Civil rights leader: vaccine distribution can be a big moment to address ‘systemic disparities’

Published: Sep. 7, 2020 at 8:00 AM CDT
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WASHINGTON (Gray DC) - The race is on to develop multiple vaccines for COVID-19 in record time, but questions remain as to how the hypothetical vaccines should be released. The Centers for Disease Control and Prevention is telling states to be ready to distribute a vaccine by late October or early November. Leaders are looking for a nuanced approach to reach the most vulnerable communities.

“This is about systemic disparities,” said Marc Morial, president and CEO of the National Urban League.

Morial says COVID-19 is hitting communities of color at a disproportionate rate. His organization released a report showing black people have higher infection rates, hospitalization rates, death rates, and uninsured rates. The report also shows a higher percentage of black people unable to work from home. So Morial concludes that there should be a focus on these communities when a vaccine is available.

“Ensure that it’s widely available, that vulnerable communities get it on an equitable basis, and that people don’t have to have insurance to get it,” said Morial.

Morial is not asking for a leg up for communities adversely devastated by the virus. He wants the same access for everyone which he says historically has not been the case for people of color.

Food and Drug Administration Commissioner Stephen Hahn says it is common sense to vaccinate the most vulnerable first.

“We would of course consider prioritizing those who are most at risk in addition to frontline health care workers, food workers, and others around the country,” said Hahn.

Former FDA official Peter Pitts says this kind of distribution is unprecedented in the U.S.

“We haven’t really reached a crisis where we need to vaccinate the whole population at the same time,” said Pitts

Pitts says a number of organizational issues need to be ironed out, like cold storage as the states prepare to unfurl their distribution plans. He also says specifically who makes the decisions on distribution is a thorny question.

“That process needs to be entirely transparent,” said Pitts. “We don’t want somebody tucked away in some office in Washington making these life and death decisions.”

He says income levels and those with better access to health care should be disregarded as distribution begins.

“There can’t be any redlining when it comes to vaccinations. It can never be income, asset, zip code based. It’s really got to be based on the priority need of the individual groups,” said Pitts.

Pitts also argues location is also something to consider. He says local leaders will need to consider extending the reach of the vaccine to different venues – i.e. vaccinating kids in school, first responders at the fire station, or health care workers in their offices.

“You can’t simply say go to your doctor’s office, or go to your pharmacist…nobody wants to wait in a queue,” said Pitts.

When priority groups are chosen, convincing people to get vaccinated could be another challenge. Polls show one-third of Americans will not get the vaccine when it becomes available.

Pitts says leaders are going to have to reassure people this process did not involve corner-cutting and that there were no political machinations in the development process. He says some communities of color have developed a mistrust of vaccines after historically being mistreated in these processes.

“Those have to be addressed honestly and with respect. We have to explain to them what’s going on and get them on board because there’s no value in having a vaccine if people don’t use it,” said Pitts.

Commissioner Hahn says whichever vaccine they approve will be safe and effective.

“There is a public advisory committee of scientific experts from around the country to actually look at our decision making. That should provide additional confidence for the American people,” said Hahn.

Morial says this could be an opportunity to take the first step in righting the wrongs of racial disparities in this country’s health care system.

“Can this be a moment when we say, ‘We’re going to fix the public health system in America’?” said Morial.

There is still no exact timeline as to when a vaccine will be sent to the FDA for approval, and whether the FDA will authorize the vaccine for emergency use, which would mean it will be distributed earlier than the normal process calls for.

Hahn maintains there is no political pressure on him to approve a vaccine before the election, despite President Donald Trump mentioning that doing so could give him a late boost. The presidential election is November 3.

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