Eleven months: after the first SARS-CoV-2 case in December 2019, pharmaceutical research and development produced an effective vaccine in November 2020. The speed of this timeline is unmatched in human history, as typically, vaccines take more than a decade to develop. Yet, science is only the first link of the public health chain. The next steps, comprising equitable distribution and accessibility, are equally important. Unfortunately, data from 23 states show that there are racial disparities in vaccine distributions. While antibodies protect cells biologically, effective policies protect people socially; vaccination equity needs to be at the forefront of public health efforts.
One example of vaccination disparities can be observed by analyzing distributions by race. For example, take Mississippi, where African Americans are 38% of the population but only 17% of vaccinations. Unfortunately, Mississippi isn’t an outlier in the data. Across Pennsylvania, Florida, North Carolina, Nebraska, Indiana, Maryland, Alaska, Ohio, Tennessee, and Missouri—to name just a handful—African Americans are between two to five times less likely to be vaccinated.
Source: KFF analysis of The COVID Tracking Project, COVID Racial Data Tracker. Data retrieved on February 1, 2021. Total state population distribution by race/ethnicity based on KFF analysis of 2019 American Community Survey.
What causes are responsible for this health disparity?
Geographical Distribution of Vaccines
One important reason is that geographical distribution of vaccines doesn’t account for several demographic variables into account. Indeed, federal vaccination efforts began with a simplistic population-based metric to allocate vaccines geographically. Unfortunately, this doesn’t take into account other factors that account for situational risk to COVID-19: African Americans and Native Americans are two to three times as likely to die as white Americans.
Thus, with the objective of maximizing the number of lives saved, the government ought to prioritize those who are vulnerable first. Although this has been partially implemented at the local level—as illustrated by current policies that give preference to elderly people and those with severe immunological conditions—they ought to consider race, ethnicity, and socioeconomic status as well.
The disparities in distribution stem from not only inequitable allocation, but also, the lack of transportation and medical infrastructure in regions with high minority populations.
Around the country, many areas with black communities (e.g., inner-city neighborhoods) lack hospital systems and support staff to conduct vaccination. As a result, affluent areas with such infrastructure have been conducting the vast majority of vaccinations. This results in unequal access, as if inner-city residents have to travel an additional hour (two for a round trip) to receive a vaccine, they’re less likely to go. Hence, city officials should consider constructing vaccination sites in less affluent areas.
The lack of infrastructure is not only physical but also digital: because of the lack of email systems for hospital janitorial staff, hospital cafeteria workers, etc., some hospitals have been unable to send vaccination registration emails to many of their low-income employees, also contributing to the racial disparity.
Making matters worse, this issue isn’t even on the radar for the majority of states; over half of states don’t report data on the racial and ethnic distribution of vaccinations, indicating that researchers and officials don’t have the tools needed to address this problem. Only once they are aware can they begin addressing the underlying causes.
Thus, while we already prioritize those biologically at risk (i.e., the elderly and the immunocompromised), we need to expand our societal notion of risk to encompass social factors as well; African Americans, Native Americans, and other disadvantaged communities should be prioritized to save the maximum number of lives. These biosocial impacts can only be addressed through improved public health efforts and support from city and state officials. Through directed and informed policymaking, we can pave a path through this pandemic.
Doherty, Tucker, and Joanne Kenen. “Just 5 Percent of Vaccinations Have Gone to Black Americans, despite Equity Efforts.” POLITICO, 9 Feb. 2021, www.politico.com/news/2021/02/01/covid-vaccine-racial-disparities-464387.
McMinn, Sean, et al. “Across The South COVID-19 Vaccine Sites Missing From Black And Hispanic Neighborhoods.” National Public Radio, 5 Feb. 2021, www.npr.org/2021/02/05/962946721/across-the-south-covid-19-vaccine-sites-missing-from-black-and-hispanic-neighbor.
Pham, Olivia, et al. “Latest Data on COVID-19 Vaccinations Race/Ethnicity.” Kaiser Family Foundation, 3 Feb. 2021, www.kff.org/coronavirus-covid-19/issue-brief/latest-data-covid-19-vaccinations-cases-deaths-race-ethnicity/.
Featured image source: U.S. Secretary of Defense, CC BY 2.0 <https://creativecommons.org/licenses/by/2.0>, via Wikimedia Commons