Half of US states want to prioritize black and Hispanic people in vaccine rollout

Alabama: The health department has said it will monitor vaccinations administered to understand current saturation by county based on available information on vaccine distributed and by race.

Communicators will confer with local entities to help ensure equitable access to immunization sites from this date.

Alaska: The state is yet to announced who will receive the vaccine following the first two tiers which include hospital-based front-line healthcare workers at highest risk for COVID-19 infection; long-term care facility residents and staff; EMS/fire personnel providing emergency medical services; community Health Aide/Practitioners (CHA/Ps); and individuals who are required to perform vaccinations.

However, the state has received 11,700 doses of vaccine for the Alaska Tribal Health System directly for the state’s native tribes.

Arizona: The state has proposed placing essential workers one step ahead of those 65 and older to receive a vaccine but all will be able to receive a shot in phase one.

‘These criteria have been provided as a proposed framework to ensure that all populations have equitable access to COVID-19 vaccination,’ it said

Arkansas: Essential workers will receive the vaccine ahead of those 65 and older in Arkansas, as per the CDC guidance.

California: California has committed to ensuring black and brown people have greater access to the vaccine.

It plans to prioritize minorities by working to remove barriers to accessibility such as transportation and wait times. Governor Gavin Newsom has said that experts are ‘making sure black and brown communities disproportionately are benefited because of the impact they have felt disproportionately because of COVID-19’.

Colorado: Higher-risk individuals aged over 65 and essential workers will both be included in phase two of the rollout in the spring.

Connecticut: Essential workers and adults over 65 will be vaccinated in the spring.

The state said, ‘Public health messages and products will be tailored for each audience and developed with consideration for health equity’.

Delaware: Over 65s and essentials workers will both be included in phase two of the rollout.

Florida: People 65 and older and those with pre-existing medical conditions will be vaccinated ahead of essential workers in Florida.

People from racial and ethnic minority groups are still listed among the state’s critical populations.

‘The Department’s Office of Minority Health and Health Equity has been engaged in vaccination planning and existing networks and data will be utilized to inform these efforts,’ it states.

Georgia: Georgia does not reference race or minorities in its initial plan but says over 65s and essential workers will be included in its first phase.

Hawaii: People from racial and ethnic minority populations are listed among Hawaii’s critical populations.

‘Current evidence has shown how COVID‐19 2 disproportionately affects particular racial and ethnic minority groups, including Black, Hispanic or Latinx, American 3 Indian and Alaska Native, and Native Hawaiian and Pacific Islander communities,’ it noted.

It will rank those most vulnerable by 15 social factors including unemployment, minority status, and 31 disability.

Idaho: People from racial and ethnic minority groups and tribal communities are named among critical communities

‘In Idaho, 13% of the population is Hispanic, but 33% of COVID-19 cases are members of the Hispanic population,’ it noted.

Illinois: Populations at higher risk such as racial and ethnic groups will be among the first to be vaccinated.

The plan gives no further details on how they will be prioritized.

Indiana: People from racial and ethnic minority groups and people from tribal communities identified as being of increased risk of acquiring or transmitting COVID-19.

‘Targeted outreach to rural areas and other specific communities, such as Amish or Potowatomi Indian populations, will also be necessary to provide direct outreach to those who may not have access to information or fewer healthcare resources in less populated areas of the state,’ its plan says.

Iowa: In Iowa, lists and maps have been provided to include several demographic databases to determine the number of people 65 years or older, people from racial and ethnic minority groups, people with disabilities and people living in rural communities.

They will all be considered in the next phase of vaccinations.

The state said it will implement ‘communication strategies about vaccine allocation to minimize perceptions of lack of equity’.

Kansas: Health officials have said they will be keeping communities of color in mind as they make further decisions on the vaccine, according to 41 Action News.

‘We have a wide representation by tribal organizations, ethnic and racial minority groups,’ said Dr. Lee Norman, secretary of the Kansas Department of Health and Environment.

‘Different socioeconomic groups and beyond that, faith leaders, medical bioethicists to look at it with many sets of optics.’

Kansas will also focus on accessibility issues by targeting transportation hubs to spread information about the vaccine and looking into sending mobile vaccine units to communities where many people may not have a car.

Kentucky: The state plans to carry out a survey of African American and Hispanic Kentuckians in order to establish the best way to target communications to them as a critical community.

Louisiana: Louisiana will target racial and ethnic minorities as high priority during the first phase of a digital communication campaign about the vaccine.

‘In addition to major newspapers across the state, the plan will also place ads in ethnic and minority publications, specifically those that serve the Vietnamese, Hispanic and African American communities,’ it adds.

It will do the same for radio stations.

‘A notable proportion of nursing home workers are Black (27.8 percent), as are home care workers (Black: 29.7 percent and Latinx: 17.5 percent). A sizable proportion of such workers are over 65 as well (Black: 9.1 percent and Latinx: 11.3 percent),’ its plan states.

Health equity is incorporated in every step of planning, the report notes.

Maine: Maine has developed a specific ‘Racial/Ethnic Minority COVID-19 Vaccination Plan’.

‘COVID-19 has not affected all groups in Maine equally. Some groups—such as racial and ethnic minorities—have experienced rates of disease that far exceed their representation in the population as a whole,’ it states.

‘Maine’s approach to ensuring timely access to COVID-19 vaccine for members of racial/ethnic minority groups will evolve following consultations with members and leaders of those groups.

‘ECOVID-19 rates for racial and ethnic persons in Maine are disproportionately high. Even though this population accounts for roughly 5% of the population (see table below), this group accounts for 25% of COVID-19 cases in Maine,’ the report continues.

‘Maine is placing special emphasis on ensuring all Mainers, especially those from diverse racial and ethnic backgrounds, have accurate information on COVID-19 vaccine and can access that vaccine, once available. Members of the Maine COVID-19 planning team have consulted with Tribal leaders, the Maine Migrant Health Program, and the District Liaisons and we acknowledge that more needs to be done to reach these populations.’

Maryland: ‘The COVID-19 pandemic has had a disproportionate impact on people of certain races, ethnicities, ages, health status and socioeconomic status. It is essential that equity be incorporated into the implementation of a COVID-19 vaccination plan,’ Maryland says of its distribution.

‘Based on Census data, of Maryland’s estimated six million residents, 31 percent are Black or African American, 11 percent are Hispanic, 0.6 percent are American Indian/Alaskan Native. Additionally, approximately 9 percent live in poverty. Those 65 years of age and older make up 15 percent of the population while those with heart disease, kidney disease, diabetes or respiratory disease (e.g., asthma, COPD, etc.) make up approximately 25 percent of the population. Communication will be essential to ensure these populations are reached as part of the vaccine program.

‘Messaging should be tailored and developed for each audience to ensure communication is effective,’ it says of its outreach to these communities.

Massachusetts: The state says it will provide equitable access to COVID-19 vaccination for all critical population such as racial minorities to achieve high COVID-19 vaccination coverage in these populations in the jurisdiction in phase two

They plan to do this through their messaging.

Michigan: Michigan will vaccinate essential workers before over 65s, who are more likely to be white.

It will consider the minority status and language spoken in deciding it what order you should receive a vaccine.

Minnesota: The state has said it will strive for fairness and protect against systematic unfairness and inequity as a key principle in distribution.

‘Other attributes to be considered in prioritization include: people with certain medical conditions, people with disabilities, and people from certain racial and ethnic minority groups who are disproportionately affected by COVID-19,’ its report states.

Mississippi: The states identified its 1,666,665 people from racial and ethnic minorities as 11,000 from tribal communities as critical populations.

Missouri: Individuals at high risk for adverse health consequences including minority groups will have vaccines by late winter.

Montana: ‘Government-to-government relations and communications with tribal nations and health partners are important and critical throughout this process,’ the Montana plan states.

Racial and ethnic minority groups and tribal communities are considered at risk and will be targeted with a communications campaign.

Nebraska:  Organizations that work with the African-American and Hispanic and Latino community, as well as other community-based organizations, have been named as partners in their vaccination plan.

Nevada: Nevada as established a specific plan for its tribal communities.

‘Special consideration needs to be made for the under- and uninsured populations and underserved racial and ethnic minorities in Nevada, to ensure they receive equitable vaccine access during the COVID-19 vaccine response,’ it states.

‘Community outreach processes are built into the pandemic influenza planning structure and are being adapted to fit Nevada’s COVID-19 vaccine response accordingly.’

New Hampshire: Racial minorities are listed among vulnerable groups and equity is promised.

New Jersey: ‘Throughout the pandemic, the State of New Jersey has been concerned about the disproportionate impact of COVID-19 on vulnerable populations, such as those in congregate settings, and communities of color,’ reads the state’s plan.

‘To bridge this inequity gap, NJDOH has enhanced partnerships with State and county correctional facilities, expanded testing at LTCFs, correctional facilities, and State psychiatric hospitals, and piloted “boots on the ground” testing at senior high rises, and among persons experiencing homelessness and seasonal farm workers.

‘Although these efforts cannot wholly reverse centuries of systemic, structural, socioeconomic, and health inequities, we recognize the need to continue shining a light on increasing equity in public health actions, particularly in the development of continued COVID response and planning.’

New Mexico: The department of health will provide outreach to racial and ethnic minority community leaders to determine best vaccine clinic models and specific ways to establish efficient vaccination

The Indian Affairs Department has also developed a plan for tribal partners.

‘We urge the CDC not to force every sovereign tribe to make a binary choice about vaccine procurement and distribution. We also urge the CDC to consider data not reflected in the template to enable tribal partners to determine the best path toward effective vaccine distribution and administration in their communities,’ it states.

‘Community Health Workers with New Mexico pueblos, tribes, and nations and promotoras in Hispanic communities are an essential part of health care and outreach. These essential workers will be integral to getting the COVID-19 vaccine message in their communities.’

New York:  New York State’s COVID-19 vaccine distribution plan will be based on standards that prioritize people at higher risk of exposure, illness and/or poor outcome. Unrelated factors, such as wealth or status, will not influence distribution.

North Carolina: The state says it will look to minorities in phase two of the distribution.

‘Although we do not list race or ethnicity groups as the sole criteria for prioritization, prioritizing groups for outreach by risk of exposure and chronic conditions in Phase 1 and 2 promotes equity,’ says its plan.

‘Historically marginalized populations are disproportionately represented among the high-risk populations, frontline and high-density occupational setting workforce, and congregate living settings. For example, nationally African Americans and Latinx people comprise 40+% of long-term care workers.

‘In North Carolina, 51% of homeless people and 52% of incarcerated people are African American. Further, prioritizing essential workers for outreach promotes equity. A national survey by Kaiser Family Foundation found higher proportions of African American and LatinX populations are essential workers as compared to white populations.’

North Dakota: They have developed maps by country to show minority groups and native American communities to focus on.

Ohio: ‘The Ohio Department of Health Equity Specialists will collaborate with the Governor’s Minority Health Strike Force to ensure that there is equitable access to vaccines, especially for racial and ethnic minorities,’ it states in its plan.

Oklahoma: The department of health said it ‘anticipates that populations including people from racial and ethnic minority groups, tribal communities, people with underlying medical conditions and/or disabilities, and those who are under or uninsured will likely be present among all priority populations’.

Oregon: ‘Though data in Oregon is clear that people of color have been disproportionately affected by COVID-19, the data to accurately describe these inequities is often not available,’ said of its plan to focus on minority groups.

‘Some of the most concerning disparities occur in seasonal influenza vaccination where Hispanic/Latino people have vaccination rates 17 percentage points lower and African Americans 6 percentage points lower than whites.

‘As we approach a respiratory season where influenza and COVID-19 patients will require the same limited pool of healthcare resources, these disparities represent critical needs that must be addressed in COVID-19 vaccine planning.’

Pennsylvania: The Commonwealth has said it will ‘redress some of the socioeconomic and racial inequities brought about the pandemic which has disproportionately affected the Latinx and Black or African American community’.

‘While racial and ethnic minorities tend to be underrepresented as clinicians, they are overrepresented as other low wage healthcare personnel,’ states its plan.

‘So, by including a broad definition of healthcare personnel, it incorporates those racial and ethnic minorities in forward-facing roles who would otherwise not be prioritized if there was solely a focus on clinicians.

‘Additionally, because individuals who have certain preexisting health care conditions are being prioritized within Phase 1A, and racial and ethnic minorities tend to have a higher prevalence of many of these conditions, this approach further mitigates inequities.’

Rhode Island:  Minorities are identified as critical communities, but no specifics are given.

South Carolina:  The only mention of ethnic groups is that a Minority Outreach group will be update of the plan.

South Dakota: They have developed maps by country to show minority groups and native American communities to focus on.

Tennessee:  The only mention of ethnic groups is that there will be outreach to minorities.

Texas: Texas’ plan mentions minority groups as critical populations but makes no reference to equity.

Utah: Utah says that racial/ethnic groups will be vaccinated in phase two in March or April.

Vermont:  Racial and ethnic groups are listed among the CDC guidelines for vulnerable groups. No other mention is made in the plan.

Virginia: Virginia has not outlined a racial or ethnic group plan.

It states that the initial distribution will ensure 480,000 health care personnel (HCP) and long-term care facility (LTCF) residents receive a first dose of the vaccine

Then at-risk people will receive a dose.

Washington: The department of health is developing a prioritization and allocation framework in consultation with public health and health care partners to include first responders; critical and essential workforce sectors; business groups; black, indigenous, and people of color communities; education systems; and other governments, including tribal nations, local governments, and local health jurisdictions. 

West Virginia: Its plan gives no specific reference to minority group vaccinations.

Wisconsin: Ethnic and racial minorities are simply reference as a vulnerable population.

Wyoming:  ‘For the COVID-19 vaccination plan special populations will include any individual, group or community with physical, mental, emotional, cognitive, cultural, ethnic, socio-economic status, language, or circumstance-related barriers to understanding or responding similarly to the general population,’ the Wyoming plan states.

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