Celebration held for special needs students
North Coast Church recently hosted the “Shine Thru” celebration, which gives special needs students ages 14 and older the opportunity to attend a drive-thru event designed just for them. The socially distanced event was a precursor to the 2021 Night to Shine virtual celebration sponsored by the Tim Tebow Foundation. Shine Thru treated guests and their families to gift bags and an array of socially distanced stations featuring Disney characters, cheerleaders, car decorating, Polynesian dancers, and cheering volunteers. Special Needs Ministry member Noah (DJ Noah) Torgeson, who has autism, supplied the music for the event. In addition, all guests received a link to participate in the exclusive Night to Shine virtual event hosted by Tim Tebow the following week. Last year, an estimated 721 churches from around the world participated in the Night to Shine, which hosted about 110,000 guests and was supported by more than 215,000 volunteers.
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U-T
Because of an editing error, an op-ed published Wednesday said California has a 60-mile border with Mexico. The reference should have been to San Diego County having a 60-mile border with Mexico. It is the policy of the UnionTribune to correct all errors. To discuss accuracy or fairness in the news, write to Readers Representative, Box 120191, San Diego, CA 92112-0191, phone (619) 293-1525 or email readers.rep@sduniontribune.com.
The first doses of the COVID-19 vaccines began to roll out just as the clock wound down on 2020, a year marked by an unrelenting pandemic that has now stolen more than half a million lives. Thanks to the herculean efforts of health care workers, volunteers and health care organizations around the county, more than 600,000 people in San Diego have received at least the first dose of a vaccine and will soon be protected against severe COVID-19.
On Feb. 18, the county of San Diego published geographic data on vaccine distribution — namely, the ZIP code of residence for vaccine recipients. This allowed, for the first time, insight into the curious question — where are these vaccines going?
Unfortunately, the new data tell a sobering yet familiar story. When vaccination rates and COVID-19 case rates by ZIP code are viewed side-byside, there is an obvious vaccine gap: Communities with more COVID-19 are getting fewer vaccines.
The county has yet to publish COVID-19 mortality rates for different ZIP codes, but during a public meeting of the San Diego County COVID-19 Equity Task Force on Feb. 9, a small subset of the data were shared. None of the county’s top 10 ZIP codes with highest mortality rates (in neighborhoods in San Ysidro, National City, El Cajon and Chula Vista) are in the top 10 in terms of vaccine distribution, a list that includes La Jolla, Coronado and Del Mar. In fact, only one of these hardest-hit ZIP codes is among the top 20 in vaccine distribution rate.
The county’s open sharing of COVID-19 mortality data in different ZIP codes will be critical in assessing whether these vaccines are blunting the effect of COVID-19 in our different communities.
Low uptake in ZIP codes disproportionately impacted by COVID-19 has been attributed to many reasons, but vaccine hesitancy has been prominently highlighted in public discourse. This dogma inherently places the responsibility of overcoming barriers to vaccination on individual behavior, and distracts from the material issue of vaccine accessibility and distribution by trusted messengers.
Another commonly cited explanation is that health care workers, who were first in line to receive vaccinations, may not be representative of people from diverse backgrounds in hard-hit areas of San Diego; however, disparities have persisted even after vaccine eligibility was expanded to all individuals aged 65 years and older on Jan. 23. Close monitoring of vaccination rates by ZIP code will be especially important as the county moves further into Phase 1B to vaccinate individuals in industries that are more racially and ethnically representative, such as food services and agriculture.
These theoretical explanations for low vaccination rates in hard-hit areas detract from a simple fact: The root cause of inequities in vaccine uptake is institutional racism. The rationale for prioritizing seniors is based on their higher risk for COVID-19 hospitalization and death. Indeed, among White residents in California, only 13 percent of COVID-19 deaths occurred in those younger than 65. However, 38 percent of COVID deaths among Native Hawaiians/Pacific Islanders, 37 percent among Latinx individuals, 27 percent among Black individuals and 25 percent among American Indian/Alaskan natives in California occurred at ages younger than 65 years.
Under current guidelines, these patients would have been ineligible for vaccination. The current age-based criteria perpetuates COVID-19 disparities by delaying vaccination access to communities that are at risk for severe COVID-19 infection, hospitalization and mortality at younger ages. Expanding eligibility to individuals aged 50-64 (Phase 1C) could mitigate severe COVID-19 disease and death in these impacted communities.
If we truly desire equitable vaccine distribution, we should be addressing racism head-on. However, policymakers are uncomfortable with using race as a factor for vaccine allocation. ZIP code serves as a proxy for race, and incorporating this into vaccine distribution planning is consistent with California’s goal of directing resources to most impacted communities.
Not only do vaccines need to be preferentially distributed to ZIP codes with the highest burden of disease, but their distribution must be led by community leaders and trusted messengers. Without this vital component, vaccination sites in hard-hit ZIP codes will be accessed by those who do not live there.
Health care has not historically prioritized equity. Given its racially and socioeconomically diverse population, San Diego has a unique opportunity to demonstrate to the country what health care equity looks like and what it means to care for all communities — not just people who are wealthy and White. COVID-19 vaccine access — not hesitancy — is the main barrier for communities of color.
Digma is an M.D. candidate at the UC San Diego School of Medicine who lives in Chula Vista. Asmerom is an M.D. candidate at the UC San Diego School of Medicine and M.P.H. candidate at the UC Berkeley School of Public Health who lives in La Jolla. Araneta is a professor of epidemiology and assistant dean of diversity and community partnerships at the UC School of Medicine who lives in La Jolla.