President Biden: Make equitable vaccine access a national priority

This week brought encouraging news that nearly 9.1 percent of the U.S. population has already received the first dose of the COVID-19 vaccine. With 1.4 million shots being administered each day across the country, the path to herd immunity and a return to some sense of normalcy will hopefully accelerate over the coming months assuming manufacturers can keep pace with vaccine demand.

But an ugly truth lurks beneath the surface of these promising data points: the glaring racial disparity between those who are receiving vaccine shots and those who are not.

A recent analysis found that in North Carolina, Black Americans comprise 22 percent of the state’s population, yet just 11 percent have been vaccinated thus far. In Philadelphia, Black residents represent 40 percent of the area’s population, but just 14 percent have been vaccinated. And in Florida, just 2 percent of Black residents have received just at least one dose. In over 20 other states, vaccination rates for Black Americans trail that of white Americans.

The statistics are even more startling for those on the frontlines. In Maryland, Black residents make up 40 percent of the state’s health care industry, yet just 16 percent have been vaccinated to date. In Mississippi, the ratio is 37 percent to 15 percent, respectively.

The true racial inequity of the vaccine rollout is undoubtedly far worse than what these numbers already show. That’s because many states aren’t tracking or reporting any racial vaccine recipient data at all. Until they do, we have no way of knowing exactly how wide the gap actually is.

The vaccine rollout has been complicated and confusing. Fifty states have 50 plans for prioritization and access based on an uncertain and fluctuating vaccine supply. Frustration is mounting across the country as people struggle to register, book appointments online, take time from work to receive the first shot, then schedule more time off in three to four weeks to receive the second dose. 

Communities of color, many of whom have a preexisting (and justified) distrust of the public health system, begin with a higher vaccine hesitancy due to historic abuse and past mistreatment by the U.S. government. They require targeted messaging about vaccine safety and access. 

Those who want the vaccine and are eligible to receive it face many challenges. The digital divide, which disproportionately impacts older people of color, creates additional burdens as vaccine eligibility data and appointment scheduling are mostly online. There are language barriers facing Americans who don’t speak English and for our nation’s 11 million undocumented immigrants, there is no greater vaccination deterrent than the fear of being identified and deported when registering for a COVID-19 shot.  

Then there are the “essential workers,” many of whom are people of color and operate as independent contractors, where the prospect of taking time off work on two separate days means less income to them and their families. We applauded them when the pandemic started. But the public health system has let them down by failing to prioritize their vaccine eligibility. For nearly a year they have put their lives on the line to help others stay fed and safe. We must make it easier for them to access the vaccine. And their employers, especially those reporting record profits in 2020, should find ways to compensate them for doing their part to end this crisis and prevent further spread of COVID-19.

Many want to be vaccinated immediately, but distribution of available vaccines should reflect the pandemic’s epidemiology. When white residents flood vaccination distribution centers intended to serve local communities, fairness and decency lose. Communities of color have been disproportionately impacted by COVID-19, yet today they are severely underrepresented in the vaccine rollout. We can — we must — do better.

President Biden and his administration can meet this moment to rebuild trust in our public health system. We need a national strategy to create a level playing field so all Americans have an equal shot at receiving a shot. We need it now.  

Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.