State tries to address vaccine inequities
Experts: It will take more than setting aside doses
Gerald Hudson had been trying unsuccessfully to get the vaccine through his kidney dialysis clinic in Hayward.
“I’m getting kind of worried,” Hudson, who is 66 and identifies as African American, said from outside his apartment in the predominantly Black neighborhood of Lockwood Gardens in Oakland on Thursday. However, Hudson’s luck may soon change. On Wednesday night, the state announced it was changing the way it distributes vaccines in an effort to be more equitable. Under the plan, an estimated 8 million eligible residents in California’s 400 lowestincome ZIP codes will receive 40% of the state’s vaccine supply, including some in the Bay Area.
One of those ZIP codes is Hudson’s.
Public health experts say prioritizing lowincome communities for doses is just one of many solutions needed to bridge significant coronavirus disparities.
While some people lack the transportation to get to vaccine sites and clinics, others struggle with significant language barriers in navigating the enrollment process. Those who don’t have access to broadband internet or computers may not be able to sign up to receive a vaccine through MyTurn, the state’s online scheduling system. Still others may be wary of a medical community that doesn’t have a track record of engaging with them.
“Black and Latino and other lowincome communities in California have the least access to health care in general,” said Kiran SavageSangwan, executive director of the California PanEthnic Health Network, a statewide multicultural health advocacy organization. “And where we have focused the vaccination efforts to date — using mega sites and also focusing first on our health care workers and our seniors — is not completely inclusive of our most vulnerable communities.”
Robert Brisco, who lives in Hudson’s apartment complex and also identified as African American, said he’s had the opportunity to get the vaccine at the nearby Oakland Coliseum but chose not to.
“I’m not convinced whether it’s going to work or not,” Brisco, 65, said at his apartment Thursday. “I’m afraid of it right now.”
As such, Brisco said the state’s policy shift doesn’t really change anything for him.
Teresa Moore, who is 45, African American and also lives in the Lockwood Gardens apartment complex, said she remained hesitant despite the fact that her son, who’s in his 20s, received the vaccine and was fine.
Two additional residents of the apartment complex who declined to give their names also said they weren’t interested in taking the vaccine. Three others who live in the neighborhood said they were.
In Oakland’s predominantly Latino Fruitvale neighborhood — another ZIP code on the state’s list — four residents said Thursday they had already been vaccinated, while four others said they weren’t yet eligible.
It’s unclear what the majority opinion is in any of these communities.
A Kaiser Family Foundation survey found resistance to the COVID19 vaccine highest among white participants, with 15% not interested. Fourteen percent of Black survey participants expressed resistance to getting the vaccine, followed by 12% of Hispanic survey participants.
Sending more vaccines to these communities won’t eliminate vaccine inequity on its own, said Dr. Kirsten Bibbins-Domingo, a health equity researcher and chair of UCSF’s department of epidemiology and biostatistics.
“Across the state — and certainly around the country — we have a history of things being done in the name of equity that, in their implementation, don’t achieve the goals and sometimes even make it worse,” BibbinsDomingo said.
An estimated 32% of Californians who have received at least one dose of the vaccine are white — the highest percentage of any race or ethnicity, according to state data. White people account for 37% of the population. About 17% of the state’s vaccine recipients are Latino, though they account for 39% of the population. Asian Americans account for 12% of known vaccine recipients and 15% of the population. Black people have received roughly 3% of vaccines, while representing 6% of the state’s population, data show.
“We’ve asked people to go online to get an appointment, we’ve asked people to go to drivethrough vaccination sites not accessible through public transportation,” SavageSangwan said. “We have to overcome those access barriers.”
The list of lowestincome ZIP codes is based on the state’s Healthy Places Index, or HPI, which measures several factors — including income, education level, transportation, housing and health care access — to determine a community’s characteristics and overall conditions. Though the index doesn’t formally incorporate race and ethnicity, many of the measured factors align closely with race and ethnicity.
Under the state’s vaccine redistribution plan, Black, Latino, Asian and Pacific Islander communities are expected to get larger supplies of the vaccine. The ZIP codes identified by the state are largely concentrated in Los Angeles and the Central Valley. Eligible ZIP codes in the Bay Area include parts of San Francisco, Richmond, Vallejo and portions of Oakland, state officials said.
Engaging community groups in a way that addresses these barriers and builds trust with community members will be key, said BibbinsDomingo.
“What we see time and time again when we face issues of equity is that people who have more knowledge, more connections, more money, more access to transportation, more access to information, can figure out how to navigate a complex system,” BibbinsDomingo told The Chronicle.
“In places that have less of those things, you can’t figure it out or it doesn’t happen. That is why it’s not enough to say, ‘Oh, we opened up a website and everyone could have access.’ ”