The great vaccine equity wars

Latinos are dead last in the vaccine race. Who is advocating for them?

Cindy Ramirez, a registered nurse, prepares a COVID-19 vaccine at La Colaborativa in Chelsea, on Feb. 16.JOSEPH PREZIOSO/AFP via Getty Images

If the COVID-19 pandemic has proved anything, it’s that public health is political. Symbolism matters and, as much as we may expect and want science to lead the way, constituencies with power shape outcomes. Those without power get left behind.

With a limited supply of vaccines, judgment calls need to be made. And the limited supply means it’s a zero-sum game. When one constituency or demographic is prioritized over another, the other group has to wait. It’s a stampede toward an imaginary finish line and, despite the overwhelming data that the virus has affected people of color at much higher rates, they remain dead last in the vaccine race.

All of which brings us to the teachers unions and their push to be vaccinated next (which they were granted as of last Thursday) and have access to special vaccination localities. But the unions then got into an ugly dispute with Governor Charlie Baker after he rejected their proposal to provide vaccines to school staff in their schools. Now the unions are backing an emergency bill filed by state legislators that would delay a full-time return to classrooms so they have more time to prepare. Public school teachers, as a group, are overwhelmingly white, according to state data, and most are not in the most vulnerable age groups.

The virus ran wild in communities where people of color are concentrated, including Lawrence, Brockton, and Chelsea. Yet the vaccination rates in those cities are paltry, new data released last week show. More than 80 percent of the population in Lawrence is Latino, but only 2 percent of Latinos there have received at least one dose of a vaccine; nearly half of Lawrence’s white residents have received at least one dose, although they account for just 12 percent of the city’s population. As of March 11, roughly 8 percent of Latinos statewide have received at least one dose, compared with 22 percent of the white population, 15 percent of Black people, and 13 percent of Asian residents.

What that means is that still more of the populations that have suffered the most are being left way behind, even as the Commonwealth inoculates some 50,000 people per day.

Of course, teachers have every right to raise their hands and argue for vaccine priority. The unions are lobbying for their members, and they believe a quick and safe return to the classroom involves vaccination for teachers. However, Dr. Rochelle Walensky, head of the US Centers for Disease Control and Prevention, said last month that teacher vaccination is not a prerequisite to reopening schools for in-person instruction. Unions argue that many of their members live with elderly relatives, but making sure all people in such vulnerable categories are vaccinated is exactly why eligibility has been limited.

Still, if asking for vaccine priority was at least understandable, demanding to delay school reopening isn’t. More delay threatens to exacerbate another form of inequity — educational — given the high number of Latino and Black students in districts like Chelsea and Lawrence and the urgent goal of bringing those kids back to the classroom.

Teachers unions, of course, are a key Democratic Party constituency, and their demand for vaccines creates an awkward situation for elected Democrats who have otherwise emphasized the need for equity in vaccine distribution. Attorney General Maura Healey, a rumored gubernatorial candidate in 2022, denied that the state had to make any trade-offs at all.

Teachers are not the reason why the vaccine rollout has been inequitable. Pitting eligible groups against each other is not how we protect our most vulnerable residents. A more localized, intentional plan is. https://t.co/wKK0tPinKH

— Maura Healey (@MassAGO) March 12, 2021

“I think it’s about a lack of planning and making everybody scramble so it feels like a zero-sum game when it doesn’t need to be,” Healey told me. But it’s unclear how more planning would change the hard reality of the limited supply of vaccines. About the teachers’ priority for vaccines, Healey said, “We should be prioritizing getting kids back to school.” What about the emergency legislation filed to delay school reopening? “I don’t have a position on that,” she said.

Yet she recognizes the profound inequity in vaccine distribution. “Massachusetts communities of color make up more than 30 percent of COVID cases, but only about 16 percent of all first doses administered have gone to people of color,” Healey said.

It’s shameful. But who’s speaking up, loud and clear, for Black people and Latinos and those in the most vulnerable communities? Some advocates are, but no one in the Baker administration seems to be listening.

The governor is expected to testify at a second legislative oversight hearing on the state’s COVID-19 response and the vaccine rollout next week. So far, despite the success in getting needles in arms, the Massachusetts vaccination program has the makings of a public health failure — and Latinos are the ones paying for it.