The Mercury News

Black Americans are receiving shots at lower rates

Analysis: Trust issues rooted in structural racism a major factor

- By Hannah Recht and Lauren Weber

Black Americans are receiving COVID-19 vaccinatio­ns at dramatical­ly lower rates than White Americans in the first weeks of the chaotic rollout, according to a new KHN analysis.

About 3% of Americans have received at least one dose of a coronaviru­s vaccine so far. But in 16 states that have released data by race, White residents are being vaccinated at significan­tly higher rates than Black residents, according to the analysis — in many cases two to three times higher.

In the most dramatic case, 1.2% of White Pennsylvan­ians had been vaccinated as of Jan. 14, compared with 0.3% of Black Pennsylvan­ians.

The vast majority of the initial round of vaccines has gone to health care workers and staffers on the front lines of the pandemic — a workforce that’s typically racially diverse and made up of physicians, hospital cafeteria workers, nurses and janitorial staffers.

If the rollout were reaching people of all races equally, the shares of people vaccinated whose race is known should loosely align with the demographi­cs of health care workers. But in every state, Black Americans were significan­tly underrepre­sented among people vaccinated so far.

Access issues and mistrust rooted in structural racism appear to be the major factors leaving Black health care workers behind in the quest to vaccinate the nation. The unbalanced uptake among what might seem like a relatively easy-to-vaccinate workforce doesn’t bode well for the rest of the country’s dispersed population.

Black, Latino and Native Americans are dying from COVID-19 at nearly three times the rate of White Americans, according to a Centers for Disease Control and Prevention analysis. And non-Latino Black and Asian health care workers are more likely to contract COVID-19 and to die from it than White workers. (Latinos can represent any race or combinatio­n of races.)

“My concern now is if we don’t vaccinate the population that’s highest-risk, we’re going to see even more disproport­ional deaths in Black and Brown communitie­s,” said Dr. Fola May, a UCLA physician and health equity researcher. “It breaks my heart.”

Dr. Taison Bell, a University of Virginia Health System physician who serves on its vaccinatio­n distributi­on committee, stressed that the hesitancy among some Blacks about getting vaccinated is not monolithic. Nurses he spoke with were concerned it could damage their fertility, and a Black co-worker asked him about the safety of the Moderna vaccine since it was the company’s first such product on the market. Some floated conspiracy theories, and other Black co-workers just wanted to talk to someone they trust like Bell, who is

also a Black person.

But access issues persist, even in hospital systems. Bell was horrified to discover that members of environmen­tal services — the janitorial staff — did not have access to hospital email. The vaccine registrati­on informatio­n sent out to the hospital staff was not reaching them.

“That’s what structural racism looks like,” said Dr. Georges Benjamin, executive director of the American Public Health Associatio­n. “Those groups were seen and not heard — nobody thought about it.”

UVA Health spokespers­on Eric Swenson said some of the janitorial crew were among the first to get vaccines and officials took additional steps to reach those not typically on email.

He said more than 50% of the environmen­tal services team has been vaccinated so far.

Historical hesitation

One-third of Black adults in the U.S. said they don’t plan to get vaccinated, citing the newness of the vaccine and fears about safety as the top deterrents, according to a December poll from Kaiser Family Foundation. Half of them said they were concerned about getting COVID-19 from the vaccine itself, which is not possible.

Experts say such misinforma­tion is a growing problem. Inaccurate conspiracy theories that the vaccines contain government tracking chips have gained ground on social media.

Just over half of Black Americans who plan to get the vaccine said they’d wait to see how well it’s working in others before getting it themselves, compared with 36% of White Americans. That hesitation can even be found in the health care workforce.

“We shouldn’t make the assumption that just because someone works in health care that they somehow will have better informatio­n or better understand­ing,” Bell said.

In Colorado, Black workers at Centura Health were 44% less likely to get the vaccine than their White counterpar­ts. Latino workers were 22% less likely. The hospital system of more than 21,000 workers is developing messaging campaigns to reduce the gap.

“To reach the people we really want to reach, we have to do things in a different way; we can’t just offer the vaccine,” said Dr. Ozzie Grenardo, a senior vice president and chief diversity and inclusion officer at Centura. “We have to go deeper and provide more depth to the resources and who is delivering the message.”

That takes time and personal connection­s. It takes people of all ethnicitie­s within those communitie­s, like Willy Nuyens.

Nuyens, who identifies as Latino, has worked for Kaiser Permanente Los Angeles Medical Center for 33 years. Working on the environmen­tal services staff, he’s now cleaning COVID patients’ rooms. (Kaiser Health News is not affiliated with Kaiser Permanente.)

In Los Angeles County, 92% of health care workers and first responders who have died of COVID were non-White. Nuyens has seen too many of his co-workers lose family to the disease. He jumped at the chance to get the vaccine but was surprised to hear only 20% of his 315-person department was doing the same.

So he went to work persuading his co-workers, reassuring them that the vaccine would protect them and their families, not kill them.

“I take two employees, encourage them and ask them to encourage another two each,” he said.

So far, uptake in his department has more than doubled to 45%. He hopes it will be over 70% soon.

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