When COVID-19 spread rapidly through Massachusetts last spring, it seemed to have taken state and local officials by surprise that communities of color, primarily those near or in poverty, were disproportionately suffering. In retrospect, it should have been obvious, because you only had to look at how these communities live in order to survive: crowded apartments, front-line jobs, limited access to health care. Unable to shelter at home when the state essentially shut down the economy, they were incubators for contagion, the most vulnerable by a mile.
Relative safety from COVID-19 was — and is — a matter of privilege. The hard truths of baked-in disadvantages have meant more Black and brown people have been disproportionately infected and died.
Now that the state is rolling out COVID-19 vaccinations, has it learned the lesson of prioritizing the populations that are dying the most? No. In a failure of moral imagination, at the least, the Baker administration hasn’t yet figured out a way to prioritize — and truly emphasize — the distribution of vaccines to vulnerable populations. It’s a failure to absorb abundant data and put it into action.
As Michael Curry, CEO of the League of Community Health Centers and a member of the Baker administration’s vaccine advisory group, said recently in a TV interview, those closest to the disease need to be closest to the vaccine.
It’s natural to wonder why we keep having to learn this lesson, because the numbers speak for themselves. As of Thursday evening, Massachusetts ranked sixth among all states for first doses administered per capita. And yet, the latest state vaccination data show that white residents have received 13 times more first doses than Black residents and 16 times more first doses than Latino residents. State data have shown the disproportionate impact of COVID-19 among these communities: According to an analysis from the Massachusetts Public Health Association, the COVID-19 case rate is more than three times higher for the Latino population and nearly two times higher for Black residents than for white residents.
True, there’s a rush to get vaccines into arms — it almost seems like a race, and that favors privilege, for privileged people have ways of winning races. They can navigate the system. They use the sharp elbows of privilege to get to the front of the line. But there should be some trade-off between volume and targeting the most vulnerable populations, who often lack resources and who may not trust the vaccine in the first place due to medical racism.
“Why can’t we have a tent in the public plaza in the middle of Villa Victoria in the South End,” said Iván Espinoza-Madrigal, executive director of Lawyers for Civil Rights and a member of Vaccine Equity Now! Coalition, which is a newly formed group of 11 local and statewide organizations that advocate for people of color and immigrants.
This week, Vaccine Equity Now! issued five demands of Baker, including directing $10 million to community organizations for vaccine outreach and engagement in communities of color, immediate implementation of Baker’s promise to reserve 20 percent of the state’s doses as extra allocations for hard-hit communities, and appointing a vaccine czar with authority and accountability to address inequities in the state’s vaccine program.
To be fair, the Baker administration did make some equity-minded moves in the vaccine rollout — at least early on. It “decided to prioritize jails and prisons, while other states did not, as well as community health centers,” said state Representative Jon Santiago of Boston, House vice chair of the newly formed Joint Committee on COVID-19 and Emergency Preparedness and Management. But somewhere along the way, the Baker administration seemed to give in to pressure to distribute the vaccine as widely as possible, a goal that is at odds with prioritizing equity.
Meanwhile, the Baker administration announced Tuesday a new equity initiative that includes vaccine outreach targeted at the 20 cities and towns with high “social vulnerability” and virus caseloads — these are communities with large Black and Latino populations, such as Boston, Chelsea, and Lawrence. But social justice advocates say it’s still not enough.
Massachusetts doesn’t have to reinvent the wheel to switch gears and make equity a vaccine priority. It’s a matter of political will. Washington, D.C., just expanded vaccine eligibility to include those living in designated “priority zip codes,” areas of the city where COVID-19 death rates have been higher and vaccination rates lower.
“The list of actions is entirely within reach,” said state Senator Sonia Chang-Diaz, who cosponsored vaccine equity legislation along with state Senator Rebecca Rausch, state Representatives Liz Miranda and Mindy Domb, and many others. Among its proposals, the bill would require the Baker administration to appoint a vaccine equity czar and create a mobile vaccination program.
The coalition, Chang-Diaz, Miranda, and others rose up and said something that had to be said in Massachusetts: When it comes to the vaccine, Black and brown lives matter.