called a “social vulnerability index” or “disadvantage index”. Such an index includes more than a dozen data points – everything from education-level income to health outcomes and car ownership – to target disadvantaged populations without specifically citing race or ethnicity. .
In doing so, the index includes many minority groups because of the impact of generations of systemic racism, while identifying socioeconomically disadvantaged people who are not people of color and avoiding “very, very difficult and toxic questions” about race, Schmidt said. .
“The point is not, ‘We want to make sure the Obama family gets the vaccine before the Clinton family.’ We do not care. They can both wait safely, “he said. “We care that the person who works in a meat packing factory in a busy life situation receives it first. It is not about race, but about race and disadvantage. ”
In Oregon, health leaders are working on a social vulnerability index, including analyzing U.S. census data and then stratifying things like employment status and income levels, said Rachael Banks, director of the Oregon Health Authority’s public health division. .
This approach “goes beyond an individual perspective and more than a community perspective” and is better than asking a person to demonstrate “how it fits into any demographic,” she said.
The committee’s recommendations will also be subject to legal scrutiny, banks said.
This makes sense for Roberto Orellana, a professor of social work at Portland State University, who has launched a program to train his students in following contacts in Hispanic communities. The data show that Hispanics have an approximately 300% higher risk of contracting COVID-19 than their white Oregon counterparts.
Orellana hopes that her students, who do internships at state agencies and organizations, can use their knowledge both in tracking contacts and in promoting vaccines in migrant and agricultural worker communities. Vaccination of essential workers, prisoners and those in multigenerational households will reach people of color and put them at the center of the vaccination plan, he said.
“I do not want to take any other group. It is a difficult, difficult question and every group has valid needs and valid concerns. We shouldn’t go through that, “Orellana said. “We should have vaccines for everyone – but we’re not there.”
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The Associated Press / Report for America Statehouse News Initiative, a member of the Sara Cline Corps, contributed to the report. Follow Flaccus on Twitter at http://www.twitter.com/gflaccus.