Even though many attribute the unvaccinated population in the U.S. to COVID vaccine hesitancy, there are also greater systemic barriers to vaccine accessibility. Unfortunately, communities with the least access to vaccines are oftentimes also the most affected by the pandemic. But what contributes to these vast vaccine equities? We’ll examine several snapshots of the COVID pandemic at different time periods in search of an explanation.
COVID Vaccine Inequities
The story naturally begins with the inception of the first COVID vaccination. As preliminary data was collected on vaccinations made available to the general public, disparities began to appear. Black, Hispanic, and indigenous communities in March of 2021 continued to make up higher portions of COVID hospitalizations and deaths, but only a fraction of the nation's vaccinations.
Many studies have found the culprit for lack of vaccination to be accessibility and poor rollout rather than vaccine hesitancy. For instance, when mass vaccination sites were being hosted at the beginning of the pandemic--often in urban metropolitan areas--many low-income individuals could not make it to the locations. Some possible explanations include barriers due to work schedules, disabilities, or even a lack of transportation. Additionally, vaccination often requires appointments and a knowledge of fluent English to navigate the complexities of registration and timing.
Vaccine Hesitancy: A History
That being said, an examination of health inequity is impossible without addressing vaccine hesitancy, especially for people of color. In particular, the federal government’s legacy of unethical medical testing on black Americans, such as the Tuskegee syphilis study, leaves behind lingering feelings of mistrust towards vaccinations. Other instances of malpractice and eugenics also affect Hispanic and indigenous communities.
Health Discrimination
Finally, as discussed in “Race in Science, Pt.1: Biological Racism,” people of color and minorities generally experience greater discrimination in the healthcare system that might deter them from seeking treatment. Studies have found that these biases not only extend to people of color, but also non-English speakers who can’t access or understand targeted information.
In fact, a study by PLOS Medicine revealed that the healthcare facilities themselves in rural and minority communities were overall less likely to administer COVID vaccinations, especially at the beginning of vaccine rollout. The same vaccine inequities can be seen through global disparities as well--a topic for an entirely different article (See "Race in Science, Pt. 3: Global Vaccine Inequities" to learn more).
So why discuss these inequities and systemic issues?
The only way in which we may begin solving these disparities is by fully understanding past mistakes. The problem, in this case, is extensively embedded into society, history, and institutions, and thus has many layers to be examined.
That being said, progress towards a healthier country does not necessarily require absolving complicated histories, but rather focusing on the importance, effectiveness, and safety of today's science. Organizations like Vaccines4Good are just one of many potential solutions to aid the community, providing safe vaccinations and also information about public health to inform those healthy decisions.
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