The role that race should play in deciding who gets priority for the Covid-19 vaccine in the next phase of the rollout is being put to the test in Oregon as tensions around equity and access to the shots emerge nationwide, reports Gillian Flaccus for the Associated Press.
An advisory committee that provides recommendations to Oregon’s governor and public health authorities will vote later today on whether to prioritize people of color, target those with chronic medical conditions or focus on some combination of groups at higher risk from the coronavirus. Others, such as essential workers, refugees, inmates and people under 65 living in group settings, are also being considered.
The 27-member committee in Oregon, a Democratic-led state that’s overwhelmingly white, was formed with the goal of keeping fairness at the heart of its vaccine rollout. Its members were selected to include racial minorities and ethnic groups, from Somalian refugees to Pacific Islanders to tribes. The committee’s recommendations are not binding but provide critical input for Gov. Kate Brown and guide health authorities crafting the rollout.
“It’s about revealing the structural racism that remains hidden. It influences the disparities we experienced before the pandemic and exacerbated the disparities we experienced during the pandemic,” said Kelly Gonzales, a member of the Cherokee Nation of Oklahoma and a health disparity expert on the committee.
The virus has disproportionately affected people of color. Last week, the Biden administration reemphasized the importance of including “social vulnerability” in state vaccination plans with race, ethnicity and the rural-urban divide at the forefront and asked states to identify “pharmacy deserts” where getting shots into arms will be difficult.
Overall, 18 states included ways to measure equity in their original vaccine distribution plans last fall and more have likely done so since the shots started arriving, said Harald Schmidt, a medical ethicist at the University of Pennsylvania who has studied vaccine fairness extensively.
Some, such as Tennessee, proposed reserving 5% of its allocation for “high-disadvantage areas,” while states like Ohio plan to use social vulnerability factors to decide where to distribute vaccine, he said.
Attempts to address inequities in vaccine access have already prompted backlashes in some places. Dallas authorities recently reversed a decision to prioritize the most vulnerable ZIP codes primarily communities of color after Texas threatened to reduce the city’s vaccine supply. That kind of pushback is likely to become more pronounced as states move deeper into the rollout and wrestle with difficult questions about need and short supply.
To avoid legal challenges, almost all states looking at race and ethnicity in their vaccine plans are turning to a tool called a “social vulnerability index” or a “disadvantage index.” Such an index includes more than a dozen data points everything from income to education level to health outcomes to car ownership to target disadvantaged populations without specifically citing race or ethnicity.
“The point is not, ‘We want to make sure that the Obama family gets the vaccine before the Clinton family.’ We don’t care. They can both safely wait,” he said. “We do care that the person who works in a meatpacking plant in a crowded living situation does get it first. It’s not about race, it’s about race and disadvantage.”