PORTLAND, Oregon. (AP) – The role that race should play in deciding who gets priority for the COVID-19 vaccine was put to the test in Oregon on Thursday, but people of color won’t be the specific focus in the next phase of the rollout of the state as tensions around equality and access to the shots come out nationwide.
An advisory committee making recommendations to the Kate Brown government and public health authorities discussed whether racial minorities should be a priority, but decided on a wide range of other groups: people under 65 with chronic medical conditions, essential workers, inmates and people living in groups.
The 27-member panel in Oregon, a democratically-run state that is overwhelmingly white, said people of color likely fell into the other prioritized groups and expressed concern about legal issues if race was the focus. The recommendations are not binding, but provide important guidelines for the distribution of vaccines.
The committee was formed with the goal of keeping fairness at the heart of vaccine rollouts in Oregon. Members were selected from racial minorities and ethnic groups, from Somali refugees to indigenous peoples.
“Our system is not yet ready to focus on the truth of structural racism and how it turns out,” said Kelly Gonzales, a Cherokee Nation of Oklahoma member and health inequality expert on the committee.
The panel included in its plan a statement recognizing the impact of structural racism and saying it was scrutinizing the needs of minority communities.
The virus has affected a disproportionate number of people of color. Last week, the Biden government reiterated the importance of including “social vulnerability” in the state’s vaccination plans – with race, ethnicity and the rural-urban divide in the foreground – and asked states to identify “pharmacy deserts” where it will be difficult to get into arms shot.
A total of 18 states included ways to measure equity in their original vaccine distribution plans last fall – and more likely have since the admissions began arriving, said Harald Schmidt, a medical ethicist at the University of Pennsylvania who researches fairness. vaccines has been extensively studied.
Some, such as Tennessee, proposed earmarking 5% of its allocation for “highly deprived areas,” while states such as Ohio plan to use social vulnerability factors to decide where to distribute the vaccine, he said. California has developed its own metrics for assessing community needs, and Oregon is doing the same.
‘We told a fairly simple story:’ Vaccines are here. “Now we have to tell a more complicated story,” said Nancy Berlinger, who studies bioethics at The Hastings Center, an impartial 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.”
Efforts to address inequalities in access to vaccines have already sparked backlash in some places. Dallas authorities recently reversed a decision to prioritize the most vulnerable zip codes – mainly color communities – after Texas threatened to reduce the city’s vaccine supply. That kind of backlash is likely to become more pronounced as states move deeper into rollout and grapple with tough questions of need and scarcity.
To avoid legal problems, nearly all states that look at race and ethnicity in their vaccination plans turn to a resource called a “social vulnerability index” or a “deprivation index.” Such an index includes more than a dozen data points – everything from income to education and health outcomes to car ownership – to target disadvantaged populations without specifying race or ethnicity.
In doing this, the index includes many minority groups due to the impact of generations of systemic racism, while also picking up socio-economically disadvantaged people who are not people of color and avoiding “very, very difficult and toxic questions” about race, Schmidt said.
The point is not, ‘We want to make sure the Obama family gets the vaccine before the Clinton family. ‘We don’t care. They can both wait safely, ”he said. “We do care that whoever works in a meat packaging factory in a busy living situation gets it first. It’s not about race, it’s about race and falling behind. “
In Oregon, health leaders are working on a social vulnerability index, including looking at US censuses and then stratification about things like occupational status and income levels, said Rachael Banks, director of public health at the Oregon Health Authority.
That approach “goes beyond an individual perspective and more of a community perspective” and is better than asking someone to prove “how they fit into a demographic,” she said.
That makes sense to Roberto Orellana, a social work professor at Portland State University who launched a program to train his students to find contacts in Latin American communities. Data shows that Hispanic people are about 300% higher at risk of contracting COVID-19 than their white Oregon counterparts.
Orellana hopes that his students, who are interning with government agencies and organizations, can use their knowledge to track down contacts and advocate for vaccines in migrant and farm worker communities. Vaccinating vital workers, inmates and people in multi-generational households will reach people of color and put them at the center of the vaccine plan, he said.
“I don’t want to take anything away from another group. It’s a tough, tough question, and every group has valid needs and legitimate concerns. We shouldn’t go through this, ”Orellana said. “We should have vaccines for everyone, but we’re not there.”
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Associated Press / Report for America Statehouse News Initiative corps member Sara Cline contributed to this report. Follow Flaccus on Twitter at http://www.twitter.com/gflaccus.