Sat. May 21st, 2022

After targeted campaigns helped narrow a racial divide in U.S. vaccination rates last fall, this hole has reopened for booster shots.

Advocates say mistrust of public health systems, access problems and staff shortages have prevented black and Hispanic residents from receiving boosters in the same proportions as their white peers.

The differences are significant as black and Hispanic populations have died of Covid-19 at disproportionately higher rates than whites, and officials worked hard to promote the vaccine in these communities. Health officials worked with religious leaders and community organizations to address the vaccine’s concerns and make it more accessible.

Eleven states plus Washington DC track booster recipients by race and ethnicity. In those places, the booster rates for white people (as a proportion of the fully vaccinated population) were among the highest, while the rates for blacks and Hispanics were lagging behind.

In Illinois, for example, more than half of fully vaccinated white residents received their booster doses on Jan. 19, compared with 38 percent of black residents and 33 percent of Hispanics. The U.S. white population is also skewed by the elderly, meaning more white residents were advised to receive boosters in the past.

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The gap is questioning whether booster rollout campaigns are reaching some of the most vulnerable populations as the case of Omicron, the new variant of the virus, rises.

“When we see differences in primary serial administration, we know it will have a trickle-down effect on the proportion of the population that is boosted,” said Joe Coyle, director of Michigan’s Bureau of Infectious Disease Prevention. “There’s obviously a cascade effect.”

White residents disproportionately received the original doses of the vaccine when the rollout began last spring. Limited vaccine supply and complex online planning systems made shots less accessible in low-income colored communities, which also expressed hesitation about the vaccine. In May, only 56 percent of black adults and 57 percent of Hispanic adults said they had received at least one dose compared to 65 percent of white adults, according to a study by the Kaiser Family Foundation.

In September, Marcella Nunez-Smith, head of Joe Biden’s Covid-19 Equity Task Force, cited survey data showing roughly equal percentages of white, black, and Hispanic adults who reported receiving at least one dose of the vaccine, saying , that the numbers were “very, very encouraging”.

But then Omicron caused record-high infections and prompted the CDC to recommend an extra dose of vaccine.

Omicron also triggered staff shortages across the country, forcing much of the previously established outreach work to be reduced, according to Monica Schoch-Spana, a medical anthropologist at Johns Hopkins University who also runs a research coalition, Community Vax, to study blacks. and Latin American communities.

“There is a return to the focus on more centralized clinics, as opposed to meeting people where they are in the community in places like the barbershops that have previously hosted vaccine clinics,” Schoch-Spana said.

She added: “The scarce resource now is staff. There are fewer health professionals to staff clinics where it is not about large numbers, it is about targeted populations and smaller numbers, but with significant public health consequences.”

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It is also difficult to track the recording of booster shots from race groups in a consistent manner. The CDC does not report the breed or ethnicity of boostershot recipients under 65, as it does with the initial vaccine doses.

Among those 65 years of age and older, federal data show that white people make up a slightly larger proportion of booster dose recipients in that age group relative to their share of the fully vaccinated population, while blacks and Hispanics make up a slightly smaller proportion.

The gaps are larger at the state level.

In Michigan, there is a gap of more than 15 points along racial lines, with 52 percent of fully vaccinated white residents receiving booster doses per capita. January 18 compared to 37.3 percent of fully vaccinated black residents and 33.6 percent of fully vaccinated Hispanics. The inequalities are greatest among young people.

Studies suggest the same pattern nationwide. Among the age group 30 to 39, 42 percent of fully vaccinated white residents between the ages of 30 and 39 had received booster doses compared with 21 percent of black residents and 28 percent of Hispanic residents.

It often does not take much to convince fully vaccinated patients to get a booster shot, said Brittani James, who practices at a medical clinic that primarily serves black residents on Chicago’s Southside. The challenge, she said, is to make sure they know they are eligible to receive one and know where to find it. Three out of ten black and Hispanic adults are unsure or unaware that they need a booster, a study showed.

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“When the CDC finally decided to make that switch and[recommend boosters for everybody over 18]. . . Who knows how well it was communicated? “Said William Parker, a medical professor at the University of Chicago.

Céline Gounder, an epidemiologist who served on the Biden administration’s advisory panel for the Covid-19 transition team, said high booster use rates among the elderly were a good sign because they were the demographic that benefited most from boosters.

However, Gounder also pointed to data showing that white and high-income educated people were among the most likely to have received boosters.

“People who get boosters, and set the older demographic aside, are pretty much people who are relatively at lower risk than others,” she said. “This means that your benefit in terms of actual impact on hospitalizations and deaths will be less than if you made sure you reached the more vulnerable populations.”

It is unlikely that outreach to these populations will resume before the Omicron wave has subsided, Schoch-Spana fears.

“We go back in some respects to the early days,” Schoch-Spana said. “It’s déjà vu.”

Additional reporting by Caitlin Gilbert

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