A racial gap has opened up in the nation's COVID-19 vaccination drive, with Black Americans in many places lagging behind whites in receiving shots, an Associated Press analysis shows.
An early look at the 17 states and two cities that have released racial breakdowns through Jan. 25 found that Black people in all places are getting inoculated at levels below their share of the general population, in some cases significantly below.
That is true even though they constitute an oversize percentage of the nation's health care workers, who were put at the front of the line for shots when the campaign began in mid-December.
For example, in North Carolina, Black people make up 22% of the population and 26% of the health care workforce but only 11% of the vaccine recipients so far. White people, a category in which the state includes both Hispanic and non-Hispanic whites, are 68% of the population and 82% of those vaccinated.
The gap is deeply troubling to some, given that the coronavirus has taken a disproportionate toll in severe sickness and death on Black people in the U.S., where the scourge has killed over 430,000 Americans. Black, Hispanic and Native American people are dying from COVID-19 at almost three times the rate of white people, according to the Centers for Disease Control and Prevention.
"We're going to see a widening and exacerbation of the racial health inequities that were here before the pandemic and worsened during the pandemic if our communities cannot access the vaccine," said Dr. Uché Blackstock, a New York emergency physician and CEO of Advancing Health Equity, an advocacy group that addresses bias and inequality.
Experts say several factors could be driving the emerging disparity, including deep distrust of the medical establishment among Black Americans because of a history of discriminatory treatment; inadequate access to the vaccine in Black neighborhoods; and a digital divide that can make it difficult to get crucial information. Vaccination sign-ups are being done to a large degree online.
"It's frustrating and challenging," said Dr. Michelle Fiscus, who runs Tennessee's vaccination program, which is doubling the doses sent to some hard-hit rural counties but is meeting with deep-rooted mistrust among some Black Tennesseans.
"We have to be working very hard to rebuild that trust and get these folks vaccinated," Fiscus said. "They're dying. They're being hospitalized."
Hispanic people also lagged behind in vaccinations, but their levels were somewhat closer to expectations in most places studied. Hispanics on average are younger than other Americans, and vaccinations have yet to be thrown open to young people.
However, several states where Hispanic communities were hit particularly hard by COVID-19 have yet to report data, notably California and New York.
President Joe Biden is trying to bring more equity to the vaccine rollout he inherited from the Trump administration. The Biden administration is encouraging states to map and target vulnerable neighborhoods using such tools as the CDC's social vulnerability index, which incorporates data on race, poverty, crowded housing and other factors.
"We are going to take extra steps to get to the people hardest to reach, and that work is happening right now," said Dr. Marcella Nunez-Smith, the chair of Biden's COVID-19 equity task force.
Most states have yet to release any racial data on who has been vaccinated. Even in the states that provided breakdowns, the data is often incomplete, with many records missing details on race. However, the missing information would not be enough to change the general picture in most cases.
The data came from Alaska, Colorado, Delaware, Florida, Indiana, Maryland, Mississippi, Nebraska, New Jersey, North Carolina, Ohio, Oregon, Tennessee, Texas, Vermont, Virginia and West Virginia, plus two cities, Philadelphia and Chicago.
The AP analysis found that whites are getting vaccinated at closer to or higher than expected levels in most of the states examined.
At the outset, health care workers and nursing home residents generally were given priority for shots in the U.S.
In the past couple of weeks, many states opened eligibility to a wider group of older people and more front-line workers, which could be further depressing the relative share of Black people getting vaccinated. The nation's over-65 population is more heavily white than other age groups.
Among the findings:
— In Maryland, Black people make up 30% of the population and 40% of the health care industry yet account for just 16% of the people vaccinated so far. White people, which in the state's data includes both Hispanic and non-Hispanic whites, constitute 55% of the population and 67% of those who have gotten shots. Hispanics of any race are 11% of the population and 5% of the vaccine recipients.
— In Philadelphia, Black people are 40% of the population but just 14% of the people vaccinated in the city so far. Hispanics are 15% of the population and 4% of the vaccine recipients.
— In Chicago, Black people make up 30% of the population but only 15% of those vaccinated. With Hispanics, the numbers are 29% versus 17%.
The vaccine drive has been slower and more problem-plagued than expected. Many Americans of all races have had trouble getting shots because the supply is limited. Overall, about 7% of Americans have received at least one dose. But there are other problems slowing vaccination among Black Americans and other groups, experts said.
Some Black neighborhoods have nobody signed up to give shots.
"What we've heard over and over again: A lot of Black folks want to get it from their doctor or from their local clinic because that's where the trust is," said Dr. Thomas Dobbs, Mississippi's health officer.
Louisiana is using the CDC tool to locate vulnerable neighborhoods without vaccination sites, then recruiting new vaccinators in those neighborhoods, said Dr. Joseph Kanter, state health officer.
Other strategies under way in some states: providing transportation so people can get to their appointments and reaching homebound people via mobile vaccination units.
To address mistrust, Thomas LaVeist, dean of the School of Public Health and Tropical Medicine at Tulane University in New Orleans, is recruiting notable Black Americans to help promote vaccination. The campaign, called "The Skin You're In," has produced a video of New Orleans hip-hop artist Big Freedia playfully demonstrating how to wear a mask.
Although LaVeist gives credit to the Trump administration for supporting vaccine development, he said naming the project Operation Warp Speed was a "disastrous" choice because it seemed to emphasize speed, not careful scientific review.
"I completely understand the mistrust," said LaVeist, who had his first shot Monday. "But you have to consider the risk of COVID versus the risk of the vaccine. This is a devastating disease and it has disproportionately impacted Black Americans. That is what we do know."
Because of deportation fears, there is also mistrust among Latinos that is undercutting the vaccination drive, as well as a language barrier in many cases, according to activists.
Many Black Americans and other people of color are taking steps to make sure their communities receive the vaccine, including Detroit health care worker Sameerah Singletary, who is set to get a shot soon.
More than 1,700 residents of the nation's largest Black-majority city have died of the virus, including some of Singletary's friends and her godmother. Yet she knows many who are refusing the vaccine.
"I think there is such a collective trauma in Black people, even in Detroit, that many people don't have nothing left," Singletary said. "They've been traumatized so much that they don't care because the virus was just another layer on top."
But she added: "I feel like we have to participate in our healing."