PORTLAND, Ore. (AP) – The role that race must play in deciding who gets preference for the COVID-19 vaccine was tested in Oregon on Thursday, but coloreds will not have the specific focus in the next phase of the rollout of the state as tension surrounds equity and access until the shots emerge nationwide.
An advisory committee that makes recommendations to government Kate Brown and public health authorities has discussed whether racial minorities should be preferred, but decides on a wide range of other groups: those under 65 with chronic medical conditions, essential workers, prisoners and people who live in group settings.
The 27-member panel in Oregon, a democratically-led state that is overwhelmingly white, said coloreds probably fell into the other priority groups and expressed concern about legal issues if race was the focus. Its recommendations are not binding, but provide important clues on the distribution of vaccines.
The committee was formed with the goal of keeping justice at the heart of Oregon’s vaccination. Its members were elected to include racial minorities and ethnic groups, from Somali refugees to indigenous peoples.
“Our system is not yet ready to bring to light the truth about structural racism and how it plays out,” said Kelly Gonzales, a member of the Cherokee Nation of Oklahoma and a health diversity expert on the committee. , said.
The panel included a statement in its plan acknowledging the impact of structural racism and saying it was reviewing the needs of minority communities.
The virus affected people of color disproportionately. Last week, the Biden government reiterated its importance of the inclusion of ‘social vulnerability’ in state vaccination plans – with race, ethnicity and the rural-urban divide at the forefront – and asked states to identify ‘pharmacy deserts’ where it is difficult to get shots in the arms.
Overall, 18 states included ways to measure equity in their original vaccine distribution plans, and this has probably also been the case since the shots began arriving, said Harald Schmidt, a medical ethicist at the University of Pennsylvania, who argued the fairness of the vaccine has thoroughly studied, said.
Some, like Tennessee, have suggested that 5% of the allocation be discussed for ‘areas with major disadvantage’, while states like Ohio plan to use social vulnerability factors to decide where the vaccine should be distributed, he said. . California has developed its own criteria for assessing the need for a community, and Oregon is doing the same.
‘We told a fairly simple story:’ Vaccines are here. “Now we have to tell a more complicated story,” says Nancy Berlinger, who studies bioethics at The Hastings Center, a nonpartisan and independent research institute in Garrison, New York. “We need to think about all the different overlapping risk areas, rather than just the group we belong to and our personal network.”
Attempts to address inequalities in access to vaccines have already backfired in some places. Authorities in Dallas recently made a decision to prioritize the most vulnerable zip codes – primarily colors – after Texas threatened to reduce the city’s vaccine supply. This kind of backlash is likely to become more apparent as states move deeper into the deployment and grapple with difficult questions about distress and scarcity.
To avoid legal challenges, almost all states apply their race and ethnicity in their vaccination plans to an instrument called a “social vulnerability index” or a “disadvantage index.” Such an index contains more than a dozen data points – from income to education level to health outcomes to car ownership – to target underprivileged populations without specifically indicating race or ethnicity.
In doing so, the index includes many minority groups because of the impact of generations of systemic racism, while also avoiding socio-economically disadvantaged people who are not colored and “very, very difficult and toxic questions” about race, Schmidt said. said.
“The point is not: ‘We want to make sure the Obama family gets the vaccine before the Clinton family. “We do not care. “They can both wait safely,” he said. ‘We care that the person working in an overcrowded living situation in a meat packaging plant gets it first. It is not about race, but about race and disadvantage. ”
In Oregon, health leaders are working on a social vulnerability index, including looking at U.S. census data and then calculating things like occupational status and income levels, says Rachael Banks, director of public health at the Oregon Health Authority.
The approach ‘goes beyond an individual perspective and more than a community perspective’ and is better than asking a person to prove ‘how it fits into any demographic’, she said.
This makes sense for Roberto Orellana, a professor of social work at Portland State University, who has launched a program to train his students to do contact detection in Spanish communities. Data show that Hispanics are about 300% more likely to contract COVID-19 than their white counterparts in Oregon.
Orellana hopes that its students, who work at government agencies and organizations, can use their knowledge to facilitate contact tracing and to advocate vaccinations in migrant and farm worker communities. The vaccination of essential workers, prisoners and those in multigenerational households will reach people of color and put them at the heart of the vaccination plan, he said.
“I do not want to take away any other group. This is a difficult, difficult question, and every group has valid needs and valid concerns. We must not go through with it, “said Orellana. “We should have vaccines for everyone, but we are not there.”
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Associated Press / Report for U.S. Statehouse News Initiative Corps member Sara Cline contributed to this report. Follow Flaccus on Twitter http://www.twitter.com/gflaccus.