Time to act on COVID vaccination racial disparities

News analysis

Black Minnesotans, Asian Minnesotans, American Indians, and Latino Minnesotans are far more likely than White Minnesotans to become infected, to be hospitalized, to suffer severe cases, and to die of COVID. That is the grim truth reported by the Minnesota Department of Health in its weekly COVID report.

The Centers for Disease Control and Prevention (CDC) reports that this disparity exists across the country, with Black and Latino Americans nearly three times as likely to die from COVID as White Americans.

That might suggest that Black, Latino, Native American, and Asian Minnesotans should be a priority for COVID vaccination. That is not happening. In fact, the way that vaccines are targeted—both in Minnesota and across the country—suggests that the opposite could be true.

“Suggests” because Minnesota and most other states are not reporting race in vaccination statistics. Minnesota reports on vaccinations administered with a breakdown by age, by gender, and by county of residence—but not by race.

The Washington Post says that only 20 states report race and ethnicity on their vaccination dashboards. In the states that do report, White people get vaccinated at a much higher rate than Black Americans.

That is likely true in Minnesota, too.

First, Minnesota’s vaccination program has named staff and residents of long-term care or assisted living facilities, K-12 education workers, and people over 65 as high priorities. That makes sense, especially for long-term care or assisted living facilities, which account for nearly two-thirds of COVID deaths in Minnesota. But prioritizing Minnesotans over 65 means favoring White Minnesotans. Some 23% of White Minnesotans are over 65, but only 6% of Black Minnesotans are over 65.

Second, vaccination programs in Minnesota and across the country prioritize health care workers but not other essential workers. Black people and other people of color are overrepresented in health care professions and also among other essential workers, including grocery workers, food production, public transit, janitorial work, security, and corrections.

When these other essential workers, mostly younger than 65, are pushed down the waiting list for vaccination, that means Black people and other people of color, are pushed down the waiting list.

Third, the pilot program for vaccine distribution in Minnesota has pilot sites in Blaine, Brooklyn Center, Fergus Falls, Marshall, Mountain Iron, North Mankato, Rochester, St. Cloud, and Thief River Falls. Some 86% of Black Minnesotans live in the Twin Cities. Minneapolis and St. Paul are not on the list.

The Minnesota Department of Health website says that “In addition to the nine community pilot sites managed by the state, we are also strategically partnering with Federally Qualified Health Centers (FQHCs)—some of which are located in Minneapolis and St. Paul.” The website also warns that this is, as yet, only a pilot program with an extremely small number of doses available.

So far, Minnesota’s vaccination rollout has been problematic in many different ways. As it goes forward, more attention must be paid to equity. Equity starts with collecting and reporting information on race for vaccinations, but it does not end with data collection. Equity does not happen by accident or as a matter of routine. Equity requires a conscious effort to identify and rectify disparities.