Vaccine policy strands vulnerable
Gov. Ned Lamont’s recent decision to abruptly jettison a policy to distribute COVID-19 vaccine according to who is at higher risk from the disease leaves our most vulnerable population stranded, in favor of an aged-based plan (except teachers and child care workers) that may be easier to administer, but may divert vaccine to those who don’t really need it as much. This shows flaws in the Lamont administration’s decisionmaking, and may lead to more unnecessary disease and death in Connecticut.
Connecticut is now the only state in the country not following the carefully crafted and scientifically based national public health strategy to distribute COVID-19 vaccines recommended by the U.S. Centers for Disease Control and Prevention.
That strategy is fairly simple: avoid overwhelming the hospitals during a pandemic by making sure those at highest risk to the virus get vaccinated first, while the healthier population can afford to wait longer since it is likely they can stay safer using masking, social distancing and other precautions.
Consider the numbers. The Connecticut Department of Public Health reports that the rate of COVID-19 cases — adjusted for age — among the Hispanic population is 7,420 per 100,000 population, more than double the case rate for the white population in Connecticut which is 3,240
The rate of COVID-19 cases among the Black population is 4,963 per 100,000 population, 53 percent higher than the white population.
The COVID-19 death rates for Black and Hispanic residents of Connecticut are also more than double that of their white neighbors. So a much higher risk of serious infection, hospitalization and death for communities of color in Connecticut. Other statistical analysis shows that a Black or Brown resident of Connecticut in their 40s has the roughly same risk of dying from COVID-19 as a white resident of Connecticut in their 60s
There is an intersection of race and poverty in this country, particularly in Connecticut’s urban areas, caused by systemic racism in many public policies and pushed by private actors throughout our entire history. This leads to higher rates of underlying health conditions that can impact lifespan such as hypertension, diabetes, heart disease, obesity, asthma and others that make communities of color more vulnerable to COVID-19. There is also often a lack of access to consistent, quality and preventative health care so problems are often not discovered until they are very serious. These are real health disparities in Connecticut that this pandemic is exploiting with impunity.
At the same time, there is also serious vaccine fear and skepticism among this same population. Some of this is historic mistrust stemming from the cruel U.S. Government sponsored “Tuskegee Study” in the 1930s that infected Black men with syphilis without informing them, to see the effects of the untreated disease. Other skepticism comes from the more modern experience of racism and disparate treatment felt by people of color who have had to deal with our health care system.
Much of this vulnerable population work minimum wage, frontline jobs critical to our economy that cannot be done remotely, such as food service or as staff in our long-term care facilities. We must make the case that vaccination it is crucial to taking care of your family and keeping your job so you don’t get sick at work.
Harder than putting up billboards or digital ads, we must engage our vulnerable populations in old-school, face-to-face conversations by fanning out across neighborhoods and knocking on doors. We could hire trusted local community health workers to talk to their neighbors and collect information so we can build a database. We need to know who wants a vaccine, who is skeptical and needs a follow-up visit, who has a comorbidity, who needs a translator, or transportation to a vaccine center, and other details to help direct resources to vaccinating the vulnerable.
If political campaigns can do it to identify voters prior to an election, than surely we can do the same to vaccinate against COVID-19. In early December I delivered a strategic communications plan to the leaders of the Department of Public Health and Governor Lamont’s office that included a significant investment in community-based grassroots organizing. It fell on deaf ears.
Whatever we gain with the ease of vaccinating according to age, we may lose in justice. A relatively healthy and affluent 57-year-old white resident of New Canaan or Madison is not more deserving of COVID-19 vaccine than a Black or Hispanic resident in their 30s or 40s with underlying health conditions, living in PT Barnum, Trumbull Gardens, or FairHaven, working three jobs to make ends meet.
Real leadership requires us to meet this challenge, not walk away from it.
Av Harris is a political commentator and consultant. He served as director of government relations and communications for the Connecticut Department of Public Health from February 2019-January 2021.