Vaccine Distribution in California: Is it Equitable?

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By Meenu Pamula 

BERKELEY– With the recent increase in available effective COVID-19 vaccines in the United States, millions of Americans feel as though they can see the light at the end of the proverbial pandemic tunnel. However, with the advent of such vaccines, policymakers and healthcare professionals are faced with a new problem: how should the limited vaccine supply be equitably distributed to the most vulnerable populations? 

In California, as of April 1, 2021, any individual who is 50 years of age or older, faces severe medical concerns, or works in healthcare, education, childcare, emergency services, or food and agriculture is eligible to be vaccinated. Beginning April 15, all Californians aged 16-49 will be eligible to receive the vaccine (although, it is worth noting that of the vaccines currently approved in the United States, minors aged 16-17 are currently only eligible to receive Pfizer).

As of the time of writing this article, the state has currently administered over 20 million vaccine shots, a deeply impressive number. With Governor Newsom’s recently announced plan to fully reopen California on June 15 provided hospitalization rates remain low and vaccine supply is sufficient, it is more important than ever to ensure that all residents who wish to get vaccinated are able to do so. The question now is when, not if, California’s most vulnerable communities will receive these protections.

On April 7, 2021, the California government’s official COVID-19 website stated that 31.7% of White, 22.3% of Latino, 13.3% of Asian-American, 3.3% of Black and 0.3% of American Indian residents in the state have received at least a first dose of a COVID-19 vaccine. These numbers demonstrate staggering systemic inequities in the state’s vaccine distribution thus far.

AP News reports that “officials at community health centers that serve as the safety net for the poor in the U.S., focused on health equity, say they are not receiving enough doses for their patients–the very at-risk residents the state needs to vaccinate.” Because certain health centers have reportedly faced severe vaccine shortages, individuals may not be able to find a vaccination site close to them. For wealthy individuals, who skew white as mentioned above, transportation may not pose an issue, thus allowing them to “skip the line.”

However, for millions of low-income Californians, lack of access to reliable transportation and the internet, combined with the inability to take a whole day off work to travel to a far location, severely constricts their ability to get a vaccine.

Compared to white, non-Hispanic populations, African-American individuals are 2.9x more likely to be hospitalized and 1.9x more likely to die after contracting COVID-19. Among Latino communities, these rates are even higher, at 3.1x the risk of hospitalization and 2.3x the risk of death when compared to white patients.

The social justice impact of equitable distribution is enormous. Research is increasingly indicating that marginalized communities have been disproportionately impacted by the pandemic. Thus, it follows that it is more important than ever for marginalized people to be among the first vaccinated.

In an interview with the Othering and Belonging Institute, UC Berkeley Professor of Public Health Denise Herd explained, “One of the most basic problems with prioritizing vaccination based on age is that Black people, Native people, and other people of color generally have shorter lifespans than other Americans… The other problem with prioritizing distribution based on age alone, is that minority groups are experiencing Covid at different ages.”

Professor Herd continued, “Among the Latinx population, for example, it’s actually the people who are younger who have the highest rates of Covid. We’re looking at a lot of young people who are getting Covid much more than others and who are dying of Covid and among the Latinx population, the elders are actually healthier than the younger people… So you’re missing the people in that population who are at most risk of getting Covid and also at most risk of dying.”

Herd’s explanation highlighted a key problem with marginalized communities in the vaccine rollout– distribution by age is often not representative of these communities’ needs. “That’s why distributing the vaccine by age is…one of the factors that are particularly hurting disadvantaged people and people of color.”

In a recent Berkeley Conversations event, Osagie Obasogie, Haas Distinguished Chair and professor of bioethics in the Joint Medical Program and School of Public Health at UC Berkeley, also expressed the issue of how many marginalized communities (especially the Black community) have expressed vaccine hesitancy given the historic scientific oppression and racist medical treatment against Black individuals.

“We have to think carefully about how these framings about hesitancy might unduly limit the ability of these communities to have access to these medicines,” Professor Obasogie stated.

Obasogie expressed that while increased vaccine supply is a significant step, it is also necessary for the Californian government to attempt to dispel hesitations and ensure that they are advocating for the Black community.

In terms of hopes for the future, Obasogie said, “I hope that as the vaccine gets distributed, there are chances to talk to people and have them understand that getting a vaccine is not about your individual health, but about your participation in the broader goal of community health … so that, when the next pandemic comes up, people have a better foundation for thinking about, what are the actions or steps that I can take to not only protect myself, but the people around us?”

According to one source who wished to remain anonymous, the issue of equitable vaccine distribution can be seen at a local level, as students at UC Berkeley have purportedly been “gaming the system” in efforts to get vaccinated despite limited supply.

“I’ve seen so many students who are nowhere near the healthcare or education sector who just show their Cal ID and are able to secure a vaccine appointment. Obviously, the system can’t be perfect but there is a large ethical concern when students who don’t really need the vaccine are taking the spots of individuals that do,” stated the source.

This lack of accountability, in combination with the inequality in distribution, is staggering. The vaccines may help  Californians can finally see the light at the end of the tunnel. However, that is exactly why our choices now are so pivotal. 

California needs to take steps to ensure accountability and promote equitable distribution at both the administrative and the community levels–and UC Berkeley is no exception.

Meenu Pamula is a writer for The Vanguard at Berkeley’s Social Justice news desk. She is a fourth year student studying Molecular and Cellular Biology. She is from Fresno, California.


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15 thoughts on “Vaccine Distribution in California: Is it Equitable?”

  1. Alan Miller

    Very thorough article discussing these critical issues.  Age-based distribution is discussed, but that’s not really an issue now that it’s open to everyone over 16.   Getting the vaccine into arms is good for everyone because of how it spreads, so equity programs should not slow or restrict the flow, as has happened in some states, but concentrate on programs to get the vaccine to marginalized communities.

    Yolo apparently has done an crazy-good job if it’s reached 73% of ag workers, thought ag workers are not the only Latino/a/x in Yolo by far and we need to focus on getting it to that group because of the higher rates of infection and lower rates of recovery.  Even if you are a white supremacist you should support that policy, because stopping the spread through all populations, especially where it is a larger problem, is good for everyone.

    I am glad you brought up the hesitation issue by race.  This is going to be seriously difficult to get beyond, because changing minds and attitudes on this issue is not easy – it is built into the core of how people think – and is probably part of people’s community-think.  I know many people who are not going to take it who are, shall we say, quite left leaning.  There is a whole think out there among some on the left — no, this no-vax think is not limited to Trumpublicans.  To his (rare) credit, Trump, post-prez, made an announcement telling people to get their vaccinations. Probably few heard it since he’s been banned from so many platforms.

    Testing also is a means of saving lives — especially over the last few months before widespread vaccines — and yet, the Davis Based Vaccination Program — um, I mean Healthy Davis Together — in my view was clearly Davis elitist and focused away from the Latino/a/x population of this county.  Instead of opening up centers in West Sac, Winters and Woodland, they opened up more and more testing sites in Davis — despite my calling this out in the Enterprise, to the Council and to County Supervisors (who I think did take it seriously).  There was some testing to the ag workers with a van, but the Latino/a/x community is so much more than that — and we should have directed the resources to where it was needed in the County, not kept it for ourselves.  As well, everyone I’ve talked to who got tested via HDT said there were plentiful testing workers all around making $18/hr and no lines, no wait, no people.  Why with all that extra capacity didn’t we roll out to the 3 W towns instead of concentrating all the resources in Davis?  If that isn’t a race-imbalanced/elitist policy I don’t know what is.  Did anyone think that through?

    The 73% of ag workers vaccinated was an amazing, almost unbelievable, wonderful number.  The number you are citing in this article —  31.7% of White, 22.3% of Latino, 13.3% of Asian-American, 3.3% of Black and 0.3% of American Indian residents in the state have received at least a first dose of a COVID-19 vaccine — are appalling in the disparities, almost unbelievable in how bad they are.  As I said, holding up the flow helps no one, but programs to get vaccine distribution out into marginalized communities must be priority.

    1. Ron Oertel

      The 73% of ag workers vaccinated was an amazing, almost unbelievable, wonderful number.

      It might indeed be unbelievable.  Not sure how they know (e.g., if someone is in the country illegally). Also – given the transitory circumstances of ag workers in the first place.

      1. Bill Marshall

        Are you equating ag workers = illegals?  Hard to parse your comment…

        Equating ag workers to “transitory” is slightly ‘interesting’, but the truth is most ‘in the field’ (‘shoes on the ground’) ag workers follow the planting, tending, and harvesting seasons, up and down the state, and other states (as the seasons vary)… yet, most follow the same pattern as far as location, year to year… a “nuance”, as to what is ‘transitory’… I know a lot of professional folk who might ‘qualify as transitory’… particularly engineers working for multi-national firms… are they “illegals”, “transitory” in your view?  No need to reply… and waste a comment… your words stand, as they are…

        1. Ron Oertel

          Are you equating ag workers = illegals?  Hard to parse your comment…

          Some, yes.  Is that news to you?

          Though the preferred term is “undocumented”.

          ag workers follow the planting, tending, and harvesting seasons, up and down the state, and other states (as the seasons vary)… yet, most follow the same pattern as far as location, year to year… a “nuance”, as to what is ‘transitory’…

          Transitory would be the same as at a “given point in time, at a given location”, in your example.

          So yes, I would question how they can make an accurate claim regarding both of the issues discussed.

          I know a lot of professional folk who might ‘qualify as transitory’… particularly engineers working for multi-national firms… are they “illegals”, “transitory” in your view? No need to reply… and waste a comment… your words stand, as they are…

          Did anyone put forth a claim regarding the percentage of local and/or transitory engineers have been vaccinated? Also, are there a significant number of them here, without documentation?

           

           

        2. Carlos Garcia

          Have to back Ron Oertel this time.

          “About half of all crop hands in the United States, more than one million, are undocumented immigrants, according to the Agriculture Department. Growers and labor contractors estimate that the share is closer to 75 percent.”

          Source: NY Times

  2. Ron Oertel

    I don’t recall if they ask what skin color you have, when making an appointment.  If so, I assume there is an option to decline providing that information.  (In which case, I wonder how that’s “counted”.)

    Or, how someone who has more than one racial background answers such questions, assuming that it was asked.

    For that matter, I don’t know how police determine this, unless it’s “visually” and subsequently recorded. “He looked like a white guy, to me.” Same question might arise regarding gender.

    1. Ron Oertel

      Oh, wait – gender is recorded on drivers’ licenses. A leftover from the days when that was a binary choice, and very rarely changed. 🙂

      As are hair color and eye color – if that’s “helpful”.  (Not necessarily.)

  3. Bill Marshall

    COVID doesn’t inspect documents or status in determining whom to infect.

    Really?  I thought I read somewhere that COVID did.

    Of course it does!  Due to systemic and unconscious/inherent racism!

    Seriously, some groups (genetics/ethnicity) have less natural resistance to certain pathogens … some can be attributed to socio-economic factors… some can result from ‘group resistance’ to accepting vaccines and/or protocols (social/political)… many of those can be inter-related… not as simplistic as some would make it out… and not as ‘nefarious’…

    So, as loathe as I am to post this, I agree with the apparent ‘irony’ of your post, Keith O… some folk like to find simple ‘scapegoats’, and perhaps due to the fact that they are ‘simple-minded’… they don’t analyze or think.

    1. Keith Olsen

      and perhaps due to the fact that they are ‘simple-minded’… they don’t analyze or think.

      “Apparently” some folk “simply” know a lot about this…

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