While State COVID-19 Numbers Improve Slightly, Vaccination Inequities in BIPOC Communities Are a Concern

by Andrew Engelson

In an online press conference on Feb. 10, Washington State Secretary of Health Dr. Umair Shah said that while 940,000 doses of COVID-19 vaccine have been given in the state, challenges remain as federal supplies remain lower than demand, and inequities in vaccine distribution among communities of color are becoming apparent.

Citing a report that is to be released later this week, Shah said that Latinx/Hispanic populations have been receiving much lower rates of vaccination than the rest of the state's population. Shah said that just 4.7% of those who had received one dose of the vaccine and 5.9% of those had received the full two-dose vaccine were Latinx/Hispanic, even though Latinx/Hispanics make up 13.2% of the state's population. While not citing specifics, he also noted that Black and multi-racial populations in the state were receiving the vaccine at lower rates than other racial and ethnic groups.

"We need a more intentional, equitable approach," Shah said. "We are committed to taking immediate action to improve our vaccine distribution efforts from an equity perspective, and ensuring equitable and culturally responsive access, particularly for communities that have been disproportionately impacted by COVID-19 in Washington."

Shah reported that the state was administering an average of 27,000 vaccine doses per day, but that supplies from the federal government have been well below what the state has requested during its Phase 1-b-1 vaccinations that include people over 65 years old and those over 50 who live in multi-generational households. In the past week, according to a press release from the Washington State Department of Health (DOH), the state requested 440,000 vaccine doses but had received just over 200,000.

During the conference, acting assistant secretary at the Department of Health, Michele Roberts, went into some detail about confusion in the past several weeks concerning allocation by healthcare partners regarding second doses. In previous weeks, some partners had been allocating what should have been second doses as first doses, but Roberts noted that the state is urging providers to prioritize vaccine series completion. She noted that the two doses of Pfizer-BioNTech should be given 3 weeks or 21 days apart, while the two doses of Moderna vaccine should be given 1 month or 28 days apart, and that it's best for patients to make a second appointment during their first vaccination.

Roberts also noted that a new one-dose vaccine produced by Johnson & Johnson was currently under review by the U.S. Food and Drug Administration (FDA) for Emergency Use Authorization (EUA) and that the FDA could decide on a EUA by the end of February.

Much of the call was dedicated to issues of racial equity in vaccine distribution and messaging.

Paj Nandi, director of Community Relations and Equity at DOH, said that state and regional public health authorities were working closely with members of BIPOC communities to listen, engage, and increase acceptance and vaccination rates for People of Color.

"There's no one single strategy that is going to turn the course on equity," Nandi said. "These are long-standing inequities and our systems are designed to perpetuate the same status quo. So it does take a lot of resources and a lot of work to work against that."

Nandi observed that the state is committed to working with "trusted community messengers" and community-based organizations to address hesitancy to the vaccine, which has roots in a long, racist history of vaccine experimentation and inequitable access to health care in BIPOC communities. Nandi cited one example in which health authorities are working with Black Lens, a BIPOC-run newspaper and radio show in Spokane, to get word out about the safety and effectiveness of the vaccine. He also noted that the state's varied messaging campaigns are being promoted in 36 different languages.

"When our supply increases, how do we create structures and systems that allow community-based sites to be more accessible and available?" Nandi said. "We've been working internally to create community-specific outreach and … just continuing that dialogue to see what is really working for the State of Washington and how can we better inform our efforts so that they are trauma-informed, they are community-driven, community-led, and so we can honor community that are truly closest to solutions."

In April of 2020, Public Health — Seattle & King County announced it has contracted with about 25 community navigators who are established leaders in their communities — most of them in the South End — to help improve messaging about the effectiveness and safety of the vaccine.

In general, the state's case numbers were improving but still high, with state epidemiologist Scott Lindstrom reporting that case counts, positivity rates, and intensive care hospital admissions were all down slightly over the past week. The new B.1.1.7 variant of the coronavirus remains a concern, however, and Lindstrom noted that about 5% of the state's positive tests were being analyzed for genotyping to track which variant strains are spreading in the state.

At the end of the call, Shah reminded state residents that now was not the time to relax on personal preventive measures such as wearing well-fitting masks, hand washing, and social distancing.

"You may be tired of this virus," Shah said, "but this virus is not tired of us."

Editor's Note: An earlier version of this article included an erroneous date for when Public Health — Seattle & King County began contracting with community navigators. It has been updated to correct our mistake.

Andrew Engelson is a Seattle-based writer and editor who lives in the South End.

Featured image: Essential workers gather at a Rainier Beach pop-up vaccination clinic held last month. (Photo: Alex Garland)