Friday, December 2, 2022

Most likely to contract Covid last in line for vaccines

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We are already seeing the consequences of these decisions. In Washington, DC, residents over 65 were encouraged to register for the immunization program online or by phone at a first come, first served system. When the data on vaccine administration became available, the racial disparities were dramatic. Ward 7, which is 92 percent black, represented only 8 percent of vaccinations, although 15 percent the city’s dead were in this neighborhood. Ward 2, which is 69 percent white, received nearly 22 percent of available vaccines, despite only 5 percent of the city’s dead.

A first-come, first-served system “will not have the desired effect of having access to the hardest hit residents,” says DC board member Kenyan R. McDuffie. “Because you have the digital divide, residents who don’t have Internet access and residents who are our frontline workers and have to work, face all types of barriers.

McDuffie has been successful in pushing for a new prioritization system in Washington, which reserves certain appointments for those in the hardest hit areas, including Ward 7.

Although the most marked disparities in coronavirus deaths fall along racial lines, the causes are social and environmental, not biological. How people live and work has a huge impact on their chances of getting Covid. People of color are more likely to hold public jobs, live in apartments rather than single-family homes, rely more on public transportation, and have less access to sick leave or jobs that allow them to work from home. They are more likely to live in polluted areas where toxic air quality can increase susceptibility to the virus.

Until now, distribution systems “have tended to favor those who have the time to sit in line and watch the opening of appointments, to be the first to register, to have access the internet in the first place or stand in line and wait. for a vaccine for hours, ”says Jessica Heier Stamm, an engineering professor at Kansas State University, who studies how to improve public health and humanitarian operations. “These are not the same people whose work requires them to be in person or whose living conditions are overcrowded or whose state of health would put them at greater risk.”

Heier Stamm a studied H1N1 vaccination campaign. She says that the first instinct of public servants is to “pull something together and try something similar to what we’ve done in the past.” But she says officials should act more deliberately and consider other factors: Are they vaccinating as much as possible as quickly as possible? Or build data collection systems to precisely target vulnerable groups? Do they have time to do it?

Giving vaccines to the most vulnerable requires more logistics and more sophisticated data collection than many regions have established. It is a problem when new epidemics and mutations threaten to erode the modest progress made.

The desire to act quickly makes it difficult to prioritize racial and ethnic groups. California initially predicted to weight age, race, and socio-economic factors into its plans, but switched to a simpler approach: everyone over 65, with no particular consideration for race.

Either way, people feel left out. In Dallas, the state initially rejected, then accepted, a plan to prioritize vaccinations based on postal code. The decision led to a series of controversial meetings between county officials.

JJ Koch, a county commissioner, suggested prioritizing 11 low income postal codes with particularly risky comorbidities such as heart disease. He says opponents have twisted his proposal as excluding everyone outside of specified zip codes. But he argues that it was necessary after the initial rollout favored wealthy white residents.

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“Anyone who had a good internet connection and could just get in a car in that first week, they were at a disproportionate advantage,” Koch said. County data shows that in that first week of vaccination, 20 percent of registrants were Hispanic, even though they represent 38 percent of the county’s cases. White filers accounted for over 60 percent, despite 31 percent of the cases.

“So the idea that leveling the playing field by prioritizing certain groups for a few days is kind of unfair, totally against what justice is,” Koch says. He fears that, if left unchecked, disparities will increase, leading to an explosion in cases among non-white residents, while white residents will benefit from greater vaccine availability.

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