When your turn arrives to receive a COVID-19 vaccine, how might you feel if you are asked to identify or verify your ethnic group?
The Saginaw County Health Department this month has added such a question, noting that leaders and staffers are “aware of and concerned about skepticism surfacing among some black and Hispanic members of the community regarding equity in the administration of COVID-19 vaccinations.”
Health Officer Christina Harrington states, “Ensuring equity and equal access to health care is the very heart and soul of public health. If we could, we would give the vaccine to everyone all at once. We can’t, of course, but we’re doing everything in our power to make the administration of scarce medical resources as fair as possible, so that everyone who wants a vaccine will get one.”
Dr. Delicia Pruitt, medical director, adds, “We are working extremely hard to be fair in every aspect of this complex process, but we can always do better. We’re course-correcting every day.”
The county’s primary covid vaccinators are the Health Department, Covenant HealthCare and Ascension St. Mary’s.
Other than vaccinating its own employees, Covenant receives referral patients from the Health Department and does not ask for ethnic information on its own, says spokesman Larry Daly, “We do support the Health Department in asking about race and ethnicity,” Daly says. “This local statistical data will help to ensure that vaccines are provided in a fair and ethical manner.”
Ascension spokeswomen, Christine Bergman does not express a specific viewpoint on seeking individual ethnic IDs for statistical analysis, but she offers a prepared statement that says:
“Ascension St. Mary’s, and all Ascension Michigan hospitals, are proud to be partnering with our local health departments supporting the State of Michigan’s plan for vaccinating our statewide 65-plus population, area healthcare professionals and eligible essential workers. Ascension Michigan is currently focused on providing vaccines to our healthcare associates across the state, as well as our over 150,000 Ascension Medical Group patients age 65 and above, starting with our most medically vulnerable, representing all races and ethnicities, as well as eligible essential workers. To date, Ascension Michigan has administered over 80,000 COVID-19 vaccine doses.
Ascension Michigan leaders are acutely aware of the need for COVID-19 vaccines to be distributed in a just and equitable way and will be conducting outreach to high-risk groups, including African Americans and other communities of color, to encourage and facilitate vaccination over the course of the coming weeks and months.”
Among the critics have been longtime civic activists John Pugh and Monica Reyes, reflected in part by their posts on their Facebook pages. Reyes says members of a regional Latino coalition support the racial IDs as a first step.
Reyes explains, “We don’t believe Saginaw Public Health was doing anything intentionally, but we felt it was imperative to raise the alarm. We all know that minorities have been hardest hit by the coronavirus. The national data shows this. We expressed our concern that it appears that our community is being left out of getting shots from the allocation that was set for 65 and older, but they had no data to verify or dispel that.”
In a written statement, Pugh says, “There are racial disparities in vaccine access in Saginaw and it is alarming. It has created a vaccine program that is leading to real problems for Black and Hispanic people who want to protect themselves, their parents and grandparents from the virus.”
He continues, “I do feel that it is consciously done. The representatives of the Saginaw health system are not being truthful. They know that the problem is not that most Black and Brown people do not want to take the vaccine. The problem is that they have not and will not set up a distribution system that will give proper access to Blacks and Hispanics. A testing site is set up at Saginaw Valley State University but not in a Saginaw city community center or church in the 48601 zip code.” (Editor’s Note: St. Mary’s is within 48601.)
“These people work public health all year. I can’t believe that they did not know that building an infrastructure in the under-served community to help eliminate barriers was important.”
Popping the question
The only method to gain racial data, of course, is to ask and survey individual patients. Peoples of color historically have been reluctant in this regard, but Reyes does not anticipate problems.
“I don’t think this will be a deterrent” to Latinos seeking vaccinations, she says, “We were encouraged to take part in the census, which was all about collecting federal funding for our community, and we did so.
“The CDC (federal Centers for Disease Control) and the state assured us that there would be a fair and equitable rollout of the vaccine, but how do we know this is happening in our region if they are not keeping that data?”
Indeed, Harrington and Pruitt note that the CDC does not ask for ethnic IDs — only for such basics as name, age, address, phone and nowadays, email. The Michigan Care Improvement Registry may ask for racial info, but does not share database info with local health agencies. And so the County Health Department also had not asked, at least until now with local equity concerns coming forth.
News analysis on national disparities has been widespread. Reports on Michigan inequities have emerged to varying degrees in statewide media, in particular in Bridge Magazine, bridgemi.com.
Pugh writes that the ethnic data is necessary and should have been compiled from the start. Unlike Reyes, he says he perceives conscious and intended bias.
“We cannot stop our efforts,” he writes, “until Black and Brown are vaccinated at the same level as Whites.”
In another Facebook post, he adds, “A lot of people in the Saginaw Public Health are proving not to have a mission to treat everyone with dignity and fairness. This is frightening.”
Event Center startup
Pruitt and Harrington respond that the Health Department will not wait for compiling the new racial data. A first step was a Feb. 11 “neighborhood-based mass vaccination clinic” at the Dow Event Center for an initial priority group, age 80 and older. They promise similar large-scale events in weeks to come across Saginaw County, including on the East Side, as federal vaccine shipments increase from an initial average of about 3,000 per week.
Covid vaccinations began in January, Pruitt notes, and they still mark new territory for the Health Department, for hospitals and for various agencies.
“We are meeting weekly to coordinate efforts,” she says. “I can’t speak for every provider, but we all ‘own’ the issue of equity and must demonstrate our commitment to it.”
Equity goes beyond ethnicity. The Health Department is using the state’s Social Vulnerability Index, SVI, to guide vaccination efforts and administration to ensure reaching population in high need. SVI indicators include socioeconomic status, family composition and disability, minority status and language minority, house type and transportation. This data is deployed in high SVI zip codes in neighborhood clinics such as the event at Dow Center, with more planned in coming weeks.
Age testing priority gradually will move to the 65-79 group. Anyone with overall questions may call the COVID-19 hotline, 758-3828, or visit saginawpublichealth.org. For free rides to vaccination sites, the STARS phone number is 753-9526, with at least one-day advance notice requested. Senior citizens may inquire at the County Commission on Aging, 797-6880.
Speaking to naysayers
Nationally, about one-third of adults offer an array of reasons for refusing the covid vaccinate. According to a University of Michigan study, blacks are four times more likely to naysay, Hispanics twice at likely.
To tackle the “vaccine confidence” concern, Dr. Pruitt has received her pair of vaccinations live and online. So have such luminaries as Saginaw NAACP President Terry Pruitt and Mayor Brenda Moore, along with Latino leaders who include Ana Hidalgo and attorney Deacon Librado Gayton.
Pruitt also has narrated media spots on KISS-FM 107, and the Health Department is mapping plans “to address vaccine distrust in minority communities, focusing on its safety, development, integrity, effectiveness, as well as its ability to protect families and provide a path to normalcy.”
She says, “If there has been even a hint of inequity, it hasn’t been on purpose. On the contrary, the Saginaw County Health Department’s guiding principles for COVID-19 vaccination are expediency, effectiveness AND equity. We are working all day, every day to vaccinate this community. And we will continue to do so until we’ve gotten to everyone who wants one.
“We need to manage everyone’s expectations. We simply have far more demand than supply right now. We hope that changes soon. But, meanwhile, waiting is as much a part of the process as registering.”
Reyes concludes, “We want to work together to resolve any concerns and I hope they will work with us. We don’t want to be left out and we don’t want to be an afterthought.”
