A racial gap has opened up in the nation's Covid-19 vaccination drive, with Black Americans in many places lagging behind whites in receiving shots, an Associated Press analysis shows.
An early look at the 17 states and two cities that have released racial breakdowns through January 25 found that Black people in all places are getting inoculated at levels below their share of the general population, in some cases significantly below.
That is true even though they constitute an oversize percentage of the nation's health care workers, who were put at the front of the line for shots when the campaign began in mid-December.
For example, in North Carolina, Black people make up 22% of the population and 26% of the health care workforce but only 11% of the vaccine recipients so far. White people, a category in which the state includes both Hispanic and non-Hispanic whites, are 68% of the population and 82% of those vaccinated.
The gap is deeply troubling to some, given that the coronavirus has taken a disproportionate toll in severe sickness and death on Black people in the US, where the scourge has killed over 430,000 Americans. Black, Hispanic and Native American people are dying from Covid-19 at almost three times the rate of white people, according to the Centres for Disease Control and Prevention.
“We're going to see a widening and exacerbation of the racial health inequities that were here before the pandemic and worsened during the pandemic if our communities cannot access the vaccine,” said Dr Uche Blackstock, a New York emergency physician and CEO of Advancing Health Equity, an advocacy group that addresses bias and inequality.
Experts say several factors could be driving the emerging disparity, including deep distrust of the medical establishment among Black Americans because of a history of discriminatory treatment; inadequate access to the vaccine in Black neighborhoods; and a digital divide that can make it difficult to get crucial information. Vaccination sign-ups are being done to a large degree online.
Hispanic people also lagged behind in vaccinations, but their levels were somewhat closer to expectations in most places studied. Hispanics on average are younger than other Americans, and vaccinations have yet to be thrown open to young people.
However, several states where Hispanic communities were hit particularly hard by Covid-19 have yet to report data, notably California and New York.
President Joe Biden is trying to bring more equity to the vaccine rollout he inherited from the Trump administration. The Biden administration is encouraging states to map and target vulnerable neighbourhoods using such tools as the CDC's social vulnerability index, which incorporates data on race, poverty, crowded housing and other factors.
Most states have yet to release any racial data on who has been vaccinated. Even in the states that provided breakdowns, the data is often incomplete, with many records missing details on race. However, the missing information would not be enough to change the general picture in most cases.
The data came from Alaska, Colorado, Delaware, Florida, Indiana, Maryland, Mississippi, Nebraska, New Jersey, North Carolina, Ohio, Oregon, Tennessee, Texas, Vermont, Virginia and West Virginia, plus two cities, Philadelphia and Chicago.
The AP analysis found that whites are getting vaccinated at closer to or higher than expected levels in most of the states examined.
At the outset, health care workers and nursing home residents generally were given priority for shots in the US.
In the past couple of weeks, many states opened eligibility to a wider group of older people and more front-line workers, which could be further depressing the relative share of Black people getting vaccinated. The nation's over-65 population is more heavily white than other age groups.
The vaccine drive has been slower and more problem-plagued than expected. Many Americans of all races have had trouble getting shots because the supply is limited. Overall, about 7% of Americans have received at least one dose. But there are other problems slowing vaccination among Black Americans and other groups, experts said.
Some Black neighbourhoods have nobody signed up to give shots.
Louisiana is using the CDC tool to locate vulnerable neighbourhoods without vaccination sites, then recruiting new vaccinators in those neighbourhoods, said Dr Joseph Kanter, state health officer.
Other strategies under way in some states: providing transportation so people can get to their appointments and reaching homebound people via mobile vaccination units.
Many Black Americans and other people of colour are taking steps to make sure their communities receive the vaccine, including Detroit health care worker Sameerah Singletary, who is set to get a shot soon.
More than 1,700 residents of the nation's largest Black-majority city have died of the virus, including some of Singletary's friends and her godmother. Yet she knows many who are refusing the vaccine.
“I think there is such a collective trauma in Black people, even in Detroit, that many people don't have nothing left,” Singletary said. “They've been traumatised so much that they don't care because the virus was just another layer on top."
But she added: “I feel like we have to participate in our healing.”