Racial disparity seen in vaccinations
Gap persists as more doses arrive in state, more people become eligible Johnson & Johnson’s one-dose shot cleared, giving US its third vaccine
White Marylanders have received more than four times as many doses of coronavirus vaccine as Black residents, state data shows — a stark racial gap that has persisted even as more doses have arrived in the state and more people have become eligible to receive them.
Early discrepancies could reflect the state’s early prioritization of medical professionals and first responders, according to experts and state officials.
Some cite increased vaccine hesitancy among minorities distrustful of the medical community.
But as eligibility expanded to include older Marylanders and essential workers, many minorities, especially those in lo w-in- come areas, have faced barriers to accessing the highly coveted appointments in the state’s current system.
WASHINGTON — The Food and Drug Administration on Saturday authorized Johnson & Johnson’s single-shot COVID-19 vaccine for emergency use, beginning the rollout of millions of doses of a third effective vaccine that could reach Americans by early this week.
The announcement arrived at a critical moment, as the steep decline in coronavirus cases seems to have plateaued and millions of Americans are on waiting lists for shots.
Johnson & Johnson has pledged to provide the United States with 100 million doses by the end of June. When combined with the 600 million doses from the two-shot vaccines made by Pfizer-BioNTech and Moderna slated to arrive by the end of July, there will be more than enough shots to cover any U.S. adult who wants one.
“I knew when this thing came out that we would have a problem with that,” said Victor Farmer, a 68-year-old traffic manager who lives in Northeast Baltimore.
Maryland’s Black and Latino residents were hit hard by the coronavirus, particularly early on.
Their difficulty in getting the limited, life-saving inoculations further magnified the inequalities of the pandemic, and critics say the state’s vaccine program has contributed to them.
Baltimore and Prince George’s County, which have the state’s highest proportions of minority residents, are home to the three state-run mass vaccination sites, and efforts are underway to improve outreach. But the sites serve people from around the state, and the jurisdictions are among four whose health departments are projected to receive fewer than 200 doses per 10,000 residents through mid-March.
Gov. Larry Hogan, a Republican, said Thursday that Baltimore City “had gotten far more [vaccines] than they were really entitled to.”
But many of the vaccines that have gone to the city went to its 11 hospitals and their staffs. The city currently ranks third from last among the state’s 24 jurisdictions for the percent of its population inoculated, ahead of only Charles and Prince George’s counties.
Earlier in the week, Del. Robbyn Lewis, a Baltimore Democrat, said in an interview that other jurisdictions “have been preferentially resourced with vaccines.”
“It’s a political decision,” she said. “It is not a sound, well reasoned public health reason. And it undermines public trust in the system.”
Farmer spent a break Tuesday night idling in a truck in a Highlandtown parking lot with Tyrone Wilson after they closed lanes for road work on Pulaski Highway. Neither has gotten a shot, despite working in-person throughout the pandemic. March 5 will mark the one-year anniversary of the state’s first confirmed cases of COVID-19.
Wilson, 61, who lives near Dundalk, gestured toward the nearby Emergent BioSolutions plant that is manufacturing the Johnson & Johnson vaccine, which the U.S. Food and Drug Administration could authorize for emergency use this weekend.
The one-dose vaccine is expected to expand supply nationwide.
But the drug maker has given no indication it will accept Baltimore Mayor Brandon Scott’s plea to buy vaccines directly for city residents.
And Hogan declined to answer the mayor’s request to set aside doses for city residents at the newly opened M&T Bank Stadium mass vaccination clinic.
“It’s produced right here,” Farmer said, “but we’re not getting it.”
A reflection of society
Karen Kennedy planned to attend a funeral Friday for her 34-year-old niece who died from COVID-19. Due to crowd restrictions, only 37 people are allowed to attend the services at Howell Funeral Home.
Kennedy, a LifeBridge Health copy center operator, was offered a vaccine through work and has been delighted seeing people lining up for shots outside drug stores. But she has suggestions for ways the state could improve the process.
“Put more in our neighborhoods and more longer hours,” Kennedy said.
Vaccination sites should be highly accessible, and appointments need to be convenient, said Dr. Georges Benjamin, executive director of the American Public Health Association. For instance, nighttime appointments should be available for those who can’t take off work during the day.
The current vaccination program disadvantages people who work hourly jobs and lack reliable internet access at home, said Benjamin, a former Maryland state health secretary. New appointments are often posted in the middle of the night or during traditional work hours.
“There are a lot of minorities that work shift work and aren’t able to get to the appointment [websites] before the appointments are all gone,” Benjamin said.
Through Friday, nearly two-thirds of the vaccine doses where the recipient’s race was known had gone to white residents, compared with only 16.2% for Black Marylanders.
About 31% of Maryland’s population is Black, according to U.S. census data, and they account for a third of the state’s confirmed infections and 35% of the deaths. White residents, about 59% of the overall population, represent 40% of the caseload and 52% of the death toll.
Likewise, Latino residents, 11% of the population, have received 4.1% of vaccine doses, yet account for 19% of cases and 9% of the victims.
“There’s nothing in the genetics of Black or Hispanic or indigenous communities that makes them more susceptible to COVID,” said Harald Schmidt, an assistant
professor in the department of medical ethics and health policy at the University of Pennsylvania. “It’s simply a reflection of the fact that society is structured in a way that minority people are disproportionately represented among disadvantaged groups.”
A lack of clear change
Equitable vaccine distribution shouldn’t be about focusing on race, Schmidt said, but on targeting disadvantaged groups, which tend to predominantly include those who are minorities.
“Equity and vaccine allocation and race is not about giving a vaccine to the Obama family before the Clinton family,” he said. “That is not what we’re concerned with.”
Schmidt said states can address inequities in their vaccine allocation efforts first by finding the areas where disadvantaged residents live and dispensing vaccines in those locations, then using proper messaging and community outreach to get them signed up.
That’s what Maryland has been doing since officials first noticed disparities in the early vaccine distribution, said Dr. Jinlene Chan, Maryland’s acting deputy health secretary.
But that recognition hasn’t changed the state’s data.
Schmidt and Chan said the ongoing discrepancies partly could reflect who’s eligible to be vaccinated. Although about three in 10 Marylanders are Black, not all of them fit into the state’s current phases for vaccination, which target certain occupations and ages.
Minorities might not be as common in some eligible groups such as health care workers and residents older than 75, Chan noted. But they might be more prevalent among essential workers, Schmidt said.
Chan said the state isn’t aware of the specific racial breakdown among those groups currently eligible.
Regardless, Maryland officials recognize the divide in who is and isn’t getting the vaccine as an issue, she said.
In Baltimore City and Prince George’s County, the government has deployed sound trucks to educate residents about the vaccine and encourage residents to get it. The state also established a vaccine equity task force, which is holding two pop-up
clinics at churches in the city Friday and Saturday to reach hard-hit communities.
Hogan has repeatedly pointed to a lack of doses supplied by the federal government as the root cause behind Maryland’s vaccine-related issues, including the consistent difficulties people experience getting appointments.
Even if the state targets disadvantaged Marylanders with certain clinics, those appointments could be scooped by other residents desperate to get vaccinated, Chan said.
“To the extent we can, we are looking at different strategies across each of the different access points,” she said. “We are trying to ensure that people who have maybe less access for a number of different reasons, that we do provide them access.”
’They are not sending buses to come get us’
Many of those efforts are happening at a “grassroots community level,” said Chan, offering the example of Prince George’s County directly calling eligible residents to get them appointments at the Six Flags America mass vaccination site.
But the drive-through Six Flags site requires a car and has served more Montgomery and Howard county residents than those from Prince George’s.
Keith James, a retired construction worker with a disability, suggested the state set up a vaccination clinic in the Mondawmin Mall parking lot, where the one in three Baltimoreans like him who lack access to a vehicle could reach it by taking a bus or subway to the Mondawmin Station transit hub. He’s seen flu vaccination clinics there before.
“I can’t go to Six Flags, simple as that,” said James, 60. “They are not sending buses to come get us and transport us out there.
“It really is tough for the minority. … The Latinos and the Black population, sad to say, always seem to be last on the totem pole.”
Although the Six Flags site is open to all eligible Marylanders, some can’t access it, Chan acknowledged.
“We have layers of different types of access points, knowing that there is no single vaccination access point that is going to fit all the needs,” Chan said. “We
absolutely recognize there is a really large proportion of our population that do not have access to transportation, that don’t have access to internet, and other important needs as part of the infrastructure we’ve been building.”
The increased use of in-neighborhood pharmacies, churches and mobile vaccination sites is aimed at making vaccines more accessible for everyone, Chan said.
Mass transit riders, including many essential workers, face a higher risk of exposure to the virus than their counterparts who can work from home and drive cars, said Lisa Shelton, 48, a former recovery center employee who lives in Milford Mill.
“You don’t know who you’re sitting next to, and it’s not always social distancing on the bus,” she said while waiting for a bus at Mondawmin. “You’re putting yourself at risk.”
‘Why not have vaccines in those hot spots?’
Shelton said she believes state officials are doing the best they can with limited vaccine supply, but she argued that more vaccines should be allocated to city neighborhoods ravaged by the pandemic. Four of the state’s 12 ZIP codes with the most confirmed cases of COVID-19 are in Baltimore City.
“Why not have vaccines in those hot spots?” Shelton asked. “It would make sense. People in the city aren’t just [as] important as the people all the way out there? That’s what it seems like they’re saying. If you have hot spots, why not have a place to get vaccines in those hot spots? It would lessen the severity. … It seems like a simple thing to me.”
Carlos Nufio initially doubted whether he wanted a vaccine. The Dundalk man, who was selling goods from the back of a vehicle in Highlandtown one night last week, said many Latino people felt the same way.
“People were saying you might be allergic to it or things like that,” Nufio said in Spanish. “But now I don’t have any doubts. I have some good friends, educators. They advised me, ‘Carlos, come on, you’ve got to get the vaccine.’ ”
Nufio credited the Rev. Bruce Lewandowski, pastor of the Sacred Heart of Jesus parish, for his efforts to educate the area’s large Latino and immigrant community about the importance of getting vaccinated.
Sacred Heart will host a pop-up clinic Friday and is among the churches Chan said Maryland National Guard Brig. Gen. Janeen L. Birckhead and the state’s vaccine equity task force have partnered with to promote vaccinations.
Such hesitancy in minority communities is a factor, said Benjamin, the former state health secretary, but that by itself can’t explain the discrepancies.
He described recently helping at a vaccination clinic in a Black community in Montgomery County.
“There was not a shortage of people,” he said. “People talk a lot about vaccination hesitancy, but that wasn’t an issue there by any means.”
Racial disparities in vaccine distribution have been an issue across the country, Benjamin said. But given the diversity of Maryland’s population, he said, “you would think that [the state] would have done better.”
WASHINGTON — The House approved a $1.9 trillion pandemic relief bill that was championed by President Joe Biden, the first step in providing another dose of aid to a weary nation as the measure now moves to a tense Senate.
“We have no time to waste,” Biden said at the White House after the House passage early Saturday. “We act now — decisively, quickly and boldly — we can finally get ahead of this virus. We can finally get our economy moving again. People in this country have suffered far too much for too long.”
The new president’s vision for infusing cash across a struggling economy to individuals, businesses, schools, states and cities battered by COVID-19 passed on a near party-line 219-212 vote.
Democrats said mass unemployment and the more than 510,000 American lives lost are causes to act despite nearly $4 trillion in aid already spent fighting the fallout from the disease. GOP lawmakers, they said, were out of step with a public that polling finds largely views the bill favorably.
“I am a happy camper tonight,” Rep. Maxine Waters, D-Calif., said Friday. “This is what America needs. Republicans, you ought to be a part of this. But if you’re not, we’re going without you.”
With unemployment benefits set to begin lapsing March 14 for the workers who have been thrown off the job longest in the crisis, Democrats have only two weeks to finish the package in the Senate and resend it to the House and Biden’s desk. Because party
leaders decided to use a fast-track budget process known as reconciliation to swiftly move the legislation and circumvent Republican opposition in the Senate, the bill will need to comply with a series of strict budgetary rules along the way.
Republicans said the bill was too expensive and said too few education dollars would be spent quickly to immediately reopen schools. They said it was laden with gifts to Democratic constituencies like labor unions and funneled money to Democratic-run states they suggested didn’t need it because their budgets had bounced back.
“To my colleagues who say this bill is bold, I say it’s bloated,” said House Minority Leader Kevin McCarthy, R-Calif. “To those who say it’s urgent, I say it’s unfocused. To those who say
it’s popular, I say it is entirely partisan.”
The overall relief bill would provide $1,400 payments to individuals, extend emergency unemployment benefits through August and increase tax credits for children and federal subsidies for health insurance.
It also provides billions for schools and colleges, state and local governments, COVID-19 vaccines and testing, renters, food producers and struggling industries like airlines, restaurants, bars and concert venues.
The battle is also emerging as an early test of Biden’s ability to hold together his party’s fragile congressional majorities — just 10 votes in the House and an evenly divided 50-50 Senate.
At the same time, Democrats were trying to figure out how to assuage liberals
who lost their top priority in a jarring Senate setback Thursday.
That chamber’s nonpartisan parliamentarian, Elizabeth MacDonough, said Senate rules require that a federal minimum wage increase would have to be dropped from the COVID19 bill, leaving the proposal on life support. The measure would gradually lift that minimum to $15 hourly by 2025, doubling the current $7.25 floor in effect since 2009.
Hoping to revive the effort, Senate Majority Leader Chuck Schumer, D-N.Y., is considering adding a provision to the Senate version of the COVID-19 relief bill that would penalize large companies that don’t pay workers at least $15 an hour, said a senior Democratic aide who spoke on condition of anonymity to discuss internal
conversations.
That was in line with ideas floated Thursday night by Sens. Bernie Sanders, I-Vt., a chief sponsor of the $15 plan, and Senate Finance Committee Chair Ron Wyden, D-Ore., to boost taxes on corporations that don’t hit certain minimum wage targets.
House Speaker Nancy Pelosi, D-Calif., offered encouragement too, calling a minimum wage increase “a financial necessity for our families, a great stimulus for our economy and a moral imperative for our country.” She said the House would “absolutely” approve a final version of the relief bill because of its widespread benefits, even if it lacked progressives’ treasured goal.
While Democratic leaders were eager to signal to rank-and-file progressives and liberal voters that they would not yield on the minimum wage fight, their pathway was unclear because of GOP opposition and questions over whether they had enough Democratic support.
House Ways and Means Committee Chair Richard Neal, D-Mass., sidestepped a question on taxing companies that don’t boost pay, saying of Senate Democrats, “I hesitate to say anything until they decide on a strategy.”
Rep. Alexandria Ocasio-Cortez, D-N.Y., another high-profile progressive, also said Senate rules must be changed, telling reporters that when Democrats meet with their constituents, “We can’t tell them that this didn’t get done because of an unelected parliamentarian.”
Traditionalists of both parties — including Biden, who served as a senator for 36 years — have opposed eliminating filibusters because they protect parties’ interests when they are in the Senate minority. Biden said weeks ago that he didn’t expect the minimum wage increase to survive the Senate’s rules. Democrats narrowly hold Senate control.
Pelosi, too, seemed to shy away from dismantling Senate procedures, saying, “We will seek a solution consistent with Senate rules, and we will do so soon.”
The House COVID-19 bill includes the minimum wage increase, so the real battle over its fate will occur when the Senate debates its version over the next two weeks.
Democrats are pushing the relief measure through Congress under special rules that will let them avoid a Senate GOP filibuster, meaning that if they are united they won’t need any Republican votes.