The role of race in the coronavirus vaccine rollout plan was tested in Oregon on Thursday (January 28) after a panel of 27 health professionals weighed the possibility of prioritizing people of color in the next phase of the state’s distribution plan for the vaccine, but ultimately went with other groups, after concerns over legalities were expressed.
The panel landed on a recommendation of its next phase to include people under the age of 65 who have chronic medical conditions, incarcerated people, and other people living in shared spaces, and essential workers.
The panel’s statement on their decision claims they did review the disproportionate impact of COVID-19 on communities of color, and that the selected groups were likely to include people of color.
“Our system is not yet prepared to center on and reveal the truth of structural racism and how it plays out,” healthcare disparity expert and panel member Kelly Gonzales said. Gonzales is also a member of the Cherokee Nation of Oklahoma.
The panel’s role is to provide Oregon Governor Kate Brown and other state public health officials with recommendations on how to navigate the state through the pandemic, though their decisions aren’t necessarily the final word on the matter, according to The Associated Press.
In Texas, state officials reportedly threatened to decrease the vaccine supply to Dallas after city health officials were prioritizing distribution using the most vulnerable zip codes – which were mostly communities of color – as guides. The city reversed its decision and is what some local entities fear will happen on a wider basis.
To get around potential legal challenges, nearly all 50 states are using race and ethnicity in what’s called a “social vulnerability index” or “disadvantage index” that includes about a dozen other data points when tallying an area’s risk.
Because of centuries of systemic racism, experts say the tools’ data points are likely capturing people of color and others who experience systemic oppression. This is done all while bypassing “very, very difficult and toxic questions,” Harald Schmidt, a medical ethicist at the University of Pennsylvania told the AP.
Schmidt added that the tools help officials plan the distribution on the basis of “race and disadvantage,” not just race.
President Joe Biden's COVID-19 Task Force gave their first briefing on Wednesday (January 27), highlighting the virus’ effect on Black people and other people of color, both in numbers of infections and deaths, and economically.
The Biden team has publicly underlined the importance of adding “social vulnerability” in vaccine distribution plans on the state level, adding that race, ethnicity, and rural communities should be considered in their plans. The team called on states to identify “pharmacy deserts” where getting the vaccine into people’s arms would be a challenge.
Eighteen states included equity measures in their original vaccination plans designed last year.
Tennessee’s plan included a proposal to keep five percent of its allocated vaccine for “high-disadvantage areas.” California created its own scale for making assessments of community needs.
“We’ve been telling a fairly simple story: ‘Vaccines are here.’ Now we have to tell a more complicated story,” bioethicist Nancy Berlinger said. “We have to think about all the different overlapping areas of risk, rather than just the group we belong to and our personal network.”
Portland State University Social Work Professor Roberto Orellana trained his students in contact tracing in Hispanic communities to address the community’s 300% higher risk of contracting the virus. He said, “I don’t want to take away from any other group. It’s a hard, hard question, and every group has valid needs and valid concerns.”
“We shouldn’t be going through this,” he added. “We should have vaccines for everybody –– but we’re not there.”
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