Vaccine distribution — addressing the inequities
Bay Area officials urge the state to prioritize hard-hit communities of color
As Bay Area health care providers work to vaccinate people against COVID-19, early data suggests that the shots aren’t reaching the people who need them most — communities of color that have been hit hardest by the virus.
As of Thursday, just three counties — Alameda, Contra Costa and San Mateo — had released numbers on the ra
cial and ethnic breakdown of vaccine recipients. But in each, the data shows that Latinx residents are receiving only a small percentage of the shots delivered so far — much smaller than their share of infections and deaths.
In Santa Clara County, leaders on Thursday implored Gov. Gavin Newsom to address the issue by prioritizing areas that have seen a disproportionate number of COVID-19 cases and deaths, including the largely Latinx neighborhoods of East San Jose.
The Latinx community — whose members are more likely to work in essential jobs and live in overcrowded housing — has borne the brunt of the pandemic statewide. Black communities also have suffered at higher rates than White communities.
“They are retired seniors who helped build this city. They are health care workers on the front lines. They are the caregivers who lovingly devote themselves to other people’s children,” said San Jose City Councilwoman Magdalena Carrasco, who represents three of the county’s hardest-hit ZIP codes. “I’m urging our governor to help our most vulnerable residents get to the front of the line. They should not be at the end of the line.”
The issue extends throughout the region. In Alameda County, Latinx residents account for 53% of COVID-19 infections where race or ethnicity is known, and 25% of deaths. But they account for just 12% of first-dose vaccines administered. Black residents account for 10% of cases and 17% of deaths, but 7% of first-time vaccinations. White residents account for 17% of cases, 34% of deaths and 35% of vaccines.
In Contra Costa County, Latinos account for 49% of cases where ethnicity is reported and 29% of deaths, but they’ve received just 14% of vaccines administered. Black residents make up 8% of cases where race is reported, 11% of deaths and 5% of vaccinations. White residents account for 28% of cases where race is reported, 46% of deaths and 42% of vaccinations.
And vaccination rates vary widely by city. In Walnut Creek, an affluent, largely White city, 21% of the population has received at least one dose of the vaccine. In Oakley and Richmond, both lower-income cities with large Latinx populations, a little more than 7% of residents have had at least one shot.
“That is clearly concerning and in my mind needs to change,” said county Supervisor John Gioia, whose district includes Richmond.
Latinos account for 56% of COVID-19 cases in San Mateo County where race or ethnicity are known, and 23% of deaths. But they make up less than 10% of people vaccinated in the county.
Similar disparities exist nationwide. Experts say communities of color may lack access to computers and reliable internet to book vaccine appointments or transportation to vaccination sites. They might not see accurate information about the vaccine, and they might be exposed to false rumors of risks and side effects. And due to a history of mistreatment by medical professionals, minority groups might be more likely to mistrust the shots.
“What’s so devastating about it, is it probably could have been prevented, and the ramifications are going to be higher mortality in groups that are already suffering disproportionately,” said Dr. Fola May, a physician and health equity researcher at UCLA.
State and local officials are expanding access to vaccines in hopes of reaching more people. Santa Clara County on Thursday opened vaccine appointments to everyone 65 and older, regardless of their insurance or health provider. Newsom unveiled the Oakland-Alameda County Coliseum as a vaccine site this week, emphasizing that the location was chosen to help reach communities “often left behind.” Alameda County opened a neighborhood vaccination clinic in the heavily Latinx Fruitvale neighborhood of Oakland on Thursday.
San Francisco planned to begin vaccinating residents at the Moscone Center starting today. And Contra Costa County is rolling out mobile vaccination clinics this week that will bring shots to people where they are.
But one major obstacle is a lack of data. Only a handful of states report the race and ethnicity of people getting vaccines, and California is not yet one of them. “The state is actively working on a dashboard to display this data updated on a regular basis, and it will be available soon,” said Darrel Ng, spokesman for the state’s COVID-19 Vaccine Task Force.
In the Bay Area, Alameda, Contra Costa and San Mateo counties collect and publish that data online, and Santa Clara County planned to make data available Thursday evening. San Francisco is working on breaking out vaccine information by age, race and neighborhood, Naveena Bobba, deputy director of health, told city supervisors Thursday.
But even when counties do collect that information, the data is full of holes.
In Alameda County, officials don’t know the race of more than a quarter of the people who received the first dose of the vaccine.
That’s a big problem, May said.
“It isn’t until we have the data that shows there are inequities in the vaccine distribution that we can actually act on it,” she said.
To experts who study health equity, these disparities are no surprise. They’ve seen the same inequities in everything from COVID-19 testing and treatment to cancer screenings. But equity has been a buzzword repeated often as the state rolls out a new COVID-19 vaccine system run by Blue Shield, and specific updates on how the insurance company will target hard-toreach communities are expected next week.
May hopes Blue Shield will make sure people can get vaccinated at night and on weekends — when Black and Brown essential workers are more likely to be available.
The hardest hurdle is likely to be rebuilding trust in communities of color, who may be wary of medical professionals because of historical events — such as the Tuskegee Experiment — or because of their own personal experiences with doctors, she said.
“I myself as a Black woman have felt discriminated against in health care settings,” May said. “It’s not until I speak up and say, ‘I’m a doctor, I know what’s going on here,’ that people start treating me a little bit differently.”