PORTLAND, Oregon (AP) – The role that race should play in deciding who would get priority for the COVID-19 vaccine was tested Thursday in Oregon, but people of color will not be the specific focus of the next phase of state deployment as tensions around equity and access to the shots emerge across the country.
An advisory committee providing recommendations to Governor Kate Brown and public health authorities discussed whether to prioritize racial minorities, but decided on a wide range of other groups: those under 65 with chronic medical conditions, essential workers, inmates, and people living in group settings.
The 27-member group from Oregon, a state run by a democracy that is overwhelmingly white, said people of color likely fell into the other prioritized groups and expressed concern over legal issues if race was the focus. Their recommendations are not binding, but they do provide key guidelines on vaccine distribution.
The committee was formed with the goal of keeping justice at the center of Oregon’s vaccine launch. Its members were selected to include racial minorities and ethnic groups, from Somali refugees to indigenous people.
“Our system is not yet ready to focus and reveal the truth about structural racism and how it works,” said Kelly Gonzales, a member of the Oklahoma Cherokee Nation and expert on commissions on health disparities.
The group included a statement in its plan that acknowledged the impact of structural racism and stated that it was reviewing the needs of minority communities.
The virus has disproportionately affected people of color. Last week, the Biden administration stressed the importance to include “social vulnerability” in state vaccination plans – led by race, ethnicity and rural-urban divide – and called on states to identify “pharmacy deserts” where they would be difficult to shoot at the weapons.
Overall, 18 states included ways to measure equity in their original vaccine distribution plans last fall, and more likely to have done so since the shootings began, said Harald Schmidt, a physician. ethicist at the University of Pennsylvania who has studied vaccine justice extensively.
Some, like Tennessee, proposed reserving 5 percent of their allocation for “high-disadvantaged areas,” while states like Ohio plan to use social vulnerability factors to decide where to distribute the vaccine, he said. California has developed its own metrics to assess a community’s level of need, and so does Oregon.
“We’ve been telling a pretty 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 independent, independent research institute in Garrison. New York. “We need to think about all the different overlapping areas of risk, rather than the group we belong to and our personal network.”
Attempts to address inequalities in access to vaccines have already provoked adverse reactions in some places. Recently, Dallas authorities reversed the decision to prioritize the most vulnerable zip codes, primarily color communities, after Texas threatened to reduce the city’s vaccine supply. This type of setback is likely to become more pronounced as states move forward and struggle with difficult questions about need and lack of supply.
To avoid legal challenges, almost all states that consider race and ethnicity in their vaccination plans resort to a tool called a “social vulnerability index” or “disadvantage index”. This index includes more than a dozen data, from income to education level, to health outcomes and vehicle ownership, to target disadvantaged populations without specifically citing race or ethnicity.
In doing so, the index includes many minority groups due to the impact of generations of systemic racism, while picking up socioeconomically disadvantaged people who are not people of color and avoiding “very, very difficult and toxic issues” about race. , said Schmidt.
“The question is not, ‘We want to make sure the Obama family gets the vaccine before the Clinton family. We don’t care. We can both wait safely,” he said. of meat packaging in a crowded life situation get it first. It’s not about race, it’s about race and disadvantage. “
In Oregon, health leaders are working on an index of social vulnerability, including U.S. census data and then pooling on income levels and employment status, said Rachael Banks, director of the U.S. Census Bureau. public health division of the Oregon Health Authority.
This approach “goes beyond an individual perspective and more than a community perspective” and is better than asking a person to demonstrate “how it fits any demographic,” he said.
This makes sense for Roberto Orellana, a professor of social work at Portland State University who launched a program to train his students in tracking contacts in Hispanic communities. The data show that Hispanics are approximately 300% more likely to contract COVID-19 than their white counterparts in Oregon.
Orellana hopes that her students, who are doing internships in state agencies and organizations, will be able to use their knowledge both in tracking contacts and in advocating for vaccines in migrant and agricultural worker communities. Vaccination of essential workers, prisoners and people from multigenerational households will reach people of color and place them at the center of the vaccination plan, he said.
“I do not want to take any other group. It’s a tough, tough question, and every group has valid needs and valid concerns. We shouldn’t go through that, “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, body member Sara Cline, contributed to this report. Follow Flaccus on Twitter at http://www.twitter.com/gflaccus.