Vaccine Disparities and COVID-19

By Karen Sternheimer

As I write, both of my parents just received their second COVID-19 vaccinations. This is of course a great relief, since they are in their 70s, but their experience highlights some of the inequities built into the scramble to get vaccinated.

While the U.S. supply cannot keep up with demand at the moment, in some countries there is no supply at all. According to UNICEF, and reported by NPR, about 130 countries had no vaccine as of mid-February. In the U.S., the distribution varies quite a bit per state, with some states vaccinating at twice the rate of others. (See this NPR Tracker to find out how your state compares.)

The process of getting a vaccine varies quite a bit as well, with most locations requiring recipients to schedule appointments online. This can be an insurmountable barrier for people without internet access or those who aren’t tech-savvy. Even if you are quite comfortable with the internet,  the process isn’t so easy. Although my mother is very comfortable using technology (she has the most trouble separating from her phone of anyone in our family), whenever she tried to book an appointment, they were always full. She would even try in the middle of the night sometimes, to no avail.

She had signed up for several notifications to find out when appointments opened up, but it was my sister who booked the appointment for her after checking at 5 am when she got up for work. She was able to get my tech-phobic father an appointment too. I ultimately got an appointment for my mother-in-law after several attempts scouring the internet and signing up for notifications.

I remembered a chance encounter with a neighbor while talking a walk, who excitedly told us he had been vaccinated at Dodger Stadium the day before rather than a local hospital, as he preferred to stay in his car. After a not-so-easy internet scavenger hunt, I found the hospital’s sign-up page and got my mother-in-law an appointment a few weeks later. The next day, I received a notification from that hospital that appointments could be made online (I was signed up for notifications). Out of curiosity I went to the site to find all of the appointments were gone. If I hadn’t remembered my neighbor saying they were vaccinating at that hospital, I never would have gotten my mother-in-law an appointment. It is now a month later and they are still not taking new appointments for first doses.

Anyone lacking the internet skills or the time to repeatedly search for an appointment is at a serious disadvantage. Once an appointment is made, elderly people often need someone to take them to the appointment, which means you need a family member or caregiver who has the time to do so, and in many places a car of their own. Many large-scale vaccination sites are drive-up; although some cities are waiving public transportation costs for people heading to get vaccines. For those at highest risk, public transportation might not be a comfortable choice, especially for those with mobility issues.

These vaccine disparities amplify racial and socio-economic inequalities that not only limit access, but trust in the institution of medicine as a whole. As has been widely reported, in Los Angeles wealthy residents obtained and used codes meant to help give access to people from underserved communities vaccines. The Los Angeles Times looked at local data on vaccinations and found that “areas hit hardest by the pandemic have the lowest vaccination rates.” Despite being 46 percent of the population, Latinx people represent 23 percent of those vaccinated.

The Kaiser Family Foundation (KFF) recently published state-by-state vaccination percentages by race. In most states, the percentage of Black residents and Latinx residents vaccinated is lower than their percentage of that state’s population. And has been widely reported, Black and Latinx people are at greater risk for contracting and dying of COVID-19.

These disparities are part of a larger history of limited access to health care, and feelings of mistrust. The tragic case of Dr. Susan Moore, a Black physician who died of COVID, highlights the experiences many report interacting with doctors. Dr. Moore detailed how her symptoms were minimized and she was initially treated as though she was just seeking painkillers, which “made [her] feel like a drug addict.”

As a previous KFF report concluded:

Black adults are less likely than other groups to say they would get a coronavirus vaccine if it was free and determined safe by scientists, with most citing safety concerns or distrust of the health care system as reasons why they would not get the vaccine. These findings likely reflect the medical system’s historic abuse and mistreatment of people of color, particularly Black Americans, as well as ongoing experiences with racism and discrimination in health care today. For example, the survey showed that seven in ten Black adults believe race-based discrimination in health care happens very or somewhat often, and Black adults were more likely than White adults to report certain negative experience with health care providers, including feeling that a provider didn’t believe they were telling the truth, being refused a test or treatment they thought they needed, and being refused pain medication.

COVID-19 has revealed many existing inequalities, as Janis Prince Inniss, Jonathan Wynn, Jenny Enos, Myron Strong, and I blogged about last year. (Check out our archived COVID-19 posts here for more.) How might we address these inequalities, both during and after the pandemic? Share your ideas in the comments below.

Comments

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