Shots not getting into arms equitably

After a chaotic rollout, more people in California are getting the COVID19 vaccine. Just not my people.

Black and brown folks have the lowest vaccination rates in all nine Bay Area counties. In San Francisco, Alameda and Contra Costa counties, Latino residents, in particular, are victims of a gaping disparity in who gets that first shot in the arm, according to a comparison of U.S. census and state public health data. Latino residents account for 21.8% of the 3.7 million people living in the three counties — yet are getting only 9.9% of distributed vaccinations.

There’s a 10percentagepoint gap for Asian residents, who average 29.8% of the threecounty population and 19.7% of vaccine recipients. The vaccination rate is also lagging for Black residents like me: We represent 9.3% of the threecounty population but only 5.1% of vaccine recipients.

The vaccination rate for white

residents, meanwhile, is closer to their share of the population. White residents average 36.7% of the threecounty population and 32.5% of vaccine recipients. This is what it should be for all racial and ethnic groups.

There are many reasons our government and public health systems are, once again, failing Black and brown communities.

California relied on public health departments and private companies such as CVS to distribute shots. Residents in wealthier counties benefited from the approach. Large vaccine distribution sites opened in places that were hard to access by Black and brown communities. Many people of color don’t have the economic freedom or resources to spend hours navigating systems, waiting on hold or refreshing websites over and over to get an appointment.

And then there’s the reality that a lot of Black and brown folks don’t have doctors and decisionmakers who look like them and can lift up their obstacles in trying to access a system that wasn’t built for them.

In 2019, only 2.6% of the nation’s doctors were Black, and only 3.8% of doctors identified as Hispanic, Latino or of Spanish origin, according to the Association of American Medical Colleges. Our communities lack critical messengers who could’ve predicted vaccine access issues months ago, says Darris Young, policy manager of the Bay Area Regional Health Inequities Initiative.

For instance, Young told me, having more Black and brown public health officials might have steered a vaccination site that went to Lafayette in January to East Oakland instead, where Black and Latino residents would have had easier access.

“These moments — none of them have helped the distrust Black and Latino people have for the medical system,” Young said. “Not treating us well is what has led us to where we are today.”

This is an area Dr. Neil Powe knows well. Powe is the chief of medicine at San Francisco General Hospital. After he received his first COVID inoculation this year, he said his 94yearold mother called him from Philadelphia every few hours to hear how he was feeling.

She recently received the vaccine, but only after Powe eased her fears. Her trepidation is common in the Black community, he said.

“Having more Black physicians isn’t something we’re going to cure overnight, but it’s something that can use attention in this moment,” Powe told me. “It’s not just physicians we need — it’s also nurses, pharmacists who administer the vaccine and just people on the front lines that you can trust because they’re from your community.”

Studies have shown Black and Latino people are more likely to accept medical advice, and treatment, from doctors of color. In a joint 2018 study by Stanford University and UC Berkeley, for instance, researchers recruited 1,300 Black men from Oakland to complete general health surveys and health screenings. The result? Black men were 20% more likely to agree to tests if their doctors were Black. Black men were also 10% more likely to receive shots from Black doctors.

“It isn’t just Black people, but Latino and Asian people who feel more comfortable talking to a physician who looks like them,” said Oakland family physician Josephine Agbowo. “Patients can relate to someone from their community on a level that they might not with someone from a different background.”

There’s reason to hope that, in a few years, more Black and Latino doctors will be doing this work. Medical school applications are up 18%, according to the Association of American Medical Colleges, with Georgetown University’s medical school seeing a 40% rise in applications from underrepresented minorities.

But let’s not overstate the distrust that Black people, in particular, have in the medical system, or use it as an excuse to withhold equitable care from communities of color.

After all, the Kaiser Family Foundation’s COVID19 Vaccine Monitor project actually shows that Black and Latino adults who are hesitant about the vaccine are still “more responsive than White adults to certain provaccine messages and information.”

But it comes back to who delivers the message — and whether Black and brown folks will be prioritized in this pandemic.