PORTLAND, Oregon (AP) – The role that race should play in deciding who has priority for the COVID-19 vaccine in the next phase of the launch is being tested in Oregon, as there is tensions over equity and access to the shots emerge across the country.
An advisory committee that provides recommendations to the Oregon governor and public health authorities will vote Thursday whether to prioritize people of color, target those with chronic medical conditions, or focus on some combination of groups at higher risk for coronavirus. Others are also being considered, such as essential workers, refugees, interns and people under the age of 65 living in group settings.
The 27-member committee in Oregon, a state run by a democracy that is overwhelmingly white, was formed with the goal of keeping justice at the center of its vaccine implementation. Its members were selected to include racial minorities and ethnic groups, from Somali refugees to Pacific islands to tribes. The committee’s recommendations are not binding, but they provide critical input for Gov. Kate Brown and guide health authorities in drafting the release.
“It’s about revealing the structural racism that remains hidden. It influenced the disparities we experienced before the pandemic and exacerbated the disparities we experienced during the pandemic, ”said Kelly Gonzales, a member of the Cherokee nation of Oklahoma and expert on the health disparities committee.
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.
The committee’s recommendations will also be subject to legal scrutiny, Banks 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.