In summary

We must find a way to ensure that those in hard hit communities of color do not get lost in the vaccine prioritization process.

By Richard Seidman, Special to CalMatters

Dr. Richard Seidman is the chief medical officer of L.A. Care Health Plan, PGriego@lacare.org.

Back in the spring, we were reading headlines like “‘A Terrible Price’: The Deadly Racial Disparities of Covid-19 in America” and “The coronavirus is infecting and killing Black Americans at an alarmingly high rate.” Health disparities in poor communities of color are nothing new, but the pandemic put a spotlight on the problem. 

Yet, in December, when two vaccines were granted emergency use authorization, the vaccine spotlight turned in a different direction. We must find a way to ensure that those in these hard hit communities do not get lost in the complicated vaccine prioritization process. 

As expected, the initial stage of the immunization rollout included a limited number of vaccine supplies, requiring prioritization. Guidance from federal, state and county health officials for the rollout made sense. 

The first phase of the rollout prioritized frontline health care workers, and long-term care and skilled nursing facility staff and residents. We need to protect health care workers and the residents of facilities where we saw such devastating death rates early in the pandemic. 

Yet subsequent phases in the vaccine rollout don’t clearly address the needs of people living in low-income communities of color, despite the fact that Los Angeles County data show death rates consistently much higher in our poorest communities. These people often work in low-wage, essential jobs – in grocery stores, restaurants, agriculture and food production plants – and are more likely to use public transportation. Many return to crowded, multi-generational homes. These people must be vaccinated as soon as possible if we are going to help slow the spread of the virus. 

Concerns only increase with the recent announcements to change vaccine priorities to simple age cohorts and the surprise selection of Blue Shield of California to serve as a third-party administrator. More troubling is the lack of transparency into the selection process and paucity of details of the role the plan will play, opportunity for public input or an oversight plan to assure equitable distribution to all Californians prioritizing those communities with the highest rates of cases and deaths.    

As the chief medical officer of L.A. Care Health Plan, a health plan that serves those most affected by the pandemic, I am deeply concerned. L.A. Care is advocating at the state and local levels for vaccine administration plans that do more to prioritize traditionally under-resourced communities, which have the highest rates of COVID-19 cases and deaths. 

L.A. Care is in regular contact with the Los Angeles County Department of Public Health leadership, providing input into the COVID-19 vaccine distribution plan, trying to direct vaccine supplies to the hardest hit parts of the county. We must provide these communities with greater opportunities to be vaccinated.

Of course, as we push to get a COVID-19 vaccine equitably into the arms of those most at risk, we have to acknowledge that some in these communities are skeptical and will be unwilling to be vaccinated. A December Pew Research Center survey found that while 71% of Black Americans knew someone who had been hospitalized or died of COVID-19, only 42% would get a vaccine. The numbers are even lower in other surveys, including among Latinos

Ensuring that African Americans and Latinos fully benefit from the protection the COVID-19 vaccines provide will require appropriate messaging and messengers. Health plans and individual primary care physicians are trusted sources of information and need to do everything possible to spread the word, first, about how to avoid contracting COVID-19, and second, about the safety and efficacy of the vaccines. 

Celebrities, politicians, star athletes and other influencers can also play an important part in getting the word out. COVID-19 has taken a tragic toll. The vaccines offer hope. Let’s make sure that that hope, and the vaccine, are distributed equitably.

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