Racial disparities in how coronavirus vaccines have been distributed so far are prompting health officials in the Louisville area to boost vaccinations in the Black population.
Black Americans face a higher risk of developing complications from COVID-19, compared to their white peers. They are nearly four times as likely to be hospitalized with the disease and three times as likely to die, according to the Centers for Disease Control and Prevention.
But vaccination rates in Black communities in many states aren’t proportionate to their share of the population or COVID-19 cases and deaths. In Indiana, Black people comprise about 10% of the population but have gotten just 3.9% of vaccinations. Less than 5% of Ohio’s doses have gone to Black people, despite accounting for 18% of the state’s COVID-19 hospitalizations.
Louisville is facing a similar issue. Chief Medical Strategist Dr. Sarah Moyer said the gap became apparent during tier 1a vaccinations of frontline health care workers.
“We reached [about] 32% of the Black population that we know are health care workers and really close to 70% of the white population,” she said. “And so we know there are disparities in that. And that's what we're hoping that we can improve going forward to make sure our entire community is protected equally.”
As vaccines become more widely available to the general population, Moyer worries the low rates in communities of color will continue. Community leaders are organizing targeted outreach efforts to prevent that.
Sadiqa Reynolds is the president and CEO of the Louisville Urban League. Last week, her team hosted an event to vaccinate prominent Black Louisvillians.
“We have ministers here, we have grandmas here,” Reynolds said. “The Black community is represented, and I wanted people to make sure that they understood that all of us are saying we trust this enough to move forward.”
VACCINE HESITANCY LINKED TO LACK OF TRUST
The low vaccination rate among Black Americans isn’t unique to COVID-19. Similar disparities also exist for flu, hepatitis and pneumonia vaccines.
Reynolds said mistrust of the medical establishment and the government plays a major role in the low rates, noting historical injustices like the Tuskegee Syphilis Experiment. She said government officials need to stop politicizing the pandemic.
“We don't care about these elected officials,” she said. “This is about the people who know the science. I'm nervous because Black people have no reason to trust the government. We are the ones who have been experimented on. We have always been disposable in this country.”
Local pastor Walter Malone Jr. was vaccinated at the Urban League’s event last week. Malone said he, too, had concerns about the vaccine.
“I know that for many African Americans, there’s some apprehension and fears about taking the vaccine because of past health care issues,” he said. “Even in many cases today, the distrust exists. So I came as one of the community leaders to take the shot to serve as an example of us moving beyond our fears and helping to turn the tide and our community in terms of this pandemic.”
Southern Indiana health officials also are planning outreach efforts to the Black community. Pamela Clark is the director of the minority health initiative at Community Action of Southern Indiana.
Clark is working alongside the Clark County Health Department to build trust in the Black community and vaccinate as many people as possible. To accomplish this, she’s leaning on community partners, like local employers, churches and social service providers.
“We have to be creative,” Clark said. “And I think as long as we have the correct message and make sure that we're at the table, I'm sure we can get the word out and encourage people to get the vaccine when their time comes.”
OVERCOMING SYSTEMIC DISPARITIES IN ACCESS TO CARE
Clark County Health Officer Dr. Eric Yazel said trust isn’t the only factor that could keep vaccination rates low.
“Our first concern was with the older population just being IT savvy enough to sign up for it,” he said. “But as we get into more marginal populations, we want to make sure if there's any transportation needs or anything like that.”
Black people have been disproportionately affected by barriers to health care services throughout history.
Yazel said even after finding ways to navigate those challenges, more vaccine doses are still needed.
“The problem is, we have all these great plans, and when it all comes down to it, we just need vaccines,” he said.
Clark County leaders are discussing the possibility of launching mobile vaccination sites to bring care directly to neighborhoods, similar to mobile testing sites that were used earlier in the pandemic.
Norton Healthcare has opened a vaccination site in west Louisville in an effort to vaccinate more Black residents, according to Dr. Kelly McCants, executive director of Norton Healthcare Institute for Health Equity.
But Yazel said such efforts are only short-term solutions prompted by the immediate threat of the coronavirus. Moving forward, he said it’s important for the medical community to work toward institutional change to eliminate health disparities.
"We’ve said it, but you’ve got to move from talking about it to action,” Yazel said. “We didn't act as aggressively as we should have. And it took a public health crisis like COVID-19 to say this is why that's important. It’s a shame it took that, but we've got to use this as a lightning rod to say, ‘Hey, we’ve got to get out here and get to work on this.’ Because unfortunately, this probably isn't the last of the public health virus issues."
