Throughout the Covid-19 vaccination effort, public health officials and politicians have insisted that the equitable delivery of vaccination across races and ethnic groups is a top priority.
But it is left to states to decide how to do this and to collect racial and ethnic data on people who have been vaccinated so that states can keep track of how well they are reaching out to all groups. The gaps and inconsistencies in the data have made it difficult to understand who is actually being shot.
Just as an inconsistent approach to coronavirus containment resulted in a higher toll on black and Latin American communities, the inconsistent data guiding vaccination efforts could leave the same groups out of vaccines, said Dr. Kirsten Bibbins-Domingo, epidemiologist at the University ofmi California – San Francisco.
“At the very least, we need the same uniform standards that every state uses and every place that delivers vaccines so we can make some comparisons and develop better strategies to reach the populations we want to reach,” Bibbins-Domingo said.
Now that federal, state and local governments are relaxing the mask requirement and ending other measures to prevent the virus from spreading, efforts to increase vaccination rates in underserved communities are even more urgent.
St. James United Methodist Church, a cornerstone for many blacks in Kansas City, Missouri, recently resumed face-to-face services after being online for more than a year. St. James also hosts vaccination events to reach out to people in the neighborhood.
“People not only mourn the loss of loved ones, but the loss of a whole year, the loss of loneliness, the loss of being at home, not being able to go to church. Not being able to go out into the ward, ”said Yvette Richards, St. James’ director of ward connections.
Missouri’s population is 11% African American, but according to an analysis by KFF, Covid cases among African Americans made up 25% of total cases for the state.
Richards said St. James lost many parishioners to the coronavirus, and the empty benches they once sat on Sundays serve as a vivid reminder of everything that community went through during the pandemic.
Missouri’s public Covid data appears to show robust data on vaccination rates broken down by race and ethnicity. However, it finds that several groups are lagging far behind on vaccinations, including African Americans, who appear to have a vaccination rate of just 17.6%, nearly half of the 33% rate for the entire state.
For Dr. Rex Archer, director of the Kansas City Health Department, a number is a sign this data is incorrect. It shows a completed vaccination rate of 64% for “multiracial” Missourians. Such an extraordinarily high rate for a group is implausible, according to Archer.
“So there is a big problem with the way the state records race and ethnicity as part of the Covid vaccination,” said Archer.
Missouri state officials have admitted this data is incorrect since February, but they have failed to correct it or explain exactly what is causing it. Archer suggested that the inflated multiracial rate is likely due to different racial data being reported when people get the first and second shots.
Other issues were identified, including the lack of racial and ethnic information for many people who were vaccinated and the use of multiple categories such as “other” and “unknown”.
The state also noted that it used national racial percentages in the state’s vaccination data rather than actual percentages based on the state’s population. For example, when the vaccination effort began, the state used national racial data showing that nearly 6% of the population is Asian, even though Missouri’s population is 2.2% Asian.
Health officials are working to target vaccination campaigns in communities with low rates, but Archer said the state’s data was of little help.
“I mean, we have to look at this, but it has too many variables to rely on,” said Archer.
Although racial and ethnic categories are clearly defined in US national census data, the same data is not collected consistently across states.
For example, South Carolina vaccination dates group Asians, Native Americans, and Pacific Islanders into one category. In Utah, residents can choose from more than one race. Wyoming does not report racial or ethnic data for vaccinations.
Bibbins-Domingo said the missing or inconsistent data doesn’t necessarily mean tracking equity is a lost cause. Vaccination rates for census areas where racial and ethnic data are known can be used as a proxy for estimating vaccine allocations.
Bibbins-Domingo, however, argued that the pandemic has shed light on racial data problems that have been lingering on US public health for far too long.
“My hope is that our lessons from Covid really get us all to think about the infrastructure we need in our state and nationally to make sure we are prepared next time,” said Bibbins-Domingo. “Data is our friend.”
Local leaders and health officials in Missouri are looking to increase vaccination rates, particularly in vulnerable communities, after Republican Governor Mike Parson recently announced steps to get residents back to work in person.
Ordered government officials back to the office in May, Parson said he would suspend additional federal pandemic-related benefits for unemployed workers in June, despite vaccination rates across the state well below what Missouri health experts wanted to achieve.
Jackson County, Missouri, which owns most of Kansas City, last month approved $ 5 million in federal CARES funding to increase immunization in six zip codes with large black populations and low immunization rates. The project will address issues of both access and hesitation, and will focus on reaching out to individuals and neighborhoods.
Although many of the state’s vaccination efforts have involved large mass gatherings, St. James Pastor Jackie McCall said she spoke to many in her church and ward who need encouragement to believe in the vaccines.
“So let’s go ahead and trust,” McCall told the congregations. “Let’s trust the process. We trust God. Let’s trust science. “
This story is part of a reporting partnership that includes: KCUR, NPR and KHN.
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