Vaccine Equity Remains Elusive as Vaccination Rates for People of Color Still Lag

Despite working in health care, Vince Ford was wary of the COVID-19 shot.

Months of following the research and development of the vaccine – and realizing without it, holidays with his out-of-state kids wouldn’t happen – moved the needle.

Now, during COVID-19 vaccine education sessions, Ford remembers his own skepticism of the shot to relate to people in his community and address their concerns.

Ford is senior vice president of Community Health Services at Prisma Health in South Carolina, where Black residents like him make up more than a quarter of the population, but only 19% of vaccinations, according to a recent Kaiser Family Foundation analysis. In contrast, white residents make up 67% of the  population and 64% of those vaccinated, state data as of April 28 shows.

Five months into America’s unprecedented vaccination effort, the trend is holding across much of the nation, as white people continue to be vaccinated at faster rates than Black and Hispanic people in most states.

Hispanics make up only 12% of COVID-19 vaccinations, but 17% of the U.S. population, according to data from the Centers for Disease Control and Prevention as of Wednesday. Similarly, 8.8% of those who have received at least one dose are Black, but Black people make up more than 12% of the population.

In another analysis, Kaiser Family Foundation found that among 43 states, white people are vaccinated at 1.6 times the rate of Black people and 1.5 times higher than the rate of Hispanic people.

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Grassroots efforts are underway, and the Biden administration has poured $10 billion into a national vaccine equity plan. But as the disparity holds, health practitioners and local leaders say hesitancy and access remain major barriers for communities of color, who have suffered disproportionate rates of COVID-19 hospitalization and deaths.

“Part of it is the pre-existing access barriers. We can disseminate as quickly as we can. But you can’t fix a structural issue overnight,” said Lisa Cacari Stone, a professor at University of New Mexico College of Population Health and director of the Transdisciplinary Research, Equity and Engagement Center.

Along with the Center for Native American Health and the Center for Participatory Research, Cacari Stone is researching COVID-19 vaccine barriers through a National Institutes of Health community engagement grant. The effort is focusing on LGBTQ communities of color and Black urban people, as well as Indigenous and Hispanic people in New Mexico. Hispanics make up 49% of the state’s total population and more than half of COVID-19 cases, but only 40% of vaccinations.

Her team is trying to understand the different access disparities between rural and urban Native and Hispanic people to inform NIH on uptake barriers. The team also is studying how historical abuses have cultivated mistrust.

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Dr. Pamela Oliver, an obstetrician and executive vice president at North Carolina hospital system Novant Health, recently helped schedule a vaccine for a family friend.

Oliver said when the elderly Black woman arrived at the vaccine clinic in a church close to home, she was ambivalent. She asked nurses if she was getting “best” shot.

“It highlights a level of distrust that is worrisome … almost that there is a different syringe that we’re using for the CEO of our company versus the syringe that I’m giving the people in the community,” Oliver said.

Oliver noted she also sees skepticism among health care workers at Novant. Physicians and nurse practitioners seem to have higher vaccine uptake, but among entry-level workers there’s a “huge fall off” in vaccination rates.

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Last week, Novant Health began setting up mobile vaccine units in vulnerable zip codes for walk-up appointments. People of color made up nearly 67% of vaccine recipients at Novant’s pop-up sites, which range from churches, housing projects and senior centers.

Back at South Carolina’s Prisma Health, Vince Ford said he’s been hearing the same deep-seated medical mistrust from community members. He recalled one question: “Are we getting the same vaccines as our white or other counterparts?”

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