When the first COVID-19 vaccine was approved for emergency use in the US, many breathed a sigh of relief. Finally a light of hope was shining through the fog of uncertainty that had surrounded us since the beginning of the pandemic. But it’s now March 2021 and as the pandemic stretches towards the one-year mark, vaccines are not getting to the communities who need them most.
From the beginning, communities of color have been among the hardest hit by the virus with two to three times more Black, Latinx, and Indigenous people experiencing severe COVID-19 symptoms or death than White people, but they are getting vaccinated at incredibly low rates.
While the vaccines were being developed, the CDC and public health professionals were working to establish guidelines on who should be prioritized for vaccination. This is a complex and sensitive process, but guidelines were released prioritizing those over age 75, healthcare and frontline essential workers, those with existing health conditions, and long-term care facility residents.
Seems simple enough, right?
Of course, it’s not that simple! Is it ever that simple?
Racism, power, and history
The prioritization guidelines set by the CDC seem straightforward, but it’s important to remember that vaccine distribution and administration rest in the hands of structures and systems in this country that were not made to serve everyone.
This country was built on racist and inequitable systems purposefully maintained over centuries. As a result, we see lower vaccination rates among Black, Indigenous, people of color (BIPOC) communities as well as higher levels of vaccine hesitancy due to centuries of medical racism.
My colleagues Adrienne Hollis and Derrick Jackson have written in-depth on the impacts of systemic racism during the pandemic, describing the egregious lack of vaccine distribution in communities who are experiencing high rates of COVID-19 related hospitalizations and deaths.
Environmental justice leader and former leader of the EPA Office of Environmental Justice, Mustafa Santiago Ali, has also written extensively on the inequities that individuals of color face when it comes to COVID-19.
Navigating the system
If you’re a healthcare worker or long-term care facility resident, you are likely to receive the vaccine from your employer or facility staff. Others find themselves trying to navigate a complex, decentralized system to schedule a vaccination appointment.
The difficulty in scheduling vaccine appointments has led to a variety of tools popping up like vaccinefinder.org or NPR’s vaccine tool. If you’re on social media, online networks of “Vaccine Hunters” are also a resource people are turning towards for help finding and scheduling vaccine appointments. Some states and counties have also created hotlines to assist with understanding eligibility and scheduling.
In my opinion, if you need that many tools to figure out how to do something as simple as make an appointment, it must be pretty difficult!
Meanwhile, countless stories have popped up about how people just got ‘lucky’—they were in the right place at the right time, and they were able to get an “extra” vaccine that needed to be used before it expired. These stories of luck often include a White, wealthy, or otherwise privileged protagonist.
At the end of the day, luck has nothing to do with it. The fact is the system was not built for everyone to thrive and succeed.
While states and counties were trying to develop a system to get the vaccines to those who need them, they seem to have failed to consider the context in which we all live. This country has a long history of racism and systems of oppression that have left many without the tools or resources they need to even schedule a vaccine appointment (i.e., reliable internet, transportation, paid sick leave, etc.).
Before we get to the numbers
The CDC recommends that states collect data on the race of individuals receiving vaccines, but the data is spotty. Certain states have released data with a racial breakdown, others have failed to do so, while others are prevented from collecting such information due to state-specific laws.
Furthermore, I must acknowledge that data collection itself has its own problematic history. For example, the very way in which we define categories of race and collect data based on those categories is flawed – to say the very least.
Nonetheless, we are working with what we have and with the data that is available, and a pattern has emerged.
BIPOC communities left without vaccines
In cities across the country, BIPOC communities are not getting vaccinated at the rate we would expect. At the same time, White people have often been seen showing up in BIPOC communities with their sleeves rolled up to take the shot that had been earmarked for a person of color.
Analysis by the Associated Press, New York Times, and the Kaiser Family Foundation gives us a basis for what’s happening at the state level. In Maryland for example, we see that Black individuals make up about 23 percent of healthcare workers and 40 percent of people over 75. Considering this, we should expect that somewhere between 23 and 40 percent of the people getting vaccinated should be Black, but that’s not what we are seeing. Instead, we see just about 16 percent of those vaccinated are Black.
If there was equitable access to the vaccine, that percentage would be close to double the magnitude.
Source: Associated Press
This is what we are seeing across the country.
In Chicago, Boston, Seattle, and New York, for example, people of color are not getting vaccinated at the rate that we would expect based on the racial make-up of the groups currently eligible for vaccination.
To understand what this is looking like from a bird’s-eye view, let’s take a look at some maps.
Chicago
Chicago is among the most segregated cities in the US. This legacy of segregation and inequality began with The Great Migration and was maintained by red-lining, racial covenants, and a plethora of other racist policies. This history and the different worlds that exist within the city is shown beautifully through Tonika Johnson’s Folded Map Project.
Maps put out by the SouthSide Weekly’s ChiVaxBot were actually the inspiration for this blog. As someone who lived just 20 minutes north of Chicago for most of my life, I was unfortunately not surprised by what I saw when these maps popped up on my Twitter feed.
Take a moment to observe the patterns here in these new maps I created:
Left: Dot Density map of race by census block group for the city of Chicago where 1 dot is representative of 5 people; Right: ‘Heat Map’ showing density of vaccination sites that are open to the community (i.e. not ‘patients only’ sites). The dark blue shows highest density of vaccination sites while light blue shows lower density of sites. Source: NHGIS IPUMS and Chicago Data Portal
Across the city, Black and Brown communities are among those most affected by COVID-19, but those communities have access to fewer vaccination sites and are getting vaccinated at lower rates compared to majority-White communities. Currently 13 percent of White Chicagoans have received their first vaccine dose compared to 6 percent of the Latinx population and 7 percent of the Black population.
To combat this disparity, community organizations such as Howard Brown Health have been working to make sure people living in communities of color get vaccinated by setting up vaccination points at the center of those communities. From the map of COVID-19 vaccination sites above, we can see that vaccination centers are sparser in majority BIPOC communities. By setting up more vaccination sites in these communities, Howard Brown Health is not only increasing access for those within prioritized groups in those areas, but they are also making sure that if someone is ‘lucky’ enough to get a ‘left-over’ vaccine, it is more likely to be a person of color.
Seattle
Currently, the Union of Concerned Scientists’ Center for Science and Democracy is working with La Comunidad Latina de Vashon in the Seattle area to provide resources to help answer people’s questions about the COVID-19 vaccine. For this reason, I decided to also look at data from the Seattle area—King County, WA to be more exact.
According to the Brookings Institute, Seattle is average when it comes to their measure of segregation, so where people are getting vaccinated is not quite as correlated with who is getting vaccinated. That is, by looking at a map of COVID-19 mortality by zip code, it’s not as easy to see which races or ethnicities are most affected by the pandemic since neighborhoods are not as homogeneous. However, we can still see clusters of BIPOC communities throughout the city and compare them to the location of vaccination sites as well as the zip codes with the highest rates of COVID-19 mortality.
Take a minute to explore the map (below). Are there areas without vaccination sites that need them? What’s the racial make-up of those areas?
Dot density map of race by census block for King County, WA. Each dot is representative of 5 people. Source: NHGIS IPUMS
‘Heat Map’ showing density of vaccination sites that are open to the community (i.e. not ‘patients only’ sites). The dark blue shows highest density of vaccination sites while light blue shows lower density of sites. Source: NHGIS IPUMS and Washington State Department of Health
Vaccination rates for King County weren’t available at the zip code or census tract level, but data from King County show that vaccination rates among communities of color are lagging behind that of their White neighbors. Based on our map of vaccination sites, we could hypothesize that the location of vaccination providers is contributing to this disparity as there are many areas with substantial BIPOC communities—some of which have experienced high COVID-19 mortality rates—with few or no vaccination sites nearby.
In the face of COVID-19 and the health disparities experienced by communities of color, community organizations adapted quickly to respond to the health crisis in their community. According to Alejandra Tres, co-founder of La Comunidad Latina de Vashon, they were able to pull from previous experiences and organize training to galvanize community-led programs to address the emerging health crisis in their communities. In particular, the youth stepped up to make sure their communities had the support, knowledge, and resources necessary to protect themselves and their loved ones. Now that a vaccine is available, the organization is advocating for their community’s right to health, working to ensure equal access to the life-saving vaccines that can prevent further death and disability.
Cleveland
As part of our vaccine response, my colleague Anita Desikan and I have been working with Greater Cleveland Congregations (GCC) to develop a FAQ document and training sessions to give members the information needed to host discussion sessions on COVID-19 vaccines. Through a series of five online sessions, we met directly with community members and have heard about the ways in which COVID-19 is impacting their communities and the questions or concerns they have about the vaccines.
Cleveland, like Chicago, is among one of the most segregated cities in the country. We see that in the map below with clusters of orange points to the east and clusters of blue and yellow points to the west. When positioned next to a map of vaccination site density, we see that vaccination sites tend to be clustered in majority-white neighborhoods.
Dot density map of race by census block for the city of Cleveland. 1 dot is representative of 5 people. Source: NHGIS IPUMS
‘Heat Map’ showing density of vaccination sites that are open to the community (i.e. not ‘patients only’ sites). The dark blue shows highest density of vaccination sites while light blue shows lower density of sites. Source: NHGIS IPUMS and Ohio Department of Health
From our experience meeting with community members as well as data provided by Cuyahoga County, we see that communities of color have been hard hit by the pandemic but they are not getting vaccinated at the same rate as their white neighbors. In Ohio, we see that Black individuals make up about 8 percent of those over 75 and 15 percent of healthcare workers in the state, but African American individuals make up just about 6 percent of those who have been vaccinated. Furthermore, Ohio’s COVID-19 dashboard shows that just 1.86 percent of the African American population has been vaccinated compared to over 6 percent of the White population.
Community organizations like GCC are working hard to make sure that their communities get vaccinated. Keisha Krumm and her colleagues at GCC’s Color of Health program took action last year, turning churches in their congregation into testing sites which lead to the testing of 5,000 community members. Now, with these sessions, GCC is making sure community members have the knowledge, resources, and support to make the decisions that are best for themselves and their loved ones.
By presenting the science behind the vaccine and addressing disinformation, the sessions have equipped more than 90 community members with the skills and knowledge to hold their own discussion sessions on the vaccines.
What can we do?
First, demand the data!
Currently, the demographic data on race and ethnicity for those who have been vaccinated is incomplete. This inhibits further analysis and prevents us from having a greater understanding of the inequities that currently exist. Without more complete data, we cannot fully identify the extreme racial inequities in vaccination rates and carry out science-based solutions that address these inequities.
Second, support local efforts.
Community organizations have an immense power to disseminate information and advocate for more equitable vaccine access at a local level. I’ve named just a few of these organizations here, but there are likely groups in your neighborhood working to help get people the information and support that they need to get vaccinated. By donating your time or money to these organizations, you can do your part to help ensure that communities of color are better able to access life-saving vaccines.