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Opinion | Don’t listen to Michigan GOP, we need equity in vaccine distribution

Michigan Republican senators have decided equity has no place in vaccine distribution.

They couldn’t be more wrong.

Let me explain why.

Debra Furr-Holden
Debra Furr-Holden is associate dean for public health integration at Michigan State University College of Human Medicine. (Courtesy photo)

The disparities in COVID vaccine distribution and administration are appalling. The federal government spent U.S. taxpayer dollars to cover the cost of what’s in the COVID vaccine vials but missed the essential step of mandating that the vaccines be distributed and administered equitably.

In the absence of federal or state mandates for equity, communities are largely reacting to the predictable drift to inequity. Michigan recently released COVID vaccine administration data through the Michigan COVID-19 Dashboard. To no surprise, African Americans are receiving COVID vaccines at half the rate of whites.

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The responsibility for equitable administration has trickled downstream to communities and individuals. And even worse, some states have criminalized the good will of individuals who choose not to waste vaccine doses and instead do their part to get it into people’s arms.

Community push with no governmental pull

I serve on the Michigan Coronavirus Task Force on Racial Disparities, the Greater Flint Coronavirus Task Force on Racial Inequities, and the African American New York City COVID Task Force. The common denominator in each of these groups is the tremendous effort being put forth by brilliant, hard-working individuals committed to pushing equity in vaccine availability and administration.

Pushing the responsibility for vaccine administration equity onto individual communities is unfair and irresponsible. There needs to be federal and state governmental pull that requires any provider who takes receipt of these vaccines to demonstrate they can and are getting the vaccines into people’s arms fairly and equitably. We knew for months that the vaccines were coming, so why were the data infrastructures and reporting systems not better planned?

A lack of data fuels the debate

Now that the Michigan data is out, my suspicions have been confirmed. The racial groups who have been hit hardest by this pandemic are underrepresented among those who have received the vaccine. Even worse, we do not have race data on more than a million people who have benefitted from this vital resource as a whopping 44 percent of the vaccine data is missing race and 70 percent is missing ethnicity.

But here’s the rub – according to the Michigan COVID-19 Dashboard, one tenth of one percent of the data is missing gender and there is no missing data on age group. How is this possible? Did providers stop short on collecting only the race and ethnicity data? Did people refuse to answer these questions?

A myopic focus on the wrong things

I imagine given Michigan’s success in closing the gap on racial disparities in COVID cases and deaths, that we can do the same with vaccine administration. But it will take more than good will and a track-record of success from Gov. Gretchen Whitmer, Lt. Gov. Garlin Gilchrist and Michigan’s top doctor, Dr. Joneigh Khaldun. 

Michigan Republican Senators are fueling the flames of inequity and working to prevent the state from using factors like race or social vulnerability to inform vaccine distribution to communities. Will they bring the same solidarity to legislation to remedy the current racial inequities in COVID vaccine administration?

I’ve heard the argument that COVID vaccine reluctance among African Americans is driving the disparity in vaccine administration. In Genesee County, we have a vaccine waitlist of nearly 60,000 people and the list has been growing by almost 2,000 people every day. Nearly a quarter of the people on that list are African American, reflective of the racial distribution in Genesee County. While vaccine reluctance remains an issue for many Americans, despite race, it is not the source of the current inequity in vaccine administration among African Americans in Michigan.

Similarly, the argument that African Americans are underrepresented in the current vaccine eligible categories doesn’t explain the racial disparities in COVID vaccination rates. Now that the demand for COVID vaccines far exceeds the supply, we must take immediate action and stop using alibis for inaction. Even better – stop blaming Black people and the underserved for their inequitable treatment.

Still more questions than answers

The question I am left asking myself is why did the federal government spend BILLIONS of taxpayer dollars for what’s in the COVID vaccine vials and not mandate equity? Why haven’t our state leaders taken legislative action to mandate equity? Those who can, have and will continue to jockey to the front of the line. The lack of federal and state policy, again, makes no sense to me.

When I visit my doctor’s office, I am required to provide very detailed demographic information including my legal name, race, gender, social security number, home address, date of birth, occupation, insurance information – and the list goes on. Why are we not requiring basic, de-identified demographic data be collected and entered into a central database on every person who joins a COVID vaccine waitlist or receives the vaccine? In Michigan, it appears that we can collect this data, we just don’t (much of the time) for race and ethnicity.

The path forward

Basic demographic information including age group, race, ethnicity, gender, residential zip code and/or residential state and county, and vaccine eligibility information should be legislated to be collected. If a COVID vaccine provider refuses to collect and enter the data into a central data base, they should not be distributed vaccine nor allowed to administer vaccine. Similarly, the same way health care consumers have to provide detailed demographic information to receive health care, all people should be required to provide basic, de-identified, demographic data to receive a COVID vaccine.

This data would inform equitable vaccine administration if we compared it with data on vaccine eligibility. Every state, every community, and every vaccine provider should have a grid that lays out who is eligible broken down by these basic demographic variables. Weekly vaccine administration should mirror the eligible population. Once a cell on the grid is full, no one – despite race, income or social standing – should be allowed to push past someone’s 80-year-old Black grandmother or 65-year-old uncle with no internet, who was unable to make it through the bottleneck of the waitlist.

The COVID vaccines, albeit imperfect, have brought a much-needed dose of hope to our nation and are an essential layer of protection that will help us to stop the spread of this virus. It’s deplorable to think that this dose of hope is not being fairly given to all people.

If there is good will, there is a legislative way. If equity truly matters, our elected leaders owe us to #MandateEquity – now!

Bridge welcomes guest columns from a diverse range of people on issues relating to Michigan and its future. The views and assertions of these writers do not necessarily reflect those of Bridge or The Center for Michigan. Bridge does not endorse any individual guest commentary submission. If you are interested in submitting a guest commentary, please contact Ron French. Click here for details and submission guidelines.

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