Within weeks, it became clear that far from being an equalizer, covid-19 instead preyed upon and exacerbated existing disparities in the United States — particularly along racial and ethnic lines, with Black people, Latinos, Native Americans and Pacific Islanders more than twice as likely as White people to die of the disease.
Now, as vaccines roll out across the country, we are seeing a repeat of the same old pattern: In nearly every jurisdiction where racial and ethnic data are being reported, White Americans are being vaccinated at higher rates. Commentators have been quick to blame vaccine hesitancy in Black and Latino communities as driving the vaccination gap. In reality, communities of color are lagging behind because they can’t access the vaccine, not because they don’t want it.
New polling from Cornell Belcher, the National Urban League and the Alliance of National Psychological Associations for Racial and Ethnic Equity makes this clear. The data show that huge majorities of all groups surveyed — 67 percent of Black people, 71 percent of Latinos, 81 percent of Filipino-Americans, 90 percent of Vietnamese-Americans and 66 percent of Native Hawaiians — are willing to take the vaccine. They are also “very concerned” about their health and the health of their immediate families.
The one-size-fits-most approaches that many states have adopted for vaccine distribution don’t fit the most vulnerable at all. Online registration is a barrier for many people of color who are eager to get vaccinated. While 8 in 10 White people own a computer, fewer than 60 percent of Black people and Latinos do, and many vaccine websites aren’t optimized for mobile Web browsers. Lack of personal transportation and inflexible schedules can also create barriers, particularly for low-income and front-line workers. Those are all reasons why multiple cities report seeing White residents booking vaccine appointments at clinics located in communities of color.
Cities and states must urgently flip the script on vaccine distribution. Instead of relying on first-come-first-served Web portals, health departments should reserve appointment slots for disproportionately impacted groups and conduct proactive, targeted outreach to communities of color.
If political campaigns can conduct targeted phone banks and canvass doors to reach certain voters, health departments can use the same tactics to reach high-risk residents based on their demographic information. In addition to setting up big, centralized vaccination sites, we should be deploying mobile vaccination units, leveraging community clinics and neighborhood organizations, and making appointments available after 5 p.m. and on weekends so people can more easily get vaccinated where they live and around their work schedules. For communities with large immigrant populations, providing vaccine information in languages other than English and having translators on hand is essential.
Meanwhile, for the minority of people of color who are hesitant toward vaccines, Belcher’s study found that concerns about safety are the driving factor. The good news is, trusted messengers — including public health professionals, community leaders and friends and neighbors — can help break through by hearing peoples’ concerns without judgment and attesting to the vaccine’s safety. All three of us have seen this in our own lives, as we have shared our own positive vaccine experiences with friends and neighbors.
Health departments should deploy targeted TV, social media and radio commercials, along with public information sessions and peer-to-peer education, to share what we know: All coronavirus vaccines approved in the United States followed all safety protocols during development and production and are highly effective at preventing symptoms, hospitalizations and deaths.
Some places are already taking positive steps, and the federal government and other states need to follow in their example. In Bergen County, N.J., the health department set up a dedicated outreach team, reserved appointments and partnered with community leaders to make them vaccine ambassadors after realizing the vaccination rate for Black and Brown residents was far lower than their share of the population. The city of Baltimore sent a sound truck to Latino neighborhoods to help spread information about vaccine safety. And in California, the governor recently announced that 40 percent of the state’s doses would be set aside for the most-impacted communities.
If we’ve learned anything in the last year, however, it’s that states and localities can’t be asked to go it alone. Just as the White House recently directed states to prioritize vaccinating teachers and school employees, the federal government must set out best practices for prioritizing getting vaccines to communities of color and offer incentives to states and localities to finally begin closing the vaccine gap. Doing so could mean the difference between life and death in our communities.