Citing outsize case rates, critics call for racial equity in COVID-19 vaccination in Vt., N.H.

  • Veterans wait in line inside the VA Medical Center in Philadelphia to receive the COVID-19 vaccine during a walk-in clinic. A racial gap has opened up in the nation’s COVID-19 vaccination drive, with Black Americans in many places lagging behind whites in receiving shots. Tyger Williams / AP

Valley News
Published: 2/2/2021 4:10:43 PM

Like most Vermonters under the age of 75, Allene Swienckowski is still waiting for her turn to be vaccinated against COVID-19.

In addition to having several underlying health conditions, Swienckowski, a 72-year-old Quechee resident, is Black, and people of color have been especially hard-hit in the pandemic.

Though the state Department of Health says on its website that it will “make sure people who are disproportionately affected by COVID-19, including Black, Indigenous and people of color (BIPOC), have equitable access to the vaccine,” Swienckowski said she’s still waiting for the details of how people of color will be prioritized in the vaccine rollout.

“I am angry,” Swienckowski, chairwoman of the Hartford Committee on Racial Equity and Inclusion, said in a phone interview earlier this month.

While Swienckowski’s age puts her in the next group slated to be vaccinated in Vermont, she said she worries about other Vermonters of color who don’t seem to be receiving priority in the vaccination process.

In Vermont, as elsewhere across the country, people of color have been disproportionately affected by COVID-19. Black, Indigenous and other Vermonters of color represent 6% of the state’s population, but 18% of COVID-19 cases, according to a December data brief from the Vermont Department of Health.

The disparity appears to be similar in New Hampshire, though race is unknown for nearly 26,000, or about 40%, of New Hampshire’s 64,200 total COVID-19 cases. Of those for which a patient’s race is known, people of color make up more than 7,500, or nearly 20%, of the 38,450 cases. BIPOC individuals make up roughly 7% of the population in New Hampshire, according to the Census Bureau.

Vermont health officials have defended the state’s vaccination plan, saying that it focuses on older Vermonters because — regardless of their race — they are likelier to die should they contract the virus. The state began by vaccinating health care workers, first responders and people living or working in long-term care facilities, and is now offering shots to those 75 and older. From there, Vermont plans to vaccinate ages 70 and older and then 65 and older, as vaccine supply allows. After vaccinating these age groups, the state plans to make the vaccine available to people with certain high-risk medical conditions.

There’s “no doubt that the right way to go is the older age group,” said Tracy Dolan, deputy commissioner of the Vermont Department of Health, in a phone interview last week.

New Hampshire has similarly focused on age and those with medical conditions in its vaccine rollout. The state first vaccinated health care workers and people in long-term care facilities and is now vaccinating those 65 and older and residents between 16 and 65 with two or more of a list of underlying medical conditions, as well as those who work in correctional facilities and residential facilities for people with developmental disabilities.

In moving away from plans that previously prioritized workers in industries that have continued to operate in person during the pandemic, such as grocery store clerks, public transportation workers, farm and factory workers and custodians, the states have “effectively deprioritized people of color,” said Anne Sosin, the program director for the Dartmouth Center for Global Health Equity.

Focusing solely on age and medical vulnerabilities ignores social vulnerabilities that drive transmission, Sosin said. In setting aside a framework for equitable allocation of COVID-19 vaccine developed by researchers at the National Academies of Sciences, Engineering and Medicine, Sosin said the states have missed an opportunity to address structural inequities such as systemic racism.

“How do we move from notions of health equity to programs that truly attend to that?” Sosin said.

Lower-income white people who work in front-line jobs are also vulnerable to contracting and transmitting the coronavirus, Sosin said. Targeting such workers of all races, who are out in the community and interacting with others at a higher rate than those who can work from home, would help to make the broader vaccination effort a success, Sosin said.

If states are going to throw out the plan researchers developed, she wondered, “What’s your better plan?”

For her part, Dolan said Vermont health officials had case managers working to help Vermonters 75 and older in “communities most at risk” sign up for vaccinations by having interpreters ready to assist English-language learners when registration opened on Monday. Moving forward, the department may set up “smaller mobile clinics” to vaccinate older Vermonters such as those living in crowded conditions. Those clinics, on a “case-by-case” basis, may include younger family members if they live in multigenerational households and require the use of an interpreter, Dolan said.

In addition, Dolan said the state is rolling out education efforts including videos in several different languages to help Vermonters of color who are hesitant about getting vaccinated feel more comfortable about doing so.

The issue of equity also came up at a news conference on Friday where Gov. Phil Scott and other state officials said they were continuing to prioritize Vermonters by age because of their risks of succumbing to the coronavirus. But Agency of Human Services Secretary Mike Smith said the state was specifically allocating 100 extra doses to help ensure vaccines get to the roughly 320 Vermonters who are people of color and 75 and over.

New Hampshire has set aside 10% of its available vaccines for “disproportionately impacted populations,” said Jake Leon, a spokesman for the New Hampshire Department of Health and Human Services. Using their pro rata shares of the set-aside vaccine doses, New Hampshire’s 13 public health networks will be conducting targeted vaccination clinics for these groups. In addition, state officials are meeting with community leaders to sort out how best to “connect with individuals in these populations,” Leon said in a Friday email.

“We believe this two-pronged approach — working with community leaders and the regional public health networks — will ensure the state is able to identify and meet people in these populations where they live to provide them access to the vaccine,” Leon said.

So far, Vermont’s plans to address racial equity have not satisfied Swienckowski.

“I know that the state feels great about providing translators for those Vermont residents that do not speak English,” she said in an email last week, “but this minor reach to some BIPOC communities is really not enough and was not well-thought-out.”

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