Vaccine disparities are worse post-emergency KATELYN JETELINA NOV 28 Data is starting to roll in on Covid-19 vaccine inequities this fall

[lankisterguy]

Vaccine disparities are worse post-emergency KATELYN JETELINA NOV 28

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Oof. Data is starting to roll in on Covid-19 vaccine inequities this fall. And it’s not pretty.

Access. Cost. Outreach. Education. All of these changed once the federal emergency ended in May. Vaccines are no longer purchased or distributed by the government, and funding ran out to support vaccine campaigns. This means the U.S., once again, faces the pre-pandemic privatized and fragmented healthcare and public health systems. And one could argue an even worse system, given the loss of trust.

Unfortunately, our communities continue to feel it disproportionately.

Zoom out: U.S. vs. U.K.

U.S. rates of Covid-19 vaccination this fall are, overall, abysmal. This is especially apparent when we compare it to counterparts like the U.K., where 68% of people over 65 years old are vaccinated (compared to 31% in the U.S.).

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Sources: CDC data here and here; UK data here

Zoom in: Inequities within the U.S.

Within the U.S., vaccination rates are not equally distributed. Disparities were evident last fall and continue this fall:

• Race and ethnicity: Communities of color continue to have much lower rates of vaccination. We see this across all sorts of data: national, state (e.g., California), and hyperlocal (e.g., Marin County in California). (Note: Data sources are very different. For example, CDC uses survey data while CA uses immunization records. This means we cannot make comparisons like CA has lower rates than the larger U.S.)

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• Rurality: A CDC analysis last week found adults in rural areas were less likely to have gotten a Covid-19 vaccine (10%) vs. those in urban (15%) or suburban (14%) areas.

• Healthy Place Index (HPI): In California, counties are ranked by an HPI: a measure of conditions that drive health, including life expectancy, income, education, etc. The highest HPI (think high-income) counties have 5.3-fold higher vaccination rates than the lowest HPI counties.

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Are disparities widening after the emergency?

Yes.

Epidemiologists in Marin County have started digging into this question.

First, they examined California data to determine differences in vaccination rates by race and ethnicity between last fall and this fall. The gaps in vaccination rates have grown between Latinx and non-Hispanic White (hereafter, “White”) and Black/African American and White residents.

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Epidemiologists then looked at uptake this fall among those who got a vaccine last fall, among Marin County residents. This would show whether there are new barriers to accessing the fall vaccine for marginalized groups (rather than hesitancy to get vaccinated).

They found lower fall 2023 coverage by usual resource level and race. Among those who got the vaccine last year, uptake of this year’s fall vaccine was 45% in White residents compared to only 18% in Latinx and 31% in Black residents, and differences between these groups were similar when limited to those 60 years of age and older.

This points to new barriers.

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Why does this matter?

The gap between Latinx and White residents who are fully protected is more than twice what it was last year. Same with African American/Black residents. Same with residents of low income.

This means two things:

1. Those who are more likely to lack access to healthcare are even more likely to be infected and get seriously ill once again.

2. The commercialization of vaccines has only amplified gaps in access and uptake. This is cause for concern about our national vaccine system during non-emergency times.

Bottom line

When the nation’s health is at stake, we need public health to ensure our resources are fairly distributed and get to those who need it most. The “marketplace” doesn’t do this naturally. In fact, it works against many of our communities. These inequities will continue unless we make big, systemic changes. One would hope that a pandemic would jumpstart these changes, but it seems we are quickly falling back to our pre-pandemic ways.

Love, YLE and the brilliant team at Marin County Health Department (Drs. Matt Willis, LeeAnn Prebil, and Pooja Mhatre)

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[G_A_L]

This is a sad article about the continued lack of the US to provide Public Health services as a guaranteed service vs a for profit private health product. Unfortunately, this way of viewing health services has been seeping into Canada. Citizens in both countries pay worker citizen taxes for the purpose of providing all citizens with essential services. Health services is an essential service and should not be offered by health service need not who can pay for a needed health service.

[cajunjeff]

I think a big reason for this is that Covid has become a much less scary illness to people. This in turn is likely due to the fact that most everyone by now has some degree of immunity from having one or more vaccines and/or from getting covid. Another part of it is that the vaccines so far dont seem to do a great job of keeping people from getting covid, but rather better at keeping covid cases less serious. Finally, the latest strains of covid appear to be less dangerous than the original.

We had a packed house for thanksgiving with my out of town kids in town. My daughter in law arrived with one of my sons on Sunday before Thanksgiving with the sniffles, which turned out to be covid. Yikes. Had this happened two years ago before vaccines, I would have showered in disinfectant, put on a hazard suit, wiped down the whole house and slept in my car. As it was, she just masked up and we tried to keep distance from her until she tested negative. When the wine flowed at night, I noticed most everyone dropping their guard.

While still dangerous for many people, Covid just is not the boogeyman it used to be. I regretted when she announced her covid that I have procrastinated on getting my booster, even though I have had flu, pneumonia and RSV vaccines this year. I still plan on getting booster, but my only case of covid so far was so mild that I’ve dropped my guard too. Having typed all this out has made me think I might get the booster tomorrow, I did wish I had taken it before thanksgiving potential exposure.

[DriedSeaweed in reply to cajunjeff]

I think you are spot on. I bet most people don’t even think about it anymore. If I was young and healthy I wouldn’t bother unless an immediate family member had problems.

[LeoPa]

Same over here. Not easy to get one. Even PCR tests are hard to come buy. Covid is so irrelevant by now.

[RosettaClapp]

Just one point after saying how sad it is to read these statistics.. My daughters in-laws came from Jamaica.. They are black and are terrified of state sponsored vaccination programs. They are educated to UK secondary level .. Even with her father-in-law having died of Covid.. There seems to be memories ofvaccine trials having been made on their community in the 59s and 60s where many people died..