Black Americans have been dying of COVID at disproportionate rates. What does that mean for vaccine rollout?

Racial and ethnic minorities have been bearing the brunt of the COVID-19 pandemic. Black Americans have higher case, hospitalization and death rates than White Americans.

These statistics raise urgent questions about how the vaccine will be distributed to communities of color. Last week, Scientific American reported that Black Americans are getting vaccinated at lower rates than White Americans. Health workers have been the focus during the first phase of vaccination rollout. Yet, the data reveals that Black people account for only a small share of total vaccinations even in states where they make up a significant portion of the healthcare workforce.

There has been a significant amount of coverage on resistance to the vaccine within the Black community. The United States’ history of medical racism certainly has an impact on perceptions of the vaccine, but this type of reporting can be misleading.  Data from Kaiser Family Foundation shows that vaccination acceptance is going up across all racial groups. Their findings also suggest that the majority of Black Americans are willing to get vaccinated. Vaccine disparities are not the result of Black resistance to the vaccination; they are the result of structural inequality and uncoordinated government response.

Local, state and federal response agencies know which communities have been hardest hit but have failed to reach a consensus on how to best reach those communities. Last week, Dallas County proposed a vaccination plan that would have prioritized zip codes with the highest rates. The plan would have given many primarily black and brown neighborhoods first access to the vaccine. They reversed course after the Texas Department of State Health Services rejected the plan and threatened to reduce the number of doses allocated to the county. This disagreement between local and state officials highlights the need for national guidance.

The new administration is working to address these needs through their COVID response plan. One of outlined goals is to “protect those most at risk and advance equity, including across racial, ethnic and rural/ urban lines.” To that end, President Biden signed an executive order establishing a Health Equity task force to develop recommendations for “mitigating the health inequities caused or exacerbated by the COVID-19 pandemic.” Many studies have explored how social determinants of health (which include factors like housing and poverty) impact COVID-19 exposure and mortality. The Health Equity Task Force must address these same factors when crafting their vaccination and policy recommendations. The question is how fast can they do it; with daily cases regularly topping 150,000 and with over 100,000 people currently hospitalized, every day counts.