Racial disparities remain in Colorado’s COVID-19 vaccination campaign
People of color are still being inoculated against COVID-19 at a slower rate than their white peers four months into Colorado’s mass vaccination campaign, despite state health officials’ repeated assurances they’re prioritizing equity in distributing the shots.
The persisting racial gap in vaccinations is notable as Black and Latino Coloradans have faced high rates of sickness and deaths from the coronavirus.
And while it’s only been three weeks since COVID-19 vaccines became available to everyone 16 and older, public health experts said the disparities are not only due to who was first allowed to receive the shots, but also because of existing barriers to health care.
“It’s tough when the states and the U.S. really did not lead with equity in terms of prioritizing certain populations that are most vulnerable, including BIPOC (Black, Indigenous and people of color),” said Dr. Oswaldo Grenardo, co-chair of the Colorado Vaccine Equity Taskforce. “Now we’re in catch-up mode.”
The state health department first acknowledged the racial gap in COVID-19 vaccine distribution earlier this year, when it released data that showed only 4.34% of the people who had received the shots by late January were Latino and only 1.84% of vaccinated people were Black — percentages that were well below their share of the state’s population.
By comparison, 70% of people who had received COVID-19 vaccines at that point were white, which was mostly in line with their share of the population.
Data from the Colorado Department of Public Health and Environment shows that while there has been some improvement in getting more people of color protected against the coronavirus since those figures were released in January, a significant gap persists.
The racial disparity in vaccinations remains largest among the Latino population. Only 8.7% of Latino Coloradans had received COVID-19 immunizations as of Thursday, despite making up almost 22% of the state’s population. About 2.5% of Black Coloradans had received the vaccine, even though they make up almost 4% of the population.
By comparison, white Coloradans have received the majority of available vaccines — 70.5% — and are being inoculated at a slightly higher rate than their share of the population (68%). They make up about 43% of cases and 64.8% of COVID-19 deaths, according to the data.
Health department officials acknowledged the racial gap in COVID-19 vaccinations persists.
“We are clearly aware that we are falling behind in our Hispanic communities and we have partnered with lots of community organizations and partners in the Latinx communities,” said Brandy Emily, deputy director of the immunization branch at the state health department during a briefing last week. “So we continue to do the work. We know that we have an uphill road… but we’re committed to doing the work.”
Emily said state health officials know many factors contribute to the disparities, including access and connection with primary care providers.
“We also know that we started with our health care workers and teachers (in the earlier phases of vaccination) and that helped to widen the gap as we know that they are largely white occupations,” she said.
The health department first began reporting demographic data from the state’s vaccination efforts in January.
About 2.9% of Asian Americans in Colorado now have received the vaccines, which is slightly below their share of the population (3.1%). Of the people inoculated, 0.5% are Native Americans/Alaskan Natives, which is in line with their share of the population. And 0.2% of people vaccinated in Colorado are Native Hawaiian or other Pacific Islanders, which is slightly above their 0.12% share of the population, according to the data.
Racial demographic data is unknown for 12.4% of the people vaccinated in Colorado, according to the health department.
“We started with a broken system…”
As with much of the pandemic, the immunization drive is highlighting existing inequities as Black and Hispanic Coloradans are more likely to face barriers such as lack of internet access and transportation — both of which are used to sign up for and to receive the vaccines. They are less likely to have work schedules that give them time off to get a vaccine and to stay home if they experience side effects, according to public health and medical experts.
Misinformation and distrust in government also can lead to hesitancy and uncertainty about the vaccines, they said.
“We started with a broken system that had not done a very good job at engaging, generally, people of color and low-income communities because health care in the United States is expensive and time prohibitive,” said Verónica Figoli, chief executive officer of the Denver Public Schools Foundation and volunteer with Colorado Vaccine Equity Taskforce.
The task force has set a goal of getting 80% of adults of color vaccinated against the coronavirus by the end of the year.
Colorado public health officials repeatedly have stressed they are focused on equitable distribution of the vaccines, but they did not have a clear plan on how to make sure people of color would get inoculated before the vaccines arrived in the state.
Advocates said this further eroded trust with communities of color because, as the vaccine rollout began, state leaders and health systems didn’t always consider ways to make everyone feel comfortable at a clinic, such as making sure information was shared in multiple languages and in culturally appropriate ways. Some mass vaccination clinics also created hesitancy by having a police presence, they said.
“It happened too late and, in doing so, it creates this problem,” said Grenardo, who is also chief diversity and inclusion officer at Centura Health.
Trying to “bridge the gap”
And while the Department of Public Health and Environment told vaccine providers not to require government IDs or other documentation from people, it wasn’t implemented consistently across the state. Some clinics also have asked people for their health insurance information — even though the vaccines are free — which can create a barrier to accessing the shots, Figoli said.
State and local public health leaders have launched “pop up” and mobile clinics to increase geographical access to COVID-19 vaccines by going to communities hit hard by the pandemic. They are also partnering with community leaders, such as barbershops and churches, to overcome mistrust.
In Denver, city and public health officials have sought to address vaccine hesitancy among people of color by debunking myths about the shot.
“The community is the one telling us where they need us to bridge the gap,” said Loa Esquilin-Garcia, spokeswoman for the city’s Office of Emergency Management. “Once we learn about that one thing, we go ahead and try to take care of it as fast as we can to make sure the barriers for the community are lower and lower each time.”
But, she said, “We also need the people to trust us and come and get vaccinated.”
Still, even mobile clinics can unintentionally create vaccine hesitancy.
Some of Colorado’s mobile clinics had used Johnson & Johnson’s vaccine until the state halted use of the one-shot vaccine following reports of rare blood clots in six women nationwide after they were inoculated. The Archdiocese of Denver advised Catholics not to take the Johnson & Johnson vaccine before the pause, citing the use of abortion-derived cells to make doses, unless there was no other option available.
These ethical, moral and safety issues can increase hesitancy, particularly among the Latino community, Grenardo said.
“There’s a lot of perceived barriers that people have,” he said. “It’s incredibly difficult.”
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