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Biden welcomes progress on vaccine equity, but some local leaders paint a different picture

When Covid-19 hit Detroit, Bishop Edgar Vann had to close his shrine, the venerable Second Ebenezer Church.

His duty became to use his voice to preach not only the word of God but also the severity of the coronavirus.

Vann was enlisted to help the city’s health department in February vaccinate hesitant residents, mostly older African-Americans. The virus, he said, had a “brutal impact” on the city, and marrying public health with worship seemed natural.

“I felt obligated to make sure that I would not only reach my congregation, but I would also go beyond my congregation to a much larger influence than I have in the community,” Vann, who is pastor of the church for 44 years. years, said in a telephone interview.

Thousands of older people have been vaccinated in the predominantly black city, and many more have been vaccinated with the help of people like Vann. Just over 30% of the city has been vaccinated, with black residents accounting for more than 82% of the total, according to city health data. Vann said he would continue to preach the safety and the need for vaccines to get the city over the hump.

Clergy and grassroots organizations have played a key role in ensuring that communities most affected by the virus have direct access to vaccines, but barriers remain. Those who are on the wrong side of the digital divide, those who lack flexibility in employment and those who do not have autonomy of transit are still left behind even as health professionals enter a phase longer than “Microtargeting” of the vaccination campaign.

President Joe Biden said last week that progress has been made towards his administration’s goal. But while more than 200 million doses have been administered since its inauguration, demographics on those vaccinated remain largely incomplete.

The Kaiser Family Foundation’s most recent analysis of what was reported by the Centers for Disease Control and Prevention would suggest those hardest hit by Covid-19, including black and Hispanic Americans, are still late to get vaccinated.

Data, as of April 26, showed race or ethnicity was only known for about 55 percent of the millions of people who had received at least one dose of a vaccine. Of this group, 64 percent were White, 12 percent were Hispanic, 9 percent were Black, 5 percent were Asian, 1 percent were Native American or Alaska Native, and less than 1 percent were Native Hawaiian or other Pacific Islanders. Nine percent reported multiple or other races.

“I wish the Biden administration had made more progress that we could brag about, but I’m not surprised that the inequalities haven’t been erased in the first 100 days,” said Manuel Pastor, professor of sociology and director of Equity Research. Institute of the University of Southern California. “I think it’s important to realize that so much inequity is ingrained in all aspects of our system. When people step in and try to make fairness a priority, they’re really working against long-term structural disadvantage. that have been blocked. “

Tackling issues such as the ability to make and stick to appointments and tackle reluctance and misinformation among underserved groups has often been the job of local officials, churches and community leaders, which the Biden administration has emphasized as part of its efforts to ensure equitable access.

“You have to get down to the grassroots level, understand what communities need, listen to these local leaders, because they know better what the needs and concerns are,” Dr Cameron Webb, senior COVID adviser to the administration. -19 Equity Task Force, recently told Axios, adding that tackling racial equity is critical to successful vaccine deployment.

Early last month, the administration announced it would work with 275 grassroots groups on the ground in a project called the Covid-19 Community Corps to help with reluctance and access.

Data limited, but vulnerable populations appear to be lagging behind

Of the more than 576,000 people in the United States who have died from Covid-19, blacks, Hispanics and Native Americans die about three times as many as whites, according to a CDC analysis. The striking figures have led public health officials at all levels to push for equitable distribution of vaccines.

In early March, the Biden administration launched a series of initiatives to “ensure that every adult is truly able to get vaccinated”, many of which were intended to help reach and vaccinate “the most affected and most affected populations. difficult to reach. . “At the end of the month, the administration announced an additional $ 10 billion to help expand access to vaccines and testing for the most vulnerable communities.

Biden boasted in a speech last week that “more Latinos and African American seniors” were vaccinated in “percentage terms than white seniors.” The White House did not respond to multiple requests for comment, including the source for this data point. The CDC said its data was incomplete due to a combination of non-reporting by people, non-collection by vendors, and state laws or policies prohibiting information sharing with the federal government.

Dr Uché Blackstock, an emergency physician and founder of Advancing Health Equity, which works with groups to tackle health inequalities, mocked Biden’s claim. She said the administration’s population-based vaccine rollout was unwise, referring to the statement by White House Covid-19 response coordinator Jeff Zients last month that “The fair and equitable way to distribute the vaccine is based on the adult population by state, tribe. and territory. This is how it was done, and we will continue to do so.”

Blackstock said: “The point is, we’ve been overrepresented in cases, hospitalizations and deaths throughout this pandemic. And so if you really mean what vaccine fairness would look like, it would appear that we are also overrepresented in terms of our share of vaccine uptake. “

She said that states’ use of various health equity measures and indices further compound the problem.

Fight against disinformation

The pandemic has hit California’s large Hispanic population particularly hard. Latinos make up 39% of the state’s population, but they are responsible for 48% of deaths, according to the Kaiser Family Foundation. As of April 19, Kaiser and the state’s public health department estimated that only 25 percent of the state’s Hispanic population had been vaccinated.

Dr Sergio Aguilar-Gaxiola, director of the University of California, Davis Center for Reducing Health Disparities, spent months organizing focus groups with migrant farm workers in the Central Valley to better understand the reluctance. He is also leading efforts to roll out mobile testing and vaccination clinics for farm workers and other essential workers, many of whom are Latinos and could not work from home or did not have the luxury of quitting their jobs.

“There are people here in California who have gone through what I call a double whammy,” he said. “On the one hand, they have been disproportionately affected by Covid when it comes to excess mortality, and at the same time, they are not yet enjoying a fair distribution of vaccines.”

Success in promoting immunization depends on dispelling misinformation about vaccine effectiveness and using community organizations and places of trust, such as churches, to promote access, Aguilar said. Gaxiola.

“What we have done very intentionally is to listen as deeply as possible to these populations,” he said. “There is a lot of mistrust, but we have to understand this mistrust.”

In Mississippi, Solving Transportation Problems

As vaccinations began to accelerate across the country, Pam Chatman, 51, a former news director for local television, looked at the numbers from Mississippi and found a “staggering” disparity between white and black populations. the state.

In the Mississippi Delta, a historic but poor rural area encompassing several counties, many black residents struggled to get information or access technology to schedule their appointments, she said. No vaccination site or large pharmacy was nearby; some were as far as 25 to 40 miles away.

Chatman, who launched an area employment program in 2018 to bring residents of a dozen counties to work in big cities at companies like FedEx, has been tasked by local health leaders to launch a initiative to bring people in rural areas to vaccination clinics. With the help of grants from counties and local community health groups, she created educational campaigns, offered incentives such as gift cards and food baskets, and transported dozens of rural residents to their appointments.

“And so what we do constantly is let the people of the Mississippi Delta see people who look like them, whom they admire, whom they respect when community leaders get their shots and watch them talk to them.” from their vaccination experience, “she said.

With nearly $ 40,000 in funding, Chatman is trying to fill access gaps, such as lack of proximity to vaccination sites and high-speed internet – as thousands of appointments go unfulfilled across the state .

She predicted an uphill battle to get young black residents vaccinated and restore confidence after the CDC suspended use of the Johnson & Johnson single-shot vaccine in early April. She said she carried 300 participants, young and old, who were waiting to be vaccinated and only about 30 ended up getting vaccinated with another brand.

She said it was “devastating,” adding that many wanted the single-shot vaccine and asked to be updated when the hiatus ended. On April 23, the CDC and the Food and Drug Administration announced that use of the Johnson & Johnson vaccine would resume after an 11-day hiatus.

Even though the break has been lifted, Chatman knows there are people who still resist any vaccination, no matter how hard they try to convince them otherwise.

“The younger generation here in Mississippi, it’s forbidden – they bluntly tell you that,” she said. “They just don’t do it.”

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