USA TODAY International Edition
Another View: Don’t sacrifice equity for efficiency
For most of the COVID- 19 pandemic, there has been disagreement on every aspect of public health policies ( e. g., universal lockdown, school reopenings). But there is near complete agreement that the path forward to end the pandemic is through rapid and mass vaccination to achieve herd immunity.
Yet, COVID- 19 vaccination has gotten off to an incredibly slow start in the United States. Early projections by the government to reach 20 million people by the end of 2020 have fallen flat. Many struggles in mass distribution of vaccines have arisen related to lack of infrastructure and resources on how to deliver vaccines efficiently.
These struggles are familiar to those experienced early in the pandemic for COVID- 19 testing. Unfortunately, the story of COVID- 19 testing became one where testing was clearly inequitable, with fewer testing centers in disadvantaged and minority communities and populations. This might have promoted disparities due to COVID- 19, with Black Americans being 2.3- fold and Latinx Americans being 2.5- fold more likely to die from COVID- 19.
These data are also consistent with decades of evidence documenting racial disparities in a variety of health outcomes, such as heart disease.
Fundamental causes of health inequities in COVID- 19 are upstream and largely attributed to structural and systemic factors, such as residential segregation and racial discrimination that lead to disproportionate burden of chronic diseases in Black and Latinx Americans.
Early in the pandemic, as lockdowns were applied, it was visibly apparent that not everybody can work from home. Substantial disparities in COVID- 19 morbidity might also have been fueled by the fact that fewer than 1 in 5 Black workers and about 1 in 6 Latinx workers are able to work from home.
While efficiency is a laudable goal, it cannot occur by sacrificing equitable distribution. COVID- 19 vaccination distribution cannot prove to have the same refrain and exacerbate documented health disparities.
Because they are among those at greatest risk, let’s focus on efficiently vaccinating our most vulnerable members of society: essential front- line workers, older adults and individuals with chronic disease.