On a recent Sunday, Paola Laverde logged into her computer from her Berkeley apartment and joined dozens of other Latino residents on Zoom in a one-hour conversation about coronavirus vaccines with a UCSF doctor.
Dr. Maria Garcia explained in Spanish how the vaccines work, what the benefits are, and why it is important to get one.
Laverde, 57, was happy to see faces like hers. She would like to get a vaccine when it is her turn, and was curious which employees would get priority. Others asked if they should still wear masks and distance themselves socially once they get an injection, and how to respond to questionable family members who believe false rumors about vaccine problems.
“We know that knowledge is power,” said Laverde, a member of the Latinos Unidos de Berkeley group that co-hosted the session. Learning about vaccines is especially important in the Latino community, which makes up 39% of California’s population. However, Latinos are disproportionately responsible for 55% of COVID infections in the state and 46% of deaths.
As vaccine distribution increases locally and in California, health officials and advocates hope to reach more residents like Laverde.
They do everything they can to ensure that communities of color and other groups – such as those with limited Internet access – are not left behind. Achieving them is particularly important, as many are key workers who face risks every day, and others may live in multi-generational households or in busier conditions.
However, there is a big problem: it is difficult to know if people of color are being vaccinated in the same way as the incidence of COVID-19 in those communities, because the state and most counties have not released information on the racial and ethnic demographics of vaccine recipients. .
This lack of transparency is widespread. On Jan. 22, only 20 states reported information about the race or ethnicity of people receiving vaccines, although it was often incomplete, according to an analysis by the Washington Post. California was not on the list. White House officials last week called on states to release more consistent demographics.
California officials say it’s vital that vaccines are distributed fairly, and they also want statistics to measure their work. On Wednesday, state officials announced that Blue Shield of California, Oakland’s health insurance company, will take over the distribution of vaccines on behalf of the state. This is expected to be a better way to measure vaccine equality, although details have yet to be announced. Similar issues arose in testing the coronavirus early in the pandemic, but the state and counties resolved the issue and provided demographics – showing that testing reached more white residents in some areas than color communities that had been badly affected by the virus. use of nearby mobile test sites.
Racial and ethnic data on vaccinations can also be more difficult to interpret, at least in the beginning, because vaccines are currently usually available to certain groups, such as seniors and health professionals, who may have different demographics than the general population.
Within the Bay Area’s nine counties, only Contra Costa and San Mateo counties provided a breakdown of vaccine recipients by race and ethnicity. However, it is difficult to draw conclusions from the local data, which largely reflects who is eligible for the vaccine, as not all providers report the race or ethnicity of the vaccine recipients.
In Contra Costa County, the majority of vaccine doses have gone to Caucasians (37%), people of multiple races (16%), people who identify as ‘other’ (16%), and Asians (14%), according to county data . The province is 43% white (excluding Hispanics or Latinos), 5.4% multi-race, and 18% Asian, according to Census data.
Part of this reflects the demographic composition of health workers and the elderly. Those groups “are” disproportionately white, disproportionately Asian, and disproportionately wealthy, “Contra Costa Deputy Health Officer Dr. Ori Tzvieli said.
The biggest inequality right now is black residents, who are being vaccinated at lower rates, Tzvieli said. There is also some inequality between Latinos, but it’s not that big, he said.
“We look at equality in everything we do and it is clear that inequalities have been a big marker of the COVID-19 pandemic,” Tzvieli said. ‘We have seen inequalities in the number of cases, inequalities in testing. And now, although the data is incomplete, we are also seeing inequalities in vaccines, and the causes are many. “
In San Mateo County, most people vaccinated are White (32%) and Asian (24%), according to county data; 12% went to people with multiple races. The province is 39% White (excluding Hispanic and Latino) and 31% Asian, according to Census figures, with 4.5% identifying themselves as multi-race.
The lack of state data is alarming, experts say.
“I am very concerned,” said Garcia, an assistant professor of medicine at UCSF and co-director of the Multiethnic Health Equity Research Center. “We already know that there are inequalities in themselves when it comes to COVID infection. To address those inequalities, we need to make sure we target those same communities specifically for some therapies and for the vaccine and for prevention efforts. I find it really hard to believe that that information is really not available. “
Dr. Sergio Aguilar-Gaxiola, director of the UC Davis Center for Reducing Health Disparities, said that while more data is needed, the state has a daunting task in its own right.
“I think the state is trying to do the best, given the constraints in the range of vaccine allocations,” said Aguilar-Gaxiola.
Aguilar-Gaxiola is a member of the state’s COVID-19 committee on vaccination guidelines and “it has been a very intensive process to be as fair and considerate as possible, and to try to guide our decision-making by science and data. He said, emphasizing that he spoke from his own experience and not on behalf of the committee.
Doctors said they are also concerned about people with language barriers and those who don’t have access to computers or have little computer knowledge – such as seniors and some low-income people – and that they are missing out on enrolling in a vaccine.
Vivian Lem, a 69-year-old Japanese American San Franciscan, said she reached out to a representative on the Sutter Health phone line through sheer persistence.
She had no luck planning a vaccination yet, as Sutter currently prioritizes patients over 75 for appointments.
Lem said success can be a matter of ‘haves of have-nots’, with the ability to get on the Internet and stay on hold, sometimes for hours, ‘a real luxury’.
“It’s awful. It’s so sad. Everyone is so desperate,” she said. “It’s life or death.”
The nonprofit On Lok operates a comprehensive care program for the elderly and is the primary medical care provider for 1,600 seniors in San Francisco, Alameda and Santa Clara counties.
More than 90% of On Lok participants in federal housing for low-income seniors have agreed to take a vaccine – the result of relationships, trust over time, and culturally competent care, said Dr. Ben Lui, head of medical informatics for the organization. .
The average age of the participants is 81, and half have dementia, Liu said. Many are people of color and some are non-native English speakers. The consent process involved translating documents into multiple languages and communicating with families – including in some cases obtaining consent from those family members – before vaccines were available.
“In seniors, depending on their support from their family, depending on some of their own abilities, meaning that some seniors are not very tech-savvy or have cognitive disabilities, they often need help getting that information,” said Lazy. “It favors those who have resources and family members who can spend the time and get the information for them.”
Outreach will also be critical to the black community. Black people in California account for 4% of coronavirus cases and 7% of COVID-19 deaths, while representing 6% of the population.
Many doctors told The Chronicle that mobile vaccination sites are an important way to address language barriers, digital gaps, and other challenges.
In Contra Costa, for example, officials plan to increase the number of pop-up vaccination sites in disadvantaged areas. They are also planning several mobile vaccination clinics at companies that employ large numbers of food distribution and service workers.
UCSF doctors who helped set up community testing in Fruitvale last year are now turning to culturally sensitive and bilingual outreach for people of color.
The UCSF doctors, including Dr. Alicia Fernandez, are working with groups associated with black seniors and Spanish-speaking residents locally and nationally to answer their questions about vaccines. The “COVID-19 Vaccine Speaker’s Bureau” has started spontaneously and many question and answer sessions are held on Zoom from doctor’s residences.
Many experts expect more people of color to be vaccinated once key workers are given access to shots.
Earlier this month, state officials said they are considering allocating 20% of the state’s vaccine distribution to counties based on an equality statistic that takes into account zip codes most affected by the virus.
A major hurdle remains the hesitation about vaccines – in part the result of a deep distrust among some people of color in the national health care system.
“People are sensitive to history,” said Aguilar-Gaxiola. “They are aware of abuses that have occurred and there is a deep-seated mistrust in some communities of government agencies or other groups. Not only about recommendations such as vaccines, but also about providing (personal) information that is identifiable. “
Dr. Adrian James, West Oakland Health’s chief medical officer, knows this well. Lately he has started every conversation with a patient by asking, “Do you have any questions about the COVID-19 vaccine?”
About 70% of his patients say they would rather wait for others to get a COVID-19 vaccine first. For the patients who agree to get immunized, James is moving quickly, hoping they will tell their friends and family.
“I had a 65-year-old lady today who said she would take the vaccine,” he said. “My question to her was, ‘Okay, we have one with your name on it, when do you want to come in?’ ”
Tatiana Sanchez, Catherine Ho, and Mallory Moench are San Francisco Chronicle staff writers. Email: [email protected], [email protected], [email protected] Twitter: @RTLnews, @cat_ho, @mallorymoench