The role the race should play in deciding who will get priority for the COVID-19 vaccine in the next phase of the rollout is being tested in Oregon as tensions rise nationwide over justice and access to the shots.
An advisory committee making recommendations to the Oregon governor and health officials will vote Thursday on whether to prioritize people of color, target people with chronic conditions, or focus on a combination of groups at higher risk for the coronavirus. Others, such as B. Refugees, inmates, and people under 65 living in groups are also considered.
The 27-member committee in Oregon, a democratically-run state that is predominantly white, was formed with the goal of keeping fairness at the heart of its vaccine implementation. Its members have included ethnic minorities and ethnic groups, from Somali refugees to Pacific islanders to tribes. The committee’s recommendations are non-binding, but provide important input for Governor Kate Brown and senior health officials who are preparing the rollout.
“It’s about exposing the structural racism that remains hidden. This affects the differences we experienced before the pandemic and exacerbates the differences we experienced during the pandemic, ”said Kelly Gonzales, a member of the Cherokee Nation of Oklahoma and expert on health differences on the committee.
The virus has affected colored people disproportionately. Last week the Biden government reiterated the importance of including “social vulnerability” in government immunization schedules – focusing on race, ethnicity and the rural / urban divide – and asked states to identify “pharmacy deserts” In which shots in the arms are hard.
A total of 18 states included ways to measure justice in their original vaccine distribution plans last fall – and more likely have done so since the gunshots hit, said Harald Schmidt, a medical ethicist at the University of Pennsylvania who delves into fairness of vaccines.
Some, like Tennessee, suggested reserving 5% of its allocation for “areas of high deprivation” while states like Ohio plan to use social vulnerability factors to decide where to distribute the vaccine, he said. California has developed its own metrics to determine a community’s needs, and Oregon does the same.
“We told a pretty simple story: ‘Vaccines are here. “Now we have a more complicated story to tell,” said Nancy Berlinger, who studies bioethics at the Hastings Center, a non-partisan, independent research institute in Garrison, New York. “We need to think about all the different overlapping areas of risk, not just the group we belong to and our personal network.”
Attempts to address inequalities in access to vaccines have already caused setbacks in some areas. The Dallas authorities recently reversed a decision to prioritize the most vulnerable zip codes – especially color communities – after Texas threatened to cut vaccine supplies to the city. This type of pushback is likely to be more pronounced as states move deeper into the rollout and ask difficult questions about needs and shortages.
To avoid legal challenges, almost all states that address race and ethnicity in their vaccination plans are turning to what is known as the “index of social vulnerability” or the “index of disadvantage”. Such an index contains more than a dozen data points – from income to education level and health outcomes to car ownership – aimed at targeting disadvantaged populations without specifically referring to race or ethnicity.
In this way, the index encompasses many minority groups due to the effects of generations of systemic racism, while at the same time targeting socioeconomically disadvantaged people who are not colored people and avoiding “very, very difficult and toxic questions” about race, Schmidt said.
“The point is not, ‘We want to make sure the Obama family gets the vaccine before the Clinton family.’ We don’t care. You both can safely wait, “he said.” It’s important to us that the person who works in a meat packing plant in a crowded life situation gets it first. It’s not about race, it’s about race and Disadvantage. “
In Oregon, health officials are working on an index of social vulnerability, including looking at U.S. census data and then overlaying topics like occupational status and income level, said Rachael Banks, director of public health at the Oregon Health Authority.
This approach “goes beyond an individual perspective, and more towards a community perspective,” and is better than asking a person to prove “how they fit into a demographic,” she said.
The committee’s recommendations are also subject to legal analysis, Banks said.
That makes sense to Roberto Orellana, a social work professor at Portland State University who started a program to train his students on contact tracing in Hispanic communities. Data shows that Hispanics are roughly 300% more likely to contract COVID-19 than their white counterparts in Oregon.
Orellana hopes its students who do internships with government agencies and organizations can use their knowledge in both tracing and advocating vaccines in migrant and farm worker communities. Vaccinating key workers, prisoners and people in multi-generational households will reach people of color and put them at the center of the vaccination schedule, he said.
“I don’t want to take anything away from any other group. It’s a tough question, and every group has legitimate needs and legitimate concerns. We shouldn’t go through that, “Orellana said.” We should have vaccines for everyone – but we’re not there. “
Sara Cline, a corps member of the Associated Press / Report for America Statehouse News Initiative, contributed to this report. Follow Flaccus on Twitter at http://www.twitter.com/gflaccus.