Equity lens for COVID-19 shots critical amid holidays and omicron concern, experts say

The threat of the omicron coronavirus variant is underscoring the importance of vaccination and boosters against COVID-19, especially for people of color who have disproportionately suffered during the pandemic.

The Biden administration points to recent surveys as evidence the racial gap in vaccinations has closed. But data is incomplete, and what hard numbers are available show equity remains a concern, experts say.

Though vaccine disparities between racial groups have been narrowing over time in many states and national trends show improvement, data suggests vaccination rates among Black people still lag behind those of whites.

Available data from the Centers for Disease Control and Prevention shows  about 36% of Black Americans have been fully vaccinated against COVID-19, and about 40% have received one shot. Among white Americans, 43% are fully vaccinated and 48% have had a first shot.

National vaccination rates for Hispanic and Latino people are roughly equal to those of whites, and American Indian and Alaska Native people have higher rates than all three racial groups, according to the CDC.

More:What are omicron variant symptoms? Everything to know about the latest coronavirus strain.

The agency says national numbers could be underestimates, because roughly 30% of race and ethnicity data is missing for those with at least one dose and because racial makeups vary from state to state. But grassroots efforts to close gaps among Black and white Americans are still needed, public health professionals say, and are crucial as holiday gatherings approach.

“We have to keep our eyes on the prize: getting everybody vaccinated,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “We shouldn’t wait until we see bigger disparities than we already have occurring.”

Last month, the White House’s COVID-19 Health Equity Task Force referred to a Kaiser Family Foundation survey that identified positive trends: about 70% of Black, white and Hispanic adults reported getting a COVID-19 shot.

“The gaps that once existed in vaccination rates among Black, white and Latinx adults has closed,” task force chair Dr. Marcella Nunez-Smith said. She added that the Centers for Disease Control and Prevention's National Immunization Survey “mirrors” the Kaiser Family Foundation's survey results and others.

But Liz Helman, the foundation's vice president and director of public opinion and survey research, said the survey wasn't meant to measure who actually received the shots. 

"The main purpose of this survey is not to estimate who has gotten the vaccine," she said. "It has been used that way, and it’s helpful to fill in some of the gaps where administrative data doesn’t have complete demographic information, for example around race and ethnicity. But really the survey is trying to serve a much broader purpose, which is tracking people's attitudes towards the vaccine."

It's difficult to measure racial distributions with certainty because of the frustrating dearth of data, said epidemiologist and Michigan State University public health dean Debra Furr-Holden. But from the data that is available, she speculates early hurdles had a great effect on vaccine confidence among Black people.

More:Will children of color get vaccinated at the rates of other kids? Experts say equity is key

"You do have a lot more reluctance around the vaccine in African American communities," she said. "It only got exacerbated with all the early difficulties that they had getting vaccinated."

The pause on the touted "one and done" Johnson & Johnson vaccine, for example, fueled wariness, she said.

"There was this push to get the J&J in the arms of Black people, homeless people, prisoners and other vulnerable populations," she said. "People have had negative thoughts confirmed."

Dr. Marcus Plescia, a physician and chief medical officer of the Association of State and Territorial Health Officials, said trust remains a barrier for some communities of color. The omicron variant, he said, is an opportunity to emphasize the importance of getting the shot and a booster.

"We need to try to make the extra effort to try to engage these communities and really help people make the decision that this is a good thing that they can do ... that is safe and effective," he said.

When it comes to booster shots, 45% of Black and 44% of Hispanic or Latino adults 65 and older have received a dose, according to the CDC. Meanwhile, 58.4% of white older adults and nearly 75% of Asians have received one. 

That could be because it took longer for many people of color to get vaccinated in the first place, researchers say.

More:How scientists in San Francisco found the first case of the omicron COVID-19 variant in the US

“Because of the earlier problems with access and some issues related to hesitancy, getting that initial first or second dose may have taken place later for communities of color,” said Johns Hopkins University medical anthropologist Monica Schoch-Spanas, who leads CommuniVax, a national initiative of community-level vaccine research and outreach.

Narrowing racial gaps overall is a positive trend, Schoch-Spanas said, but “there is still work to do.” States need to leverage and support grassroots efforts to keep communities engaged and get them boosted, she said.

“It is a ground-level-up, community-led response that is closing the gap,” she said. “They stepped in to fill a significant gap in how our health care systems operate. … We can’t let these collaborations wither on the vine.”

Benjamin said misinformation is still a barrier, and “a big knowledge gap” persists when it comes to people understanding the need for a third dose.

“We’ve certainly made some progress in closing the disparities,” he said. Still, “we do need to do a big push to make sure that communities of color and underserved communities in white communities are aware of the need to get boosted.”

Reach Nada Hassanein at nhassanein@usatoday.com or on Twitter @nhassanein_.