As the distribution of the COVID-19 vaccine ramps up across the country, Philadelphia data show that most of those vaccinated in the city are white, a trend reflected statewide.
The vaccine is still largely available only to health-care workers and residents of nursing homes and long-term care facilities; paramedics and EMTs in Philadelphia started receiving their first doses two weeks ago.
Philadelphia officials said Wednesday that of the 28,476 people who have been immunized at city health facilities, 43% were white, 12% were Black, 10% were Asian American, and 10% reported their race as “other.” For the rest, race was unknown.
The city’s population is about 34% white, 44% Black, 15% Hispanic, and 8% Asian American, according to U.S. Census Bureau estimates.
Philadelphia hospitals and health officials say they are working hard to get more residents of color vaccinated, especially because people of color are more likely to contract the virus and suffer serious complications.
The racial disparities in vaccine distribution are likely due to several factors, officials say, including the underrepresentation of people of color in the health-care industry; hesitancy among long-mistreated communities of color; and communication issues — such as a lack of regular access to email — that may disproportionately affect workers of color.
The city opened a mass vaccination clinic on Friday whose first aim is to vaccinate home health-care workers who aren’t affiliated with a hospital — a population that’s largely people of color.
“One of the ways to achieve health equity is by identifying and pulling out these job categories largely filled by people of color [and making sure they are offered the vaccine] — that’s most evident in this essential workforce. These are people who have to come to work every day, and they often go under the radar,” said Caroline Johnson, the city’s acting deputy health commissioner.
Both Jefferson Health and Penn Medicine offered the vaccine to employees based on their risk of contracting COVID-19, not by job title.
“It doesn’t matter if you’re a doctor, or someone who’s in security, or in dietary, or dining service,” said Jaya Aysola, executive director of Penn’s Center for Health Equity Advancement. “Your high-risk status is based on exposure to patients, not your position.”
Jefferson officials are also working with “influencers” — employees of color who can reach out to colleagues across the hospital about their vaccine experience — to help make the decision easier.
“Informally, the feedback has been positive, and we’ve had a number of people who came back to us and said, ‘Hey, you know, I was on the fence, and now I’m going to make my appointment,’” said Sandra E. Brooks, senior vice president and chief medical officer at Jefferson’s Center City division.
Statewide data also indicate a similar pattern of racial disparity in vaccine distribution, although those data are not complete. Of 193,492 vaccines that had been distributed, 63% had gone to white Pennsylvanians as of Friday. But those statistics don’t represent the total tally of Pennsylvanians who have received the vaccine: It does not include data from Philadelphia, which has its own vaccine allotment, and includes includes only partial data from the state’s nursing homes that have received the vaccine. The vaccine only recently became available to nursing home residents, and is being handled by a federal partnership with Walgreens and CVS.
State health officials said they are committed to ensuring an equitable distribution of the vaccine, and are planning a number of initiatives to make sure it’s offered to the most vulnerable Pennsylvanians as quickly as possible, including launching mobile vaccine units and using census and other data to pinpoint communities that could benefit from a local site.
“I think it’s clear that historical inequities contribute to reduced vaccinations,” said Executive Deputy Health Secretary Sarah Boateng.
Trust-building will be crucial in the community at large as more doses of the vaccine become available to a wider population, said Ala Stanford, the physician who runs the Black Doctors COVID-19 Consortium, which has been working in Black neighborhoods around the city to provide free COVID testing.
“We’re going to be administering the vaccine, and we’re going to be administering it at churches, in the community, the same as we’ve been doing the COVID testing. That’s going to make a big difference,” she said. “The fact that the city has said, ‘Ala, we need you to help get it in the community,’ is a step in the right direction. We can go places they may not be able to. Certain folks in the community recognize who we are, and so there’s a trust that comes with that.”
For her part, Stanford received her second dose of the coronavirus vaccine this week. But she said that she researched the vaccine carefully before deciding to get it. She worried about how quickly the vaccine had been produced, and that there were too few African Americans who participated in the initial trials.
Though the vaccines — from Pfizer-BioNTech and Moderna — have been produced at record speed, they have been tested on thousands of people in clinical trials, and approved by the Food and Drug Administration for most people over age 16.
“Once I read everything I could get my hands on and talked to expert virologists and vaccine experts, then I felt comfortable,” Stanford said.
But mistreatment of Black patients in the health-care system has caused many to be leery of the vaccine.
“There’s this cultural norm for many African Americans that you really don’t go to the health-care system until you’re really sick,” she said. “And then you add the cultural experiences, where the health-care system was untrustworthy over centuries. You’re not going to change all of that in a month or a couple weeks because there’s a vaccine here, and available.”
Still, she said, her phone has been “blowing up” with patients eager to learn when and how they can get the vaccine. Stanford is also getting the word out informally — last week, while shopping in the Reading Terminal right after her second shot, she was recognized by two Black women who she’d tested for COVID-19 last year.
“She said, ‘You gave me my COVID test at [Triumph Baptist Church]. I said, ‘So, we’re going to be administering the vaccine, too.’”