Nearly a year into the COVID-19 pandemic, we have arrived at a moment of both hope and frustration. On the one hand, we have highly effective vaccines reaching people who need them. And we have more on the way, signaling real hope for moving beyond the most challenging phases of the pandemic.
On the other hand, our communities have been hit hard by the pandemic, and there is not nearly enough vaccine yet to meet the urgent need.
Given the mismatch between supply and demand, our strategy at Public Health is to center equity in how we focus our limited resources. That means prioritizing people and communities who are at high risk because they have been disproportionately impacted by the pandemic, and especially vulnerable adults, including those who are disconnected from the health care system.
So how do we measure whether we’re making progress on those goals? One important way is to constantly listen to the communities we are trying to support. Whether it’s through our Task Forces, our Pandemic and Racism Community Advisory Group or our Community Navigators, we continuously work with and learn from them in order to adjust our response.
We also rely on data to inform and improve our approach. Data tells us:
- where COVID-19 has had the greatest impact
- where people are more likely to have been vaccinated
- where there are inequities
- where we need to focus attention and resources.
It’s up to us to use this data to push for equitable access to vaccines. Otherwise, left on its own, the system will give favoritism to those who already have resources and privilege – and leave out too many who are vulnerable.
Vaccine data dashboard
Public Health has a recently enhanced vaccine data dashboard that shows which populations have received the vaccine so far. The data helps shape Public Health strategies. The dashboard also gives the public access to information to hold us accountable.
It includes numbers and rates by race/ethnicity, age and geography. The dashboard also has information by job category for the health care workers eligible in Phase 1A (as of this writing, Washington is in phase 1B1 of the state Department of Health’s vaccine eligibility framework).
What the current data tells us
The dashboard lays out the challenge before us: In the first months since vaccines were approved, a smaller percentage of Black, Latinx and other people of color have received the vaccine than White people. Through February 11:
- for White residents of King County, about one in eight (13.3%) had received at least one dose
- for Black residents, that number is one in 14 (7.3%)
- among Latinx people, just one in 18 (5.7%) has received their first dose
(There are some limits to what we can conclude from King County’s demographic data collected so far. Race and ethnicity are voluntarily self-reported, and 8% of people chose not to answer that question. Another 13% selected “other” for their race. In addition, data collected by the state of Washington and by King County has to be reconciled and cleaned up, a process that can sometimes lead to revisions in the numbers.)
We can identify factors that contribute to these outcomes, such as the fact that the health care workers prioritized in phase 1a of vaccine eligibility tend to be more heavily White than the county overall. The demographic makeup of neighborhoods closest to health care facilities (with easiest access) also tends to be more White.
But ultimately, the mismatch is rooted in systemic inequities and racism that long predate the pandemic. For example, whether someone can get to a vaccination location and get online have a huge impact on their ability to get the vaccine, and transportation and internet access are deeply influenced by systemic and historic racism. By assuming everyone has the same opportunities, we create extra burdens for those who don’t.
Also, a larger share of people in Hispanic/Latinx, Black and Pacific Islander communities don’t have health insurance, because of policies and systems that have marginalized and excluded them. These communities also have histories of abuse and discrimination by health care systems that lead to justifiable mistrust. And, people without access to health care have less access to vaccine, which is mostly delivered by private health care providers.
Cities and neighborhoods in south King County have borne an outsized burden since the pandemic began. Our data dashboard shows that the southern part of the county’s COVID-19 cases, hospitalizations and deaths are far higher than the county overall. These communities are home to relatively large shares of Black, Indigenous and people of color.
Reaching communities disproportionately impacted by COVID-19
Public Health’s vaccine strategy focuses on reaching communities most impacted by COVID-19. This includes older residents, especially those in long-term care (who are shown in the data to be far more likely to die or be hospitalized due to COVID-19). And it includes communities of color and neighborhoods in south King County. Examples include:
- Two community-based high-volume vaccination sites opened on February 1 in south King County. Those two sites, located in Kent and Auburn, have begun serving residents 75 and older and those over 50 from multigenerational households.
- The county is also coordinating mobile vaccination teams in the field, with more to come, focusing on vulnerable populations across the county, such as residents of adult family homes. King County has exceeded its goal of launching ten of these teams and is on track to field 17 by mid-February.
- Public Health works directly with community-based organizations, trusted advocates and case workers serving BIPOC communities to support and assist with getting people vaccine appointments.
High-volume sites will play a major role in serving south King County and other parts of our region, but we know they are not a good fit for everyone. Community-based health centers, pharmacies and pop-up clinics are doing vital work to distribute vaccine, and it will be crucial that they have the doses and resources they need to serve their neighborhoods.
As Washington State Department of Health allocates vaccine across the state each week, Public Health will continue to advocate for shifting vaccine to areas where we see gaps in access.
It’s clear from this early look at the data that we have work to do to achieve an equitable distribution of vaccines. It won’t happen by itself. We need to remove barriers, sustain an inclusive process, and be intentionally anti-racist, as described in King County’s “Principles for Equitable Vaccine Delivery,” as well as the vaccine delivery progress report.
An increase in the supply of vaccine doses will help. But past experience and community partners have shown that we need an all-hands-on-deck approach, including support from the business community, community-based organizations and others.
Using the Vaccine Data dashboard:
How can I find the data referenced in this blog? The Vaccine Data dashboard has several pages that you can access in two ways: first, by using the tabs at the top of the dashboard above the title; and second, by using the large grey buttons just below the dashboard’s title. This blog references the entire dashboard but looks more closely at the tabs called “Demographics” and “Maps, COVID rates”.
How can I view more descriptive explanations of the data on these dashboards? Use your mouse to hover over the data for more description of those data points, including a summary of that data point and the actual numbers.
Originally posted February 12, 2021