The Biden administration knew the key to a successful Covid vaccination campaign would be reaching the most vulnerable populations. But more than five months in, even a blueprint that’s worked with other ethnic and racial groups isn’t doing enough to win over Black Americans.
Fewer than a quarter of Black Americans had received their first Covid-19 shot as of June 3, amid a weekslong stagnation that has defied the government’s ramped-up effort to accelerate vaccinations and reach the nation’s most vulnerable communities.
The slowdown has put Black Americans behind the pace set over the past month by other racial and ethnic groups tracked by the Centers for Disease Control and Prevention. The trend line worries health officials and experts who say the immunization drive is running into a particularly complex web of distrust, outreach challenges and stubborn barriers to access.
“It’s a tough layer that we have to address — it requires relationship building and it’s going to take a little longer,” said Octavio Martinez, executive director of the Hogg Foundation for Mental Health, who sits on the White House’s Covid-19 Health Equity Task Force. “We have a systemic issue here.”
One of the task force’s first assignments was recommending ways to build trust in the vaccines and effectively roll them out to those marginalized communities — chief among them Black Americans who are dying from Covid-19 at disproportionate rates. Some early ideas were incorporated into the administration vaccination plan crafted within the White House, task force members said. Yet as the panel has shifted its focus to other, long-term health equity issues in recent months, vaccine disparities have persisted.
“We still have some places where the past history of bias, discrimination and hate has just caused such an ingrained mistrust of political and social structures that it’s hard to break through that,” said James Hildreth, CEO of Meharry Medical College and a task force member. “We need to make a stronger effort to bring the vaccine to the communities, rather than relying on the communities to come to vaccination centers.”
The administration had long anticipated that vaccinating minority groups and other hard-to-reach populations would require a concerted effort, prompting it to assign several Covid-19 response officials to focus on equity issues, in addition to creating the outside task force. The administration and public health experts continue to believe many members of the groups aren’t openly hostile to vaccines, but need reassurance and prodding to get the shots.
The White House has intensified the equity push in the past month in particular, as it races to hit President Joe Biden’s July 4 deadline for getting 70 percent of U.S. adults to take at least one dose of a Covid vaccine.
That initiative has shown signs of success. Over the last two weeks, Hispanic Americans accounted for more than a quarter of total vaccinations, CDC data show, a sharp acceleration from just a month ago, when they ranked as the least-vaccinated demographic group. Asian Americans over that period have also accounted for a greater share of shots, compared with their proportion of the overall population.
But the government’s outreach has yet to gain similar traction among Black communities — where vaccinations still lag more than a month after the shots became widely available to all adults.
Health experts cite myriad factors: Ingrained skepticism of a federal government that’s historically failed minorities when it comes to public health, difficulties getting the transportation or time off to seek out a vaccine or a lack of community outreach, among others.
At the same time, Black people in several areas have accounted for an increasing proportion of Covid-19 cases and deaths — including in Washington, D.C., where government data indicate they’ve made up nearly 8 in 10 new cases and close to 90 percent of deaths since May 1.
“We all realize that this is the critical moment in the struggle,” said Reed Tuckson, founder of the Black Coalition Against Covid-19, which is coordinating with the administration on its vaccination campaign. “It’s going to take a lot of effort from a lot of different places.”
Administration officials insist that Biden can still hit his 70 percent goal without a significant acceleration in Black vaccinations over the next month, arguing there are millions of people across various demographics that are still reachable by July 4.
Yet last Wednesday, the White House rolled out a series of new initiatives to boost vaccinations across the board that includes partnering with Tuckson on a program enlisting Black-owned barber shops and beauty salons to promote the shots and even serve as vaccination sites. Other efforts aim to ensure people receive paid time off and child care help to get the vaccine are aimed in large part at convincing more Black people to seek out the shot.
Vice President Kamala Harris will also lead a vaccination tour across the South and Midwest, where states with large Black populations like Mississippi and Alabama rank among the lowest overall vaccination rates.
“We are not leaving anyone behind,” Osaremen Okolo, a policy adviser on the White House Covid-19 response team, said in an interview. “Our equity initiatives — every single one of them — are intended to uplift the Black community.”
Regardless of whether the administration hits its 70 percent mark nationally, there remains lingering concern that without significant progress in vaccinating Black people, the virus could continue circulating within the community for months. That would leave Black Americans grappling with disproportionate caseloads after the rest of the U.S. has moved on, and put them at greater risk if new, more contagious strains emerge later this year.
“As this is no longer affecting mainstream white Americans, it’s not going to get the same media attention and people are going to think that means the problem is over,” said Celine Gounder, who advised Biden on the Covid-19 response during the transition. “It’s going to be a replay of what we saw at the beginning of the pandemic, where those most vulnerable communities are going to be the ones that continue to suffer the most.”
Biden alluded to those fears last Wednesday, warning that the burden of hospitalizations and deaths would increasingly fall on the dwindling number of unvaccinated people.
Still, officials and health experts say they’re searching for the solution to jump-starting the Black vaccination rate in the same way that it did for Hispanic Americans.
Community health centers, which were seen as central to reaching minority communities, have proved critical to vaccinating Hispanic patients — with close to 40 percent of shots administered by the federally backed clinics going to Hispanic Americans.
They’ve been less successful attracting Black people, administering only about 1 in 10 vaccinations have to that group.
And while organizations nationwide launched a host of campaigns focused on specific groups — such as immigrants, Spanish speakers and even vaccine-skeptical conservatives — advocates and public health experts suggested there hasn’t been quite the same intense targeting of Black Americans, despite the nation’s long history of racial health disparities.
“I have seen a real explosion in the Hispanic community being reached out to in their own language,” said Georges Benjamin, executive director of the American Public Health Association, adding that the challenge in the Black community has been finding both the most effective messengers and approaches. “The things that have created disparities in the first place, we have fixed some of them. But not all of them, and not to a large enough degree.”
Advocates are hoping the barbershop initiative, combined with vaccination efforts led by churches or focused on other faith-based communities, will be difference-makers over the next month. Tuckson stressed that much of the hesitancy that remains among Black Americans isn’t outright opposition to the vaccine — chalking it up instead to unanswered questions.
“What’s left in the Black community is a significant number of people who still need and want more assurance,” he said. “To be able to pass on scientifically valid and factual information is really key.”
Beyond that, the White House is vowing to bear down on making the vaccines easily accessible — betting that by promoting the shots in as many ways as possible, through as many channels as possible, it can gradually close the vaccination gap within the Black community in the process.
“We’ve been engaging, we’ve been listening,” Okolo said. “Now we’re trying to adapt what we’ve heard.”