Playing The Race Card in The Race to Vaccinate

 


Photo by Obi Onyeador | Unsplash

Photo by Obi Onyeador | Unsplash

I am standing outside Lincoln Financial Field in South Philadelphia on a crisp February morning watching a press conference hosted by Councilman Allan Domb and former Congressman Bob Brady. They are calling on Philadelphia Mayor Jim Kenney to deploy the city’s NFL stadium as a mass vaccination site. Domb and Brady happen to be white men, and they are joined by four other members of City Council – three of whom are Black.

 

As the press conference gets underway, reporters start receiving the following text from the mayor’s spokesperson: “We ask Councilman Domb and other supporters this: Are you deliberately trying to ensure that white privileged suburban residents of other counties and states are prioritized for vaccination over Black and brown taxpayers of Philadelphia?”

 

FEMA and the White House COVID-19 Task Force joined in this race-based line of reasoning in rejecting the push to use Lincoln Financial Field instead of opting for the Pennsylvania Convention Center, which is located in downtown Philadelphia.  Homeland Security Secretary Alejandro Mayorkas said at the opening of the convention center mass vaccination site: “As we work to increase access to the COVID vaccine in communities across the country, we are prioritizing equity, because your socio-economic status, your race, your ethnicity, your access to transportation, or your immigration status should not impact whether you are able to receive a vaccine.”

So, in Philadelphia our NFL stadium in South Philadelphia became a symbol of white privilege and our convention center in Center City became a symbol for racial equity.  How did this work out for communities of color?  Turns out, not so good.

 

The convention center site sits between the predominantly white neighborhoods of Center City and the Asian neighborhood of Chinatown.  It should come as little surprise that, in the latest reported data, the Asian population is now the highest vaccinated demographic by race in Philadelphia – hitting 65% currently receiving one dose. whites are at 50%, Hispanics 34%, while African Americans continue to lag at 31%.

 

It didn’t help that in its first five weeks of operation, our FEMA site at the Convention Center was only accessible through the city’s registry, which happened to be 65% white. Only after it came to light that the FEMA site was exacerbating racial disparities in vaccination did the city begin to allow for walk-up vaccinations from targeted ZIP codes.

 

But even that didn’t close the gap city-wide, so now the Feds are changing up their messaging. 

 

Eight weeks after FEMA opened the Convention Center doors for vaccinations to “prioritize equity,” Rachel Levine, Assistant Secretary for Health at the U.S. Health and Human Services Department (and former PA Secretary of Health), came to Philadelphia. Standing in an almost empty convention center, she said, “there’s always this tension between mass vaccination sites [and] the vaccination that you need to target toward specific groups for health equity.” 

 

Now it doesn’t matter whether you put the mass vaccination site in the middle of Center City on top of its major public transportation grid or in South Philadelphia, there seems to be something about being Black that is inherently at odds with mass vaccination sites.

 

Dr. Levine’s shoot-from-the-hip narrative of an inherent tension between communities of color and mass vaccination sites fuels a vicious racial stereotype – that Blacks will not be able to figure out how to access vaccines if the mass vaccination site is not located in a Black neighborhood. What is more racist: saying that Blacks will not get vaccinated unless you put the vaccinations at their doorstep, or saying that Blacks will not have the wherewithal to figure out how to get a potentially life-saving vaccine at a 24-hour drive-in/walk-up mass vaccination site located at the city’s NFL stadium?

 

The Black vaccine hesitancy narrative is nothing more than a cover-up for the failure of elected officials to plan for mass vaccinating communities of color. 

 

Sharelle Barber, a social epidemiologist at Drexel University, told NPR that the assumption about hesitancy caused significant delays in getting vaccines to Black and Latino communities. “That then puts the blame on individuals and communities as opposed to actually planning for action and equity,” said Barber.

 

And to be clear, Philadelphia’s plan for mass vaccinations was really no plan at all. The “plan” was to simply put the vaccines in all of the pre-pandemic neighborhood-based vaccine distribution channels – pharmacies, hospitals, health systems, and federally qualified health clinics. On the surface, that sounds like the fairest, most racially equitable approach: to not force communities of color to go outside their neighborhoods if you’re not going to force white residents to go outside of theirs. 

 

But what this approach misses is the reality beneath the surface; the reality of health deserts in communities of color. If you don’t plan ahead of time to build out additional mass vaccine channels for the Black and Brown health deserts – either within communities of color or outside of them tied to a robust public transportation system – then the pre-pandemic disparity will play out once again in vaccine distribution.  That is precisely what’s happening to African Americans in Philadelphia.

 

The largest distribution channel in Philadelphia before the FEMA site coming online was our hospital systems. A just-released national study by the Lown Institute, a Boston-area health care think-tank, found that the “Philadelphia area ranked among the metro regions with the most segregated hospitals, with 78% of hospitals falling either in the top 50 most inclusive or bottom 50 least inclusive – meaning their patients are disproportionately Black or white.”

 

If the hospital systems were segregated, the vaccine distribution was going to be segregated as well.

 

The second-largest distribution channel pre-FEMA was the retail pharmacy chains.  Yet, according to The Philadelphia Inquirer, three months after vaccine supply entered the Philly market, “almost 87% of Rite Aid’s doses went to white recipients, while just 4% went to Black ones.”

 

None of this should have come as a surprise to the so-called experts running the Philadelphia Department of Public Health (PDPH) in the 6 months they had to plan for vaccine distribution.  Yet no one – not the mayor, not city council, nor the PDPH – planned for this built-in vaccine inequity.

 

Philadelphia now attempts to redress this inequity by building pop-up vaccination sites in the health deserts it failed to cover in the first place. The city is now repurposing its 2020 census outreach program to push vaccines in neighborhoods of color. 

 

However, this smaller-is-better neighborhood-based approach hasn’t seemed to work either. From a high of 133,000 plus vaccinations administered the week of April 4th, Philadelphia’s vaccination rate for the past three weeks has dropped to 67,000, then 56,000, and most recently 36,000 per week. At this rate, we may be opening the Christmas Village at City Hall before Black Philadelphia reaches herd immunity.

 

We will never know if a real plan to transport communities of color to mass vaccination sites like Lincoln Financial Field would have prevented the racial disparity in vaccine distribution.  We will never know if communities of color would have accessed this so-called symbol of white privilege if it was presented to them.

 

But we do know this: when politicians play the race card with vaccine distribution instead of planning to mass vaccinate communities of color, it is those communities that get left behind.


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