Scarce doses of the COVID-19 vaccine have so far gone disproportionately to white Washington residents, new data from the state Department of Health (DOH) shows.
As in other states, Black and Hispanic residents have tested positive for the coronavirus at a higher rate compared to white residents, but vaccination numbers haven’t matched each group’s vulnerability.
The Seattle Times obtained data on the race and ethnicity of vaccine recipients from the state through Jan. 30, and compared it to the case counts, deaths and population demographics. The Times analysis shows Washington has some clear gaps.
While 67% of people who received their initial doses were white, 48% of the state’s cases of COVID-19, the illness caused by the coronavirus, have been in white patients.
On the other hand, Black and Hispanic residents have been comparatively under-vaccinated. Just 5% of people receiving an initial dose were Hispanic, while 32% of people who have tested positive for coronavirus have been Hispanic. Black residents have received 2% of the initial doses, but they account for 6% of cases.
The picture changes slightly when you look at COVID-19 deaths. White residents, who make up 71% of the state’s deaths, are relatively under-vaccinated. But Hispanic residents, with 12% of the total deaths, still face a larger gap.
A DOH spokesperson said officials are still analyzing the race data, and haven’t come to any conclusions about inequities.
“That being said, we do want to address any gaps in vaccination and get the vaccine to those who are at highest risk,” DOH spokesperson Danielle Koenig said in an email. “We are always assessing our activities for equity and social justice, supplying vaccine information in up to 37 languages, and working to identify and overcome barriers as they come up.”
The department is “meeting regularly with many different communities to get direct feedback on what they need to support getting vaccinated,” Koenig added.
One obstacle for addressing inequities is that the state’s data is incomplete. About 1 in 10 patients receiving an initial vaccine are listed as “unknown,” and an unusually large share reported “other” as their race. Vaccine providers are required to enter race and ethnicity into the state’s immunization registry, but not all do. At least two providers told The Seattle Times they don’t ask for race. Also, Koenig said “unknown” is an acceptable response.
It is important for the state to track race to understand who is receiving the vaccine, said Estela Ortega, executive director of Seattle-based nonprofit El Centro de la Raza. El Centro de la Raza primarily serves the local Latino population, and is working to add a vaccination site at its Plaza Roberto Maestas & Centilia Cultural Center in Beacon Hill, although an opening date has not been established.
The state’s vaccine priority scheme and disjointed registration systems could explain some of the disparities, Ortega said.
The current DOH guidelines prioritize people 65 and older as well as people 50 and over in multigenerational households who live with and care for grandchildren or can’t live independently. But Ortega believes that the younger Latino population has higher incident rates of COVID-19 because they’re essential workers, in sectors like food service and construction. “Although we know that the Latino population is working and they’re in another age group, the vaccine can’t be given to them right now,” she said.
Additionally, people eligible to receive the vaccine have faced difficulty scheduling appointments and navigating Phase Finder, the state’s online questionnaire for vaccine eligibility. “The system appears to be broken, because people can’t get in,” Ortega added. An elder in her community woke up at 4 a.m. to schedule an appointment, and she said within 30 minutes of securing his spot, he looked again and found that all appointments were booked.
Another barrier to vaccine access is that DOH prioritized high-volume vaccination sites over community health centers, said Teresita Batayola, president and CEO of International Community Health Services (ICHS). Now the state is ramping up vaccines for community health clinics.
ICHS places its vaccination orders with DOH, and since Jan. 18, ICHS has not received any vaccines from the state, Batayola said. Last week, Public Health − Seattle & King County gave ICHS 500 doses. Then this week, the department convinced Swedish Health Services to give ICHS 800 of their doses.
“Community health centers serving the disproportionately impacted should be assured supplies,” Batayola said. “In the formal allocation process, we would have been standing to the side,” Batayola said. The vaccine shortage became even greater when Gov. Jay Inslee expanded the eligible population in phase 1B last month from 70 years to those 65 years and older.
ICHS says it serves close to 33,000 patients, and most are low income, people of color and 1 in 5 are 65 and older. The clinic’s patients speak over 50 languages.
About 7,000 of the agency’s patients are eligible to receive the vaccine, and the flagship clinic in the Chinatown International District expanded its vaccination distribution to nonpatients living in the largely low-income area.
If the vaccine shortage continues, Batayola believes that inequity will become worse. “Once essential workers are part of the mix to be eligible to be vaccinated, it will be an even bigger problem,” she said.
Compared to other states with similar racial demographics, Washington’s vaccine disparities appear to be comparable. Oregon, for instance, has the same share of Hispanic residents as Washington, and they make up 35% of cases there, according to an analysis by the Kaiser Family Foundation. But just 6% of Oregon’s vaccinations have gone to Hispanic people.
As with other aspects of COVID-19 data, Washington’s effort to collect and publicly share racial data around vaccinations has been slow and prone to problems. The state has planned to post race and other demographic data on its online vaccine data “dashboard,” but as of Friday it had not done so.
“Unfortunately, we have had to work through a lot of technical difficulties, along with some data collection, analysis, and capacity hurdles that have delayed getting it to the dashboard,” Koenig said.
Racial disparities in vaccination rates have been found throughout the country, said Eric Schneider, a senior vice president at the New York-based Commonwealth Fund, a private foundation that supports research on health care practice and policy.
However, it’s difficult to know the accurate rate of disparity since about 50% of the vaccine recipients’ races are listed as “unknown” in the U.S. Centers for Disease Control and Prevention data.
“We need to have better data to really understand the inequity,” Schneider said.
Vaccine hesitancy contributes to some of the disparity because it is higher among people of color, Schneider said, referring to recent surveys. Additionally, Schneider said vaccination sites appear to open more often in areas with a higher white population.
“We’re still in a scarcity period of the vaccine being in short supply,” Schneider said. “I think that this problem will get worse as the vaccine becomes more available and if people let their guard down about ensuring that it’s equitably distributed.”