Racial, wealth gaps show up in vaccine lines
WASHINGTON — As soon as this city began offering COVID vaccines to residents 65 and older, George Jones, whose nonprofit agency runs a medical clinic, noticed something striking.
“Suddenly our clinic was full of white people,” said Jones, the head of Bread for the City, which provides services to the poor. “We’d never had that before. We serve people who are disproportionately African American.”
Similar scenarios are unfolding around the country as states expand eligibility for the shots. Although low-income communities of color have been hit hardest by COVID-19, health officials in many cities say that people from wealthier, largely white neighborhoods have been flooding vaccination appointment systems and taking an outsized share of the limited supply.
People in underserved neighborhoods have been tripped up by a confluence of obstacles, including registration phone lines and websites that can take hours to navigate, and lack of transportation or time off from jobs to get to appointments. But also, skepticism about the shots continues to be pronounced in Black and Latino communities, depressing signup rates.
Early vaccination data is incomplete, but it points to the divide. In the first weeks of the rollout, 12 percent of people inoculated in Philadelphia have been Black, in a city whose population is 44 percent Black. In MiamiDade County, just about 7 percent of the vaccine recipients have been Black, even though Black residents comprise nearly 17 percent of the population and are dying from COVID-19 at a rate that is more than 60 percent higher than that of white people. In data released last weekend for New York City, white people had received nearly half of the doses, while Black and Latino residents were starkly underrepresented based on their share of the population.
And in Washington, 40 percent of the nearly 7,000 appointments initially made available to people 65 and older were taken by residents of its wealthiest and whitest ward, which is in the city’s upper northwest section and has had only 5 percent of its COVID deaths.
“We want people regardless of their race and geography to be vaccinated, but I think the priority should be getting it to the people who are contracting COVID at the highest rates and dying from it,” said Kenyan McDuffie, a member of the City Council whose district is two-thirds Black and Latino.
Alarmed, many cities are trying to rectify inequities. Baltimore will offer the shot in housing complexes for the elderly, going door to-door.
“The key with the mobile approach is you can get a lot of hardhit folks at the same time — if we just get enough supply to do that,” said the city’s health commissioner, Dr. Letitia Dzirasa.
Officials in Wake County, N.C., are first attempting to reach people 75 and older who live in nine ZIP codes that have had the highest rates of COVID.
“We weren’t going to prioritize those who simply had the fastest internet service or best cell provider and got through fastest and first,” said Stacy Beard, a county spokesperson.
Fixing the problem is tricky, however. Officials fear that singling out neighborhoods for priority access could invite lawsuits alleging race preference. To a large extent, the ability of localities to address inequities depends on how much control they have over their own vaccine allocations and whether their political leadership aligns with that of supervising county or state authorities.
The experiences of Dallas and the District of Columbia, for example, have resulted in very different outcomes. Dallas County, predominantly Democratic, has been thwarted by the state health department, under the aegis of a Republican governor, which quashed the county’s plan to give vaccines to certain minority neighborhoods first. But Washington was able to quickly coursecorrect.
D.C. pivots on plan
A few days after its 65-and-older population became eligible for the vaccine on Jan. 11, McDuffie, the city councilman in the District of Columbia, flagged the issue of wealthier residents getting disproportionate access to the vaccine in a call with city officials. 74 percent of deaths and 48 percent of cases in Washington have been among Black residents, who make up 46 percent of the population; 11 percent of deaths and 25 percent of cases have been among white residents, who make up nearly the other half of the district.
By the end of that week, the city announced a new policy — offering the first day of new appointments to people in ZIP codes with the highest rates of infection and death from the virus. Under the new system, more appointments would be added a day later and people from other neighborhoods could sign up then. The city also quadrupled the number of workers helping people make appointments through its call center, to 200.
But email lists in wealthier neighborhoods lit up in protest.
“It looked like maybe Ward 3 was being punished for being more computer savvy,” said Mary Cheh, a city council member representing the ward, where houses in neighborhoods near American University or the Potomac River routinely sell for more than $2 million. “I was inundated with emails from people who were just really angry about it.”
The day after the policy change, Cheh wrote to her constituents, citing the data about the shots and saying that “our anxiety to get one right away should not cloud the pursuit of equitable vaccine distribution.”
“When I sent out that note, people said, ‘Oh thank you, I understand now,’” Cheh said. Still, she called the city’s new system “a very blunt instrument,” and said it would be fairer to base need on an individual’s risk, not an entire neighborhood’s.
Dallas County’s rollout plans for the vaccine included an inoculation hub in a neighborhood that is largely African American and Latino. But when the sign-up website went live, the link speedily circulated throughout white, wealthier districts in North Dallas.
“Instead of getting a diverse sampling, we had a stampede of people who were younger and healthier than those who had initially gotten the links,” said Judge Clayton Jenkins, who is essentially the county’s chief executive. Observers told commissioners that those in line were overwhelmingly white.
‘Stampede of people’
The county commissioners quietly contacted Black and Latino faith leaders in South Dallas, who encouraged constituents to show up for shots without appointments, as long as they offered proof that they were 75 and older.
That plan worked for a day or so.
“Then city council people in North Dallas got calls and the mayor said it would be open to everyone over 75,” Jenkins said. “That led again to a huge stampede of people from the suburbs who had reliable cars.”
John Wiley Price, a Dallas commissioner who represents voters in South Dallas, argued that the 27,000 people who had signed up from 11 vulnerable ZIP codes should be given the vaccine ahead of other neighborhoods. Already, more than 300,000 Dallas County residents had registered; the county was only receiving a weekly allocation of about 9,000 doses.
But when Jenkins inquired whether geographical priority would pass muster, state officials said that if Dallas proceeded with the plan, the state would withhold the county’s supply.
Dallas backed down.