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COVID-19 vaccine access, not hesitancy, main barrier for San Diegans of color

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A limited supply of COVID-19 vaccine combined with language and technology barriers are keeping many San Diegans of color waiting for their shot at immunity.

Most White San Diegans eligible for the vaccine have gotten a shot, with roughly 551 vaccinated per 1,000 eligible residents, compared to 527 for Latinos, 520 for Asians and 349 for Black San Diegans, according to data on current vaccinations from the county’s vaccine dashboard and eligibility estimates from the San Diego Workforce Partnership.

How equitable is San Diego's vaccine rollout?

Some of the county’s demographic data, posted on its online dashboard, is poorly defined. Roughly 15 percent of those vaccinated are listed as “other race,” and 12 percent did not disclose their race or ethnicity. Supervisor Nathan Fletcher said on Thursday that the county is still looking into the matter, noting that the dashboard combines data reported from various sources.

Vaccination for communities of color has lagged behind the county as a whole for reasons ranging from vaccine hesitancy to, in many cases, difficulty securing an appointment and making the trek to get the shot. And then there’s the matter of a vaccine rollout that is still mostly focused on older adults, whereas communities of color tend to be younger overall.

Only certain groups are currently eligible for the vaccine — mainly health care workers, people 65 or older, and those who live or work in long-term care facilities.

But San Diego State University bioethicist Joseph Stramondo says the skewed demographics of those at the front of the vaccine line are no accident.

“It’s kind of a cop-out, simply because who’s eligible at this point is a result of political power,” he said. “Who has the opportunity to work in the health care profession? Who’s living into their old age in a nursing home or otherwise?”

Prioritizing vaccine doses by age is speedy and straightforward, and there’s good reason to do it. About one out of every seven San Diegans 80 or older who’ve gotten COVID-19 has died, according to the county. Andeight out of every 10 people who’ve died of COVID-19 in the U.S. have been 65 and older.

Cande Bernal sits with her parents in a monitoring area after they got a COVID-19 vaccine shot in Chula Vista.

Cande Bernal, left, sits with her parents Jesus and Soledad Bernal in a monitoring area after they got a COVID-19 vaccine shot at the Sharp South Bay Super Station on Thursday in Chula Vista.

(K.C. Alfred/The San Diego Union-Tribune)

COVID-19 has also taken a heavy toll on minority communities. Black, Hispanic and Asian San Diegans have suffered from higher rates of hospitalization and death from coronavirus infections than White residents, according to the county’s weekly coronavirus report. That’s due in part to people of color being less likely to have jobs that can be performed from home and more likely to suffer from pre-existing conditions that worsen the disease, such as sickle cell, obesity and Type 2 diabetes. And while the state announced Friday that individuals with certain underlying health conditions will be able to get vaccinated regardless of their age, that effort won’t begin until March 15.

The disproportionate impact of the pandemic on minorities hasn’t always translated into extra eagerness for a COVID-19 vaccine.

To George McKinney, senior pastor of Impact Global Ministries in Valencia Park, that hesitancy boils down to a simple question.

“Nobody really seems to care about the Black community. Then, all of a sudden, there’s all this concern about getting us vaccinated,” he said “Why now?”

Researchers say that immunizing the vast majority of the public against the coronavirus is essential to ending the pandemic. But a long history of neglect and, at times, abuse of people of color in medical research has made many minorities wary of vaccines.

An October survey by the Public Policy Institute of California showed that 44 percent of Black Californians would definitely not get a COVID-19 vaccine, compared to 17 percent of White people.

McKinney says he’s seen skepticism soften over the past several months. In addition to serving as a pastor, he’s president of St. Stephen’s Retirement Center in Valencia Park, where 30 of 50 residents at one of the retirement center’s facilities recently opted to get vaccinated through CVS.

“The response to taking the vaccine is a lot better than what I imagined,” he said.

Part of the reason, he suspects, is simply fear — as the pandemic has raged on, most of the people in his circle now know someone who has died from COVID-19. But he believes that local Black doctors endorsing the vaccine has helped, too.

Dr. Suzanne Afflalo, who has spent 23 years as a family physician at Kaiser Permanente and helped found the county’s COVID-19 Equity Task Force, is one of those trusted messengers. Friends, neighbors and patients peppered her with questions after she got her shot.

“When I got my first dose, they reached out and said, ‘Well, how was it and how did you feel?’ And they were curious,” Afflalo said. “There’s a level of fear in not knowing what to expect.”

Afflalo is one of many Black physicians, community leaders and county officials (including public health officer Dr. Wilma Wooten) who’ve contributed to blackcovidfactssd.org, a one-stop-shop for all things COVID-related, including information on who can get vaccinated, the truth behind vaccine myths and what side effects to expect after your shot.

Community health workers are sharing this same information with the county’s diverse array of refugee and ethnic groups. The San Diego Refugee Communities Coalition, a collective of ethnic community-based organizations, is working alongside the county to share information about the ever-changing vaccine rollout in 21 different languages, from Amharic to Burmese to Swahili. Community health workers are sharing that information through Facebook Live town halls, religious centers and, at times, one-on-one conversations.