As Shelby County lowers the age of eligibility for COVID-19 doses to people 70 and older, health officials are examining some of the potential racial, ethnic and economic inequities surrounding vaccine distribution.
“There’s some work we have to do in terms of making sure that there’s not a disparity in the vaccination and the administration of the vaccination,” Dr. Bruce Randolph, Shelby County’s health officer, said at a press conference on Thursday.
Health department leaders previously cautioned against making any sweeping conclusions about disparities because vaccines have so far been narrowly doled out—based on age or occupation. But Randolph said that some preliminary data analysis raises concerns.
The department recently looked at a group of about 13,000 people aged 75 and older who have received a shot. About 50 percent of those were white, 12 percent were Black, 17 identified as "other" and 21 percent didn’t say. When asked about ethnicity, less than one percent identified as Hispanic or Latino.
These numbers are not in line with Shelby County’s overall demographics, although the data shared is limited to one age group and many did not share how they identified.
So far, it also appears that the wealthier suburbs such as Arlington and Germantown have a higher vaccination rate per 100,000 residents than Memphis, which is poorer and more racially diverse.
Jenny Bartlett-Prescott with the nonprofit Church Health medical center says barriers to getting vaccinated mirror other systemic reasons underserved populations face health inequities such as a lack of resources and time to access care. She says the new data might also reflect less obvious issues.
“Because of these historical inequities and historical determinants of health, we just don’t have as many people of color living as long; the life expectancy is shorter,” she says. “We have to take that into account when we’re using only an age-based system for eligibility for vaccines. It will inherently create some of those disparities.”
That’s why she says it’s important to quickly move through the age-based priority groups to vaccinate people with other high-risk factors such as those with chronic health conditions and those working frontline jobs in places like grocery stores.
So-called safety net providers such as Church Health that serve low-income populations are now receiving small allotments of the vaccine to administer to their patients who qualify.
“We need to still have these big mass sites. We have a lot of people to vaccinate, but we also need to do these kind of smaller special population access points, like through the safety net clinics, though the community pharmacies," she says. “So that we can try to reach people how they normally receive their healthcare.”
Carla Baker with the Common Table Health Alliance says opening more vaccine distribution sites in predominantly African American neighborhoods, like the new Southwest Tennessee Community College site in Whitehaven, is a step in the right direction.
But, a secondary concern for her is getting people without transportation to these places.
“For many people, they do not have a car, they rely on public transportation, or they walk to wherever they need to go within their neighborhood,” she says. “It’s so important that as we increase our sites that there are options for both drive-up and walk-up.”
The health department says it’s currently working with the state’s Medicaid program to explore transportation options for vulnerable populations.