COVID-19 vaccine must be given with equity in mind
By: Dr. Tony Iton
Tags: Public Health, Social Equity, Covid 19, Pandemic, Vaccines

After a very divisive election, it is now time for unity as we enter this phase of the COVID-19 crisis. For the sake of everyone’s health, now is the time for respectful listening and dialogue across religion, race, region and politics.

If we have learned anything in 2020, the COVID-19 virus is relentless. More than 290,000 Americans have already died and infection numbers are currently surging.

As a nation, we have gotten almost every critical aspect of our pandemic response wrong. We dismantled our global early warning systems, we let our strategic stockpile wither, we botched our first efforts at developing a test, we failed at rapidly expanding test capacity, we stumbled on building up our supply of PPE and ventilators, we miscommunicated on masks, we failed to ensure adequate and enduring economic stimulus, and we have no coherent plan for safely opening schools. America was the Keystone Cops of pandemic response. Our response has been a global embarrassment.

The silver lining has been the local response. Local health officers, particularly in California, have been stalwart at tracking the data and taking early action. Most local political leaders, including the governor, listened and supported bold, science-based mitigation strategies. These heroic local health officers have been harassed and threatened, had their homes picketed, received death threats, been undermined by boards of supervisors, and some have resigned in protest and others fired. Despite this, they continue to fight for us day-in, day-out.

These same local health officials who will chart a path for equitable COVID vaccine distribution. The arrival of several apparently effective COVID vaccines is promising news that heralds the triumph of fact-based science in this unprecedented public health crisis. Step aside politics, science is coming to the rescue. Mindless politics drove us into a ditch in this pandemic, we cannot allow that to ever happen again.

The logistics of the vaccine roll-out will be tricky, and we must develop an effective strategy to get it out quickly to health workers, nursing home residents, frontline workers and the most vulnerable in our communities.

We have an anti-vaccination movement in this country that has set back public health efforts to control and eliminate diseases such as measles and whooping cough. We also have a sordid history of medical experimentation on African Americans and others that gives rise to legitimate distrust of the American medical system among communities of color.

To top it off, we have populations that have been terrorized by federal immigration authorities and draconian immigration policies. They reasonably fear any interaction with government authorities. In the face of these entrenched concerns about vaccination, developing an equitable and effective vaccine distribution process will be a challenge.

We must ensure that all decisions are made transparently so that everyone knows what the priority system will be. The front-line workers who we have asked to continue serving our economic needs — those picking the crops and working in warehouses, packing houses, transportation — have carried an unfair burden by getting the virus at higher rates because of the work they do.

It is critical that they get the vaccine early to help stem the exposure rate, and out of fairness and equity. To reach the most marginalized, we must fund and support trusted community organizations to work closely with people who have been made vulnerable by our callous and predatory social policies.

We have the means to do this, if we have the will. The good news is that we can vanquish this pandemic by continuing to limit exposure while we get ready for the vaccine. Let’s support our local health officers and get this done.

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Dr. Anthony has also written that California must invest in a contact tracing workforce led by people of color and that the COVID-19 vaccine should be given first to those most vulnerable.