Kaplan-Myrth: As a doctor promoting vaccination, I live in fear

From our family doctor:

I am afraid. I can no longer walk to work alone. I startle awake at night. I’ve ramped up my security but still my sense of safety has gone out the window.

A couple of months ago, I stood up in front of Queen’s Park and asserted that “we aren’t seeking normal, we are seeking safety.” It was late August and I had organized a panel to talk about what we needed for a safe September for our children at school. We called for better ventilation in schools, higher quality masks, and mandates for COVID-19 vaccination for all educators and staff who interact with children. We spoke to the news media and reached out to politicians. We were all busy and exhausted from a summer immunizing our patients and advocating for marginalized populations, seniors, children and others in our communities.

Nobody is safe until we are all safe, I said.

The next day, the anti-vaccination protests started in the streets outside of hospitals across Canada. Throngs of people blocked ambulances. They were disruptive to patients seeking care and disrespectful of the staff hard at work indoors. The media caught ample footage of those hostilities.

What’s hidden from view – then and now – is the daily, private onslaught of nastiness directed at those of us who stand up for science, for vaccines and for your safety and care. We are bombarded with vitriol from anti-vaccination and anti-science trolls on social media. Some of these perpetrators go even further.

This past week, I was targeted by one such individual. Someone I have never met sent a threat, guised as a complaint, to the College of Physicians and Surgeons of Ontario. The letter started with, “Complaint versus criminal fraudulent chart violating Nazi slut,” and then the person went on to threaten to kill me in retribution for immunizing my patients and others in Ottawa.

It is shocking, but it is not an isolated event. It has happened to many of my esteemed colleagues. Tires slashed in hospital parking lots. Hand-written letters of hate dropped off at offices. Racist slurs. Misogynist attacks. Death threats.

We care about what we do, so we have been stoic, put on our scrubs and our masks and persisted in our work. We certainly continue to immunize our patients. We speak on behalf of pandemic safety measures, even while police cruisers sit in front of our homes to protect our families.

What does this say about our society? What does it say about our political leaders who stoke the flames of divisiveness and gaslight those same health care professionals who they once said were heroes?

Canada’s beleaguered health care providers, advocates for your safety, are being targeted. We haven’t even started to immunize children aged 5 to 11 against COVID-19 and we are so tired, so scared. The thousands of adults who I immunized last spring and summer at my “Jabapalooza” clinics were hoping I’d do similar events for their children. I cannot because it would not be safe for me or my volunteers. The schoolyard bullies have chased us off our street. That is where we are, in this pandemic, after 20 months of saying we are “in this together.” Demoralized isn’t a strong enough word to describe how we feel.

A police sergeant finally phoned me four days after I submitted a request to them for help. The College of Physicians and Surgeons sat on the letter for 12 days before they sent it to me, and they never phoned the police themselves. Even though it contains a death threat and an antisemitic message of hate. Who has our backs?

If we want this pandemic to end, if we want to ensure that we thrive as a country, then to safeguard the health of all Canadians it is up to our leaders and organizations to step forward and say they condemn any – and all – threatening behaviour directed at health care workers.

Take care of us, so that we can take care of you. That isn’t asking too much.

Source: https://www.theglobeandmail.com/opinion/article-as-a-doctor-promoting-vaccination-i-live-in-fear/

Daphne Bramham: Right-wing Justice Centre forges a new path with old leader

Interesting twist:

Apparently, it’s not such a terrible thing that a lawyer and head of a conservative-rights organization hired a private detective to spy on a provincial chief justice who was hearing a case that he was involved in.

A little mea culpa, seven weeks off and then it’s back to work at an organization that claims to be committed to defending citizens’ fundamental freedoms.

At least that’s the way it is working for John Carpay, founder and president of the Justice Centre for Constitutional Freedoms.

Carpay railed against Alberta Health Services’ mandatory vaccination policy for employees in a news release last week. He declared it “morally repugnant” and “an insult to every individual’s inherent human dignity.”

That is strong language for someone being actively investigated by Winnipeg police for invasion of privacy, intimidation and obstruction of justice, as well as by the law societies of both Manitoba and Alberta for breaching their codes of conduct.

The JCCF itself is also under scrutiny. Canada Revenue Agency has received a complaint regarding its status, since hiring a private investigator doesn’t seem a fit expenditure for a registered charity. CRA doesn’t comment on ongoing investigations.

To recap, Carpay admitted in July to hiring a detective to follow Chief Justice Glenn Joyal of Manitoba’s Court of Queen’s Bench while Joyal was hearing the JCCF’s constitutional challenge to provincial COVID restrictions.

In court, Joyal raised concerns about being followed, about his privacy, safety and security, and that of his family. But he also questioned whether it was being done to intimidate him or obstruct justice.

In court, Carpay apologized and went on “indefinite leave.”

Manitoba’s Justice Minister Cameron Friesen was outraged and said, “It is difficult to believe that these actions were not intended to influence the outcome of the court case.”

Friesen sparked Manitoba Law Society’s investigation of Carpay and all of JCCF’s 10 lawyers. Meanwhile, Ottawa human-rights lawyer Richard Warman filed a complaint with the Alberta Law Society against Carpay and JCCF litigation director Jay Cameron.

In his complaint, Warman noted the potential for criminal charges and suggested both lawyers had breached the Code of Professional Conduct rules relating to “integrity, competency, honesty, candour, conflict of interest, encouraging respect for the administration of justice and harassment.”

An Alberta law society spokesperson said its Manitoba counterpart is leading the investigation. No date has been set for the hearing.

Before starting his “indefinite leave,” Carpay insisted that he acted without the JCCF directors’ knowledge, prompting the board to review the centre’s operations and decision-making.

Seven weeks later, Carpay was back, and the board was down to four members from nine.

Board member Bruce Pardy, whose opinion piece in the National Post described Carpay’s actions as “an affront to the integrity of the judicial process,” was not one of them. He does, however, remain on its 10-member advisory council.

The slimmed-down board has only one lawyer and a new director, who is a bit of a mystery. His name is Gareth Hudson, but the centre’s website has neither his photograph nor a biography. The chair is Jonathan Allen, a retired Toronto asset manager who has been on the board since 2020.

The fourth director is Troy Lanigan, a Victoria-based consultant, president of the Manning Centre, founder of SecondStreet.org, and former head of the Canadian Taxpayers Federation, where Carpay also cut his political teeth.

The Manning Centre is “dedicated to strengthening Canada’s conservative movement through networking,” while SecondStreet “examines public policy through the lens of stories and experiences shared by individuals, families and entrepreneurs impacted by government policy.”

JCCF did not respond to written requests for information about Hudson, Allen’s contact information, or to questions forwarded to Allen and other directors through communications director Marnie Cathcart.

In September, the board said it is “taking steps to strengthen governance, and to provide increased independence between the litigation and educational activities of the organization” and “seeking to streamline and refresh its membership to better respond to demands on the organization.”

Since then, JCCF has been acting a bit more like an American political action committee than as a legal rights’ defender.

Recently, JCCF news releases have been illustrated with unflattering images of Prime Minister Justice Trudeau, Alberta Premier Jason Kenney, Ontario Premier Doug Ford, and former Manitoba Premier Brian Pallister.

Excluded from attack is Maxime Bernier, the People’s Party of Canada leader, who harnessed the anger of anti-vaxxers during the election campaign with his cry: “When tyranny becomes law, revolution becomes our duty.”

Bernier is one of the people JCCF is defending following his June arrest in Manitoba for failing to self-isolate on his arrival in the province and for attending an outdoor anti-lockdown rally banned under COVID restrictions. That case has yet to be heard.

Throughout the election campaign, Bernier and his supporters flouted COVID restrictions, including on election night in Saskatoon. Charges are also pending there.

Without comment from the JCCF, it is hard to know where the organization is headed.

Had the JCCF chairman responded to my questions about Carpay’s reinstatement, he might have said that the presumption of innocence is a keystone of the Canadian court system. Of course, Carpay admitted to his seriously flawed judgment in court.

Very few organizations would be as forgiving. They protect their brands.

But maybe this isn’t about protecting a brand. Maybe this is a rebranding, with the centre moving away from defending the law to something far different.

Source: Daphne Bramham: Right-wing Justice Centre forges a new path with old leader

Why Many Black Americans Changed Their Minds About Covid Shots

Of note, both the hesitancy and the means taken to overcome it:

By the time vaccines for the coronavirus were introduced late last year, the pandemic had taken two of Lucenia Williams Dunn’s close friends. Still, Ms. Dunn, the former mayor of Tuskegee, contemplated for months whether to be inoculated.

It was a complicated consideration, framed by the government’s botched response to the pandemic, its disproportionate toll on Black communities and an infamous 40-year government experiment with which her hometown is often associated.

“I thought about the vaccine most every day,” said Ms. Dunn, 78, who finally walked into a pharmacy this summer and rolled up her sleeve for a shot, convinced after weighing with her family and doctor the possible consequences of remaining unvaccinated.

“What people need to understand is some of the hesitancy is rooted in a horrible history, and for some, it’s truly a process of asking the right questions to get to a place of getting the vaccine.”

In the first months after the vaccine rollout, Black Americans were far less likely than white Americans to be vaccinated. In addition to the difficulty of obtaining shots in their communities, their hesitancy was fueled by a powerful combination of general mistrust of the government and medical institutions, and misinformation over the safety and efficacy of the vaccines.

But a wave of pro-vaccine campaigns and a surge of virus hospitalizations and deaths this summer, mostly among the unvaccinated and caused by the highly contagious Delta variant, have narrowed the gap, experts say. So, too, have the Food and Drug Administration’s full approval of a vaccine and new employer mandates. A steadfast resistance to vaccines in some white communities may also have contributed to the lessening disparity.

While gaps persist in some regions, by late September, according to the most recent survey by the Kaiser Family Foundation, a roughly equal share of Black, white and Hispanic adult populations — 70 percent of Black adults, 71 percent of white adults and 73 percent of Hispanic adults — had received at least one vaccine dose. A Pew study in late August revealed similar patterns. Federal data shows a larger racial gap, but that data is missing demographic information for many vaccine recipients.

Since May, when vaccines were widely available to a majority of adults across the country, monthly surveys by Kaiser have shown steady improvement in vaccination rates among Black Americans.

How the racial gap was narrowed — after months of disappointing turnout and limited access — is a testament to decisions made in many states to send familiar faces to knock on doors and dispel myths about the vaccines’ effectiveness, provide internet access to make appointments and offer transportation to vaccine sites.

In North Carolina, which requires vaccine providers to collect race and ethnicity data, hospital systems and community groups conducted door-to-door canvassing and hosted pop-up clinics at a theme park, a bus station and churches. Over the summer, the African American share of the vaccinated population began to more closely mirror the African American share of the general population.

In Mississippi, which has one of the country’s worst vaccination rates and began similar endeavors, 38 percent of people who have started the vaccine process are Black, a share that is roughly equal to the Black share of Mississippi’s population.

And in Alabama, public awareness campaigns and rides to vaccination sites helped transform dismal inoculation rates. A store owner and county commissioner in Panola, a tiny rural town near the Mississippi border, led the effort to vaccinate nearly all of her majority Black community.

Today, about 40 percent of Black Alabama residents — up from about 28 percent in late April — have had at least one dose, a feat in a state that has ranked among the lowest in overall vaccination rates and highest in per capita deaths from Covid-19. About 39 percent of white people in the state have had one dose, up from 31 percent in late April.

Health officials and community leaders say that those who remain unvaccinated have pointed to concerns about how quickly the vaccines were developed and what their long-term health effects might be, plus disinformation that they contain tracking devices or change people’s DNA. The damage wrought by the government-backed trials in Tuskegee, in which Black families were misled by health care professionals, also continues to play a role in some communities, helping to explain why some African Americans have still held out.

“It’s less about saying, ‘This racial ethnic group is more hesitant, more unwilling to get vaccinated,’ and more about saying, ‘You know, this group of people in this given area or this community doesn’t have the information or access they need to overcome their hesitancy,’” said Nelson Dunlap, chief of staff for the Satcher Health Leadership Institute at the Morehouse School of Medicine.

When the U.S. Public Health Service began what it called the “Tuskegee Study of Untreated Syphilis in the Negro Male,” 600 Black men — 399 with syphilis and 201 without the disease — were told they would be treated for so-called bad blood in exchange for free medical exams, meals and burial insurance. In reality, treatment was withheld. Even after penicillin was discovered as an effective treatment, most did not receive the antibiotic.

The experiment began in 1932 and did not stop until 1972, and only after it was exposed in a news article. The surviving men and the heirs of those who had died were later awarded a settlement totaling about $10 million, and the exposure of the study itself eventually led to reforms in medical research. Still, the damage endured.

“Few families escaped the study. Everyone here knows someone who was in the study,” said Omar Neal, 64, a radio show host and former Tuskegee mayor who counts three relatives in the study and who wavered on a vaccine before finally getting one, his mind changed by the rising number of deaths. “And the betrayal — because that is what the study was — is often conjured whenever people are questioning something related to mistrusting medicine or science.”

Rueben C. Warren, director of the National Center for Bioethics in Research and Health Care at Tuskegee University, said the study served as a real example in the long line of medical exploitation and neglect experienced by Black Americans, eroding trust in the government and health care systems.

“The questions being asked about the vaccine should be understood in the larger context of historic inequities in health care,” Dr. Warren said. “The hope, of course, is they finally decide to get the vaccine.”

A national campaign led by the Ad Council and Covid Collaborative, a coalition of experts, tackled the hesitation. This summer, a short-form documentary including descendants of the men in the Tuskegee study was added to the campaign.

When Deborah Riley Draper, who created the short-form documentary, interviewed descendants of the Tuskegee study, she was struck by how shrouded it was in myths and misconceptions, such as the false claim that the government had injected the men with syphilis.

“The descendants’ message was clear that African Americans are as much a part of public health as any other group and we need to fight for access and information,” she said.

In Macon County, Ala., which has a population of about 18,000 and is home to many descendants of the Tuskegee trials, about 45 percent of Black residents have received at least one vaccine dose. Community leaders, including those who are part of a task force that meets weekly, attribute the statistic, in part, to local outreach and education campaigns and numerous conversations about the difference between the Tuskegee study and the coronavirus vaccines.

For months, Martin Daniel, 53, and his wife, Trina Daniel, 49, resisted the vaccines, their uncertainty blamed in part on the study. Their nephew Cornelius Daniel, a dentist in Hampton, Ga., said he grew up hearing about the research from his uncle, and saw in his own family how the long-running deception had sown generational distrust of medical institutions.

Mr. Daniel, 31, said he overcame his own hesitation in the spring because the risks of working in patients’ mouths outweighed his concerns.

His uncle and aunt reconsidered their doubts more slowly, but over the summer, as the Delta variant led to a surge in hospitalizations across the South, the Daniels made vaccination appointments for mid-July. Before the date arrived, though, they and their two teenage children tested positive for the coronavirus.

On July 6, the couple, inseparable since meeting as students on the campus of Savannah State University, died about six hours apart. Their children are now being raised by Mr. Daniel and his wife, Melanie Daniel, 32.

“We truly believe the vaccine would have saved their lives,” Ms. Daniel said.

Source: https://www.nytimes.com/2021/10/13/us/black-americans-vaccine-tuskegee.html

Unvaccinated Conservative MPs should ‘stay home’ from Parliament: Bloc leader

Valid given vaccine mandates elsewhere even if this will only affect Conservative MPs:

Bloc Québécois Leader Yves-François Blanchet said Wednesday the next session of Parliament should happen in person with any members who are not fully vaccinated against COVID-19 staying home.

Questions remain about what the return to Parliament will look like for Canada’s 338 elected representatives after the recent federal election saw the Liberals re-elected with a minority government.

Prime Minister Justin Trudeau says he will name his cabinet next month and Parliament will resume sometime in the fall.

Since the pandemic hit in March 2020, the House of Commons and committees had been functioning with some MPs working from Ottawa, but many others appearing virtually, including, later on, to vote, before the election was called.

Blanchet said he wants to see Parliament resume quickly with MPs having to be fully vaccinated in order to be there in person because now vaccines against the novel coronavirus are more widely available.

His party, along with the New Democrats and Liberals, made it a rule that candidates had to be fully vaccinated in order to hit the doorsteps, but the Conservatives did not.

“They get fully vaccinated or they stay home,” Blanchet said of Conservative MPs who might not have had their shots.

“Parliament should not come back under any kind of hybrid formation … now we know that we can go on with the way this building is supposed to work, and we should not refrain from doing so because a few persons don’t believe that the vaccine works. This belongs to another century.”

NDP MP Peter Julian said in a statement that because Canada is battling a fourth wave of the virus, the party wants to talk to others about continuing some of the hybrid practices when Parliament resumes.

“All of our NDP MPs are vaccinated and we’ve been very clear that federal government employees must be vaccinated too. Getting vaccinated is the right thing to do and elected leaders have a responsibility to set a good example by following public health advice,” Julian said.

The Liberals and Conservatives did not immediately respond to requests for comment Wednesday.

The Conservatives saw 119 MPs, including incumbents and new candidates, elected on Sept. 20, after the party spent the race dogged by questions about its opposition to making vaccines mandatory as a tool to defeat COVID-19.

Conservative Leader Erin O’Toole refused to say on the campaign trail whether he knew how many of those running for the Tories had been fully vaccinated, saying he told campaign teams that those who are not immunized against COVID-19 should take daily rapid tests.

O’Toole is himself vaccinated and has been encouraging others to get their shot, but the Conservative leader says he also respects the personal health choices of Canadians and attacked Trudeau for using the issue to sow division in the country.

Conservative MPs will make their way to Ottawa next week to have their first caucus meeting since the election, where they will have to decide whether they want to review O’Toole’s leadership.

The call for MPs to be vaccinated comes as Trudeau works on bringing in a mandate requiring the federal civil service, along with those working in its federally regulated industries, to be fully vaccinated.

His government has promised to make it a rule by the end of October that travellers flying or taking a train in Canada have to be immunized in order to board.

Many provinces have already introduced a vaccine passport system requiring consumers to provide proof of immunization to access non-essential businesses like restaurants and sports and entertainment venues.

“For the safety of House of Commons staff, translators, pages, security, other MPs and their staff, all parliamentarians should show proof that they are fully vaccinated in order to take their seats in the House,” tweeted former Liberal cabinet minister Catherine McKenna, who didn’t seek re-election, but served for six years in government.

As of Friday, Health Canada reported that around 79 per cent of people 12 and older as having being fully vaccinated, with about 85 per cent receiving at least one dose.

Source: Unvaccinated Conservative MPs should ‘stay home’ from Parliament: Bloc leader

Picard: The troubling Nazi-fication of COVID-19 discourse

Good commentary:

If you spend any amount of time on social media engaging about COVID-19, you will know discussions tend to get personal and ugly pretty fast.

Encourage vaccination of young people, and you’re labelled a pedophile.

Support masking in indoor settings? You’re a goose-stepping fascist.

Laud vaccination as a way out of the pandemic, and you are Joseph Goebbels and should brace yourself to be on trial for crimes against humanity at the fictional Nuremberg 2 tribunal.

Acknowledge that lockdowns are sometimes necessary to control the spread of a pandemic virus, and brace yourself for the onslaught of Hitler images.

These types of responses are predictable to a certain degree.

Godwin’s law (coined by U.S. lawyer Mike Godwin in 1990) holds that as an online discussion grows longer, the probability of a comparison involving Nazis or Hitler becomes more likely.

These days, debates go from zero to Hitler in about a nanosecond.

Some may want to dismiss this kind of over-the-top rhetoric as laughable, the work of a tiny minority of extremists and their bots.

But it’s obscene, and obscenely commonplace.

The Nazi-fication of public discourse is no longer the sole purview of pathetic man-boys holed up in their basements.

Enabled by social-media giants hiding behind freedom-of-speech arguments, trolls can now spread their misogynist, racist and anti-social views readily and mercilessly.

The goal here is to muddy the waters between fact and fiction, between truth and lies, and to undermine democratic institutions.

The grunts of a few can be turned into shouts that unfortunately have a growing audience, especially among the disgruntled and disenfranchised.

Playing the victim card appeals to them.

The ragtag collection of conspiracy theorists who gather at anti-mask, anti-vaccine, anti-lockdown rallies is fascinating – a stinking potpourri of grievances, with denunciations of everything from vaccines to “fake news,” to 5G, to the so-called “deep state.”

These rallies – which are getting bigger as pandemic frustrations grow – have more than their fair share of Hitler talk and imagery. They also include people wearing the yellow Star of David, implying that being told to wear a mask or get a jab is a level of persecution comparable to Jews who were rounded up and shipped in cattle cars to death camps.

Clearly some people have lost the plot.

Yet, they are being encouraged by politicians who embrace rhetoric suggesting that a position is invalid because the same view was held by Hitler.

A case in point is odious Ontario MPP Randy Hillier, who claims that lockdowns, mask rules and vaccine mandates are forms of Nazi-like tyranny.

His perverse version of freedom holds that individual rights are absolute, and that, for example, unvaccinated people have a God-given right to do as they please up to and including infecting others with the coronavirus.

Mr. Hillier and his acolytes have made a habit of casually tossing around Nazi analogies and Hitler images.

This mainstreaming of hateful images and thinly veiled hate speech should alarm us on a number of levels.

First of all, it betrays a profound ignorance of the Holocaust.

There can be no comparisons made between the state-sponsored mass murder of six million people and the temporary shutdown of the local mall.

Those who have the unmitigated gall to wear yellow stars to anti-mask rallies offend the memory of the victims of the Shoah and their descendants.

It is worth noting that Mr. Godwin, when he fashioned his adage, actually wanted people to think harder about the Holocaust and why Nazi comparisons should not be casually tossed into conversation.

Thinking is certainly not what’s happening here.

What we’re seeing is a lot of projection, the psychological impulse to project on other people what you’re actually feeling.

Former U.S. president Donald Trump, sometimes called the “Projection President,” was the embodiment of this phenomenon.

Mr. Trump, a chronic liar who wallowed in corruption, routinely attacked his opponents as corrupt liars. He also frequently described his opponents in a derogatory fashion, a lynchpin strategy of hate-mongers, and now a mainstay of social media.

Next time you hear the claims of Nazi-like tyranny and oppression, think about what is really being said.

Those who don’t want masks under any circumstances – those who not only want to refuse vaccines but prevent others from getting them – are actually the tyrants.

Their use of Hitler images and analogies are not a caution, but an embrace, one we should call out, not dismiss casually.

Source: https://www.theglobeandmail.com/opinion/article-the-troubling-nazi-fication-of-covid-19-discourse/

Black Canadians more likely to be hesitant about COVID-19 vaccines, survey suggests

Not just governments but governments do have a role in reducing economic barriers to vaccination (paid time off work etc). Access has become less of an issue given pop-up and other clinics, compared to earlier periods when it was more significant:

Black Canadian leaders say governments must do more to help overcome vaccine hesitancy in their communities.

Toronto orthopedic surgeon Dr. Ato Sekyi-Otu, leader of the health-care task force of the Black Opportunity Fund, says a new survey confirms unpublished public health data that hesitancy is higher among Black Canadians than among white or non-Black racialized people.

“There’s a 20-point gap with respect to the rate of vaccination in Black Canadians compared to the Canadian average,” Sekyi-Otu said in an interview. “When you look at vaccine confidence, unvaccinated Black Canadians are least likely to say that they’ll definitely get the vaccine.”

Sekyi-Otu said the Black Opportunity Fund partnered with the African Canadian Civic Engagement Council and the Innovative Research Group to try to understand why Black Canadians appeared to be getting vaccinated in lower numbers.

The survey found that as of early June, when more than 60 per cent of Canadians had received at least one dose of the COVID-19 vaccine, 45 per cent of Black Canadians surveyed said they were at least partially vaccinated, compared with 65 per cent of white Canadians and 43 per cent of non-Black visible minorities.

Sixty per cent of Black Canadians surveyed who didn’t have at least one dose expressed some level of hesitancy to get vaccinated, compared with 55 per cent of white Canadians and 44 per cent of non-Black visible minorities.

The figures are in line with vaccination data in Toronto, where the neighbourhoods with the lowest vaccination rates also have some of the largest Black populations.

Dunia Nur, president of the African Canadian Civic Engagement Counsel based in Edmonton, said addressing hesitancy in Black communities will require “a variety of policy shifts” from government that take into consideration language needs, as well as differences in education and socio-economic disparities.

“These include investing in strategies that work with Black-led and Black-focused community organizations to address COVID-19 vaccine knowledge gaps and related trust barriers,” Nur said in a statement.

Black Canadians responding to the survey were less likely to be hesitant about vaccines if they trusted their health-care providers and the vaccine makers, could take paid time off work to get vaccinated, and were confident in where and how to go about getting a shot.

“When we talk about hesitancy, we speak about the ABCs,” said Sekyi-Otu. “I’m talking about access, belief and confidence.”

He said access is affected when Black Canadians are more likely to work in jobs where taking paid time away to be vaccinated is difficult or impossible. Belief in the vaccines can be eroded if you don’t trust the people providing the information about them, and confidence that the vaccines work is harmed when people who are already less trusting of the health-care system get mixed messages about vaccine safety and effectiveness.

“It’s not surprising that if someone has a bad experience with one institution, for example, criminal justice, when he or she is 19 years old, he or she may not want to take the vaccine in 2021 when he or she is 45 years old,” he said.

Sekyi-Oto says governments need to ensure that people can take time off work to be vaccinated and take immediate steps to provide culturally sensitive and appropriate delivery and education about vaccines in Black communities.

“You have to build a system where the people who are leading the system look like the people using the system,” he said. “And so we want to create a culturally sensitive system, engage with the community so that they can come up and take the vaccine.”

The survey is being released as the Public Health Agency of Canada reports new data showing COVID-19 death rates in the first eight months of the pandemic were highest in communities with lower incomes and higher visible minority populations.

The data is the latest report from the agency that outlines the inequities surrounding COVID-19 in Canada.

Source: Black Canadians more likely to be hesitant about COVID-19 vaccines, survey suggests

‘Fortress Australia’: Why calls to open up borders are meeting resistance

Of note and the challenge of reopening:

Australia has been one of the world’s Covid success stories, where infection rates are near zero and life mostly goes on as normal.

That’s in large part thanks to the early move to shut its borders – a policy that has consistently been supported by the public.

But after a year in the cocoon, there is growing unease in the country over the so-called “Fortress Australia” policy.

Recent announcements declaring that Australia won’t open up until mid-2022 – meaning a two year-plus isolation – have amplified concerns.

Critics argue the extension of closed borders will cause long-lasting damage to the economy, young people and separated families. It also tarnishes Australia’s character as open and free, they say.

Calls for a clear plan to pull Australia back into the world are growing, as the country wrestles with an uncomfortable tension – balancing the safety of closed borders against what is lost by living in isolation.

“A Fortress Australia with the drawbridge pulled up indefinitely is not where we want to be,” says former Race Discrimination Commissioner Dr Tim Soutphommasane.

“Australia is at its best when it’s open and confident – not fearful and insular.”

Locking the gate

In March 2020, the government closed the borders. It barred most foreigners from entering the country and put caps on total arrivals to combat Covid. Mandatory 14-day quarantine and snap lockdowns have also been used to control the virus spread.

The measures are extreme, and among the strictest in the world.

But they’ve worked. Australia regularly sees months without a single case in the community, and it has recorded fewer than 1,000 deaths in the pandemic.

Given that, the strict border controls have proven tremendously popular. Public polls regularly report 75-80% approval ratings for keeping the door shut.

Even higher numbers – around 90% – approve overall of the government’s pandemic handling, and trust in government has increased in contrast to views of voters in some Covid-ravaged nations.

Languishing behind

But the government now also faces mounting pressure over how it plans to handle the next phase of the pandemic.

Prime Minister Scott Morrison – who faces an election next year – has announced Australia won’t re-open borders until mid-2022. The exact timing and just how that will happen are unclear.

But the budget announcement was a shock extension to previous forecasts of an opening-up to occur slowly at the end of this year.

The main reason for the delay is vaccination.

Australia’s immunisation programme has been beset with delays, and lags well behind other developed nations such as the UK and US.

Critics say complacency over the low virus circulation delayed its kick-off. And now rising hesitancy – fuelled at least in part by Australia’s isolation – has also slowed the vaccine rollout.

Facing those failures, the government fell back on the border ban as a resort, critics say.

That’s dealing a heavy blow to sectors like tourism and higher education. Australia’s strong migration programme – relied on to address skills shortages and population growth – has also been cut almost completely.

Ernst and Young, an accounting firm, estimates that Australia’s economy is losing A$7.6bn (£4.18; $5.9bn) a month from the closed borders.

So a group of experts from the University of Sydney have called for an exit plan to be put in place. People need to know their options and prepare for the future, they say.

Their “roadmap to re-opening” focuses on prioritising vaccination, expanding quarantine and starting trials to bring in people for affected industries.

They point to successful examples like the New Zealand travel bubble, and the Australian Open tennis tournament.

“This is the case when measured in hard dollar terms, but also when measured against less tangible factors such as fuelling a negative and inwards-focused national psyche that threatens our global standing, as well as national unity and cohesion.”

‘Us and them’ mentality

Others have also voiced their concerns over how an extended retreat from the world could damage Australia’s character.

When Australia was parochial it had a White Australia policy (1900s-1970s), which restricted immigration from non-European nations. Multiculturalism has replaced that policy in recent decades, but the ideal is still fragile, experts warn.

Dr Liz Allen, a demographer at the Australian National University, contends that Covid has already made the nation more “protectionist and insular”.

Government policies have created an “us and them” division, she argues.

The hostile treatment of migrants is a clear example, she says. Australia’s conservative government of eight years has never advocated for immigration – the coalition won the 2019 election pledging to “slash” the migrant intake.

At the start of the pandemic, Mr Morrison told the nation’s two million migrants on temporary visas to “go home”.

Those visa holders – often doing the low-paid, essential jobs of cleaning and food delivery – were also ineligible for the government’s pandemic welfare support, leaving many facing destitution.

The border ban has also sown community division, seen in its most extreme form last month when Australia took the world-first step of threatening jail for citizens who returned home from Covid-ravaged India. The Indian-Australian community expressed outrage they were being treated like second-class citizens.

Multicultural roots

The issue of stranded Australians reflects Australia’s character as an intensely multicultural nation.

Nearly 30% of the population were born overseas, and another quarter have a parent who was. As a nation of migrants, so many Australians have deep personal ties to other parts of the world.

Prior to Covid, about one million Australians were estimated to be living and working overseas. A section of the population – often highly educated and skilled – was also very mobile.

But the closed-border policy doesn’t appear to recognise these global connections or the disproportionate impact on first and second-generation Australians, critics say.

In addition, the borders created a narrative where blame for a virus outbreak was often laid at the feet of returning individuals.

“We turned on ourselves, on our own people,” says Dr Allen.

Political leaders described the virus as “imported” by returning travellers, rather than escaping through failures in the hotel quarantine system. Such rhetoric egged on social media commentary blaming incoming Australians.

Just happy to be safe

But while there’s division aimed at Australians outside the country, within the borders people feel comfortable with their lot.

First and foremost, people say they feel relieved and grateful to be shielded from the virus.

“There’s a lot of sympathy and real feeling for people caught up outside, and for the people who can’t go to weddings and funerals overseas,” says Melissa Monteiro, head of a migrant resource community centre in western Sydney.

“But you know, everyone ends with ‘that’s just how it is’. People are firstly, just grateful to be in this country and to be safe.”

Race relations researcher Andrew Markus, an emeritus professor at the University of Monash, says most Australians also don’t view the closed borders as a cultural isolation, or a “shutting yourself off from the world”.

Instead it’s just seen as a necessary short-term health measure – an attitude adopted across the political and cultural spectrum, he says.

He notes too that polling throughout the pandemic showed Australians’ support for multiculturalism and globalisation remained strong – about 80% approval – despite concerns about social cohesion and a rise in hate crimes against Asian-Australians.

Dr Allen says that the strong support for the government’s Covid fight is understandable – particularly when it has worked.

But she also says that the Australian public has been presented with no other options. The prolonged border closure and city lockdowns on single infections have all been largely uncontested policies.

She says it’s time now for Australia to move past such policies which she feels are rooted in fear. The country continues to face calls to bring back its own citizens.

“I don’t think it’s bad that people are afraid of Covid – we should be afraid. But we require leadership going forwards that doesn’t leave people behind.”

Source: ‘Fortress Australia’: Why calls to open up borders are meeting resistance

Provinces are working with outdated vaccine tracking systems, hindering national data

Canada’s patchwork system at its worst:

As Canada prepares for a massive increase in vaccine doses from abroad, some provinces and territories are using outdated technology to record their vaccination data and not fully participating in a system Ottawa created to manage infectious disease outbreaks.

The results of a Globe and Mail survey sent to every province and territory found a patchwork of systems for recording vaccine information that will be crucial in monitoring supply, adverse reactions and population immunity across the country, and for booking appointments. Some provinces reported that they had not enabled core pieces of the technology, called Panorama, that the federal government designed for campaigns like this one.

The SARS epidemic of 2003 highlighted the fact that Canada lacked a modern public-health database to manage all the information related to outbreaks of infectious diseases. Ottawa funded the creation of Panorama for all provinces and territories to use. The platform is actually a suite of technologies and databases for vaccine and infectious disease tracking. But more than a decade of delays and the increasing cost of participation led some provinces to opt out of some parts, revert to their previous systems, or adopt other technology platforms.

The end result is 13 different vaccine-tracking systems, many of which do not communicate with each other or Ottawa.

Shannon MacDonald, an adjunct professor at the University of Alberta faculty of nursing and a researcher with the Canadian Immunization Research Network, said the situation gives the federal government an incomplete picture of the national vaccine program.

“We can’t look at immunization coverage nationally,” Prof. MacDonald said. Some provinces and territories, she added, will struggle even to track their own programs.

Panorama has been in use for several years to track immunizations. The federal government obtained new technology in January to address some of the gaps, and that platform came online on Feb. 2.

Every province that responded to The Globe confirmed it has yet to plug in to the new system.

Representatives of some provinces said health officials still use paper or basic Excel spreadsheets to track vaccines and vaccinations.

The Globe survey found that Quebec, British Columbia, Yukon and Saskatchewan use Panorama, or some version of it, for various aspects of the COVID-19 vaccination campaign. Alberta, the Northwest Territories, Ontario and Manitoba have their own systems. Other provinces did not respond or did not indicate what technology they use.

In light of COVID-19, Ontario hired the accounting company Deloitte Canada to develop a new system. COVaxON, once it comes online, will manage “scheduling, client management, recording administered doses, site inventory management, receipt of vaccination” in a platform that is easy to use, Ministry of Health spokesman David Jensen wrote in response to the Globe survey.

Since December, Canada has received just over a million doses of two types of COVID-19 vaccines. In the next six weeks, four million are scheduled to arrive, and tens of millions more before the end of summer.

The shelf life and storage requirements of each vaccine must be closely monitored. Dale Hunter, a spokesperson for Saskatchewan’s Health Ministry, said the state of the province’s vaccine cold storage is “reported and tracked manually,” meaning the data are sent to the ministry via e-mail or fax. Panorama can be used to manage inventory, but several provinces and territories, including Saskatchewan, said they had not enabled that feature.

The Northwest Territories is using Excel spreadsheets and “specially trained logisticians” to ensure that “no dose is wasted,” Health Ministry spokesperson Andrea Nilson said.

Panorama includes a feature that allows health authorities to scan the barcodes on pallets and doses to keep track of the vaccines and who needs a second dose of which one. None of the provinces or territories that responded to the survey said they had enabled that feature, meaning health authorities enter the data manually.

In Ontario, government employees enter lot numbers into COVaxON when vaccine shipments arrive. Nurses and doctors who administer the vaccines can select the identifying serial numbers on their computers from a drop-down list. This helps clinics track doses both used and unused. Quebec does something similar, Health Ministry spokesperson Robert Maranda wrote.

Mr. Jensen wrote that Ontario’s system could be more efficient if the federal government provided lot numbers in advance.

Many provincial and territorial health systems are accessible on only a limited number of hospital and clinic computers, raising the question of whether they could be used more widely, such as in pop-up clinics or pharmacies.

The Globe asked provinces how they would deal with data entry for vaccinations in makeshift clinics or pharmacies. Manitoba, Alberta, Ontario and Quebec said their systems are designed to be accessible in all clinics and pharmacies. Saskatchewan reported that only public health facilities and some First Nations communities have access to Panorama. Data from pharmacies will be entered manually.

Prof. MacDonald said most provinces and territories have “good enough” systems to manage the vaccination programs. But she said that if any continue recording data with pen and paper, “we’re in a lot of trouble.”

There’s also the question of how provinces and territories will book vaccination appointments.

Alberta, British Columbia, and Saskatchewan are finalizing their booking systems. The Northwest Territories is leaving that issue to health authorities and hospitals. Booking systems for Quebec and Ontario are online.

Health authorities will need to monitor for adverse reactions and the possibility that some people who received the vaccine still contract COVID-19 – which could indicate a defective batch, a more potent variant, or that the patient is among the few for whom the vaccine is not effective.

Quebec’s system is designed to identify defective batches based on reports of adverse reactions and to notify those who received doses. Ontario is tracking adverse reactions with a system that has not been integrated into COVaxON. Saskatchewan and the Northwest Territories have not activated Panorama’s adverse-reaction module, and submit their reports manually.

The Public Health Agency of Canada is the main body responsible for monitoring adverse reactions. However, some provinces told The Globe they report to Ottawa on that manually or infrequently.

As the vaccinations continue, provinces will want to know what proportion of their population is immune at any given time. A 2016 study found the majority of provinces and territories lacked the ability to do a complete analysis of a mass vaccination campaign.

New Brunswick spokesman Shawn Berry said the province’s technology can “obtain near real-time immunization data for COVID-19 vaccinations.” Quebec said its system allows good population surveillance for infectious disease outbreaks, which includes vaccination data. While many provinces and territories that responded did not provide much detail, most told The Globe that, even if they can analyze their data, they do not automatically share the results with the federal government.

Most provinces and territories provided complete answers to the Globe survey, but British Columbia spokesman Devon Smith wrote that “confidentiality and safety” issues prevented the province from answering. Manitoba spokesman Brian Smiley said the province was unable to respond to most questions. Newfoundland and Labrador spokesperson Erin Shea indicated the province was still struggling with a recent outbreak of COVID-19 cases and could not fulfill the request. Nunavut, Nova Scotia and Prince Edward Island did not send responses.

Prof. MacDonald said the COVID-19 crisis should inspire provinces to modernize their health infrastructure. “God forbid it takes a pandemic for us to get moving on this,” she said. “But let’s make hay.”

Source: https://www.theglobeandmail.com/canada/article-provinces-working-with-outdated-vaccine-tracking-systems/

India’s Vaccine Rollout Stumbles as COVID-19 Cases Decline. That’s Bad News for the Rest of the World

Of note:

India’s COVID-19 vaccination scheme looked set for success.

For the “pharmacy of the world,” which produced 60% of the vaccines for global use before the pandemic, supply was never going to be a problem. The country already had the world’s largest immunization program, delivering 390 million doses annually to protect against diseases like tuberculosis and measles, and an existing infrastructure that would make COVID-19 vaccine distribution easier. Ahead of the launch, the government organized dry runs, put up billboards touting the vaccines and replaced phone ringing tones with a message urging people to get vaccinated.

And yet, one month into its vaccination campaign, India is struggling to get even its health workers to line up for shots. In early January, India announced a goal to inoculate 300 million people by August. Just 8.4 million received a vaccine in the first month, less than a quarter of the number needed to stay on pace for the government’s goal. So far, vaccinations are only available for frontline health workers, and in some places police officers and soldiers.

And even that initial interest might be waning. India’s vaccine scheme relies on a mobile phone app that schedules vaccination appointments. On the first day doses were administered, Jan. 16, some 191,000 people showed up. But four weeks later, when those people were summoned for the second dose, only only 4% returned.

A. Valsala, a community health worker in the southern city of Kollam who spent months fighting COVID-19 door-to-door, skipped her appointment to get her first dose of the vaccine after a hectic day on Feb. 12. “I don’t feel the need to rush because the worst is over,” she says. “So there is a sense that it is okay to wait and watch since there are concerns about how these vaccines were developed so fast.”

A. Valsala’s comments point to a troubling trend—one reflected in TIME’s interviews with health workers across India. A combination of waning COVID-19 cases nationwide, questions over the efficacy of one of the two vaccines currently authorized for use in the country and complacency are resulting in growing hesitancy to get vaccinated.

“There is a reduced perception of threat with regard to the virus,” says Dr. Chandrakant Lahariya, a New Delhi-based epidemiologist. “Had the same vaccines been available during the peak of the pandemic in September and October, the uptake would have been different.”

A troubling sign for the rest of the world

Public health experts are now concerned that the sluggish start could impact the subsequent phases of the vaccination drive, especially when the vaccination scheme is widened next month to include older people and those with preexisting conditions.

“In India, people have an inherent trust in doctors,” says Dr. Smisha Agarwal, Research Director at the Johns Hopkins Global mHealth Initiative. “So when [doctors] don’t turn up to get vaccines, it reaffirms any doubts that the general public might have.”

In an effort to accelerate the vaccination drive, the government started walk-in vaccinations as opposed to allowing only those scheduled for the day to get the shots. It also set up new vaccination centers across the country.

For now, India might be an outlier: a country with a surfeit of vaccines with few takers. But its experience shows that, while the first challenge is stocking up on vaccine supplies, convincing people to take them can be its own huge task. It might be a portent for the rest of the world as the number of COVID-19 cases decline globally and vaccines become more widely available, warns Dr. Paul Griffin, an infectious diseases specialist at the University of Queensland in Brisbane.

It’s easy to be complacent about getting a vaccine when cases are declining,Griffin says, “but now, when the trajectory looks favorable, is the right time to step back and realize that this will be our reality for a long time if we don’t speed up the vaccinations at this moment.”

How India fell behind on vaccinations

Despite being well-positioned, India’s vaccination drive got off to a rough start. The hasty approval of the country’s homegrown vaccine, Covaxin, with little data available while Phase 3 trials were still underway (those remain ongoing) drew criticism from health workers and scientists. The mainstay of India’s vaccination scheme is Covishield, the Indian variant of the vaccine developed by University of Oxford and AstraZeneca, which has been approved by regulators in the U.K., the E.U. and elsewhere. However, Covaxin is the only vaccine on offer in some vaccination centers in urban areas and health workers don’t get to choose which jab they receive.

“Covaxin might be efficacious but what guides me is data,” says Dr. Nirmalya Mohapatra at the Dr. Ram Manohar Lohia Hospital in New Delhi, where only Covaxin is available. “We also want vaccines faster because we have seen deaths because of this disease but that doesn’t mean we should cut corners with the data.” Mohapatra has refused to take Covaxin until more data is available.

But even for Covishield, there aren’t as many takers as expected. In the western city of Nagpur, fewer than 36% of those scheduled to take the vaccine turned up Feb. 11, as per a Times of India report. In the north, the city of Chandigarh is planning to set up counselling centres to dispel fearsabout the vaccines. In a hospital in the southern city of Thrissur, Dr. Pradeep Gopalakrishnan was the last one to get the vaccine on the morning of Feb. 8. “No one came in after me, so around 69 doses set aside for the day remained unused,” he says.

Experts say the lack of enthusiasm could also be attributed to a decline in cases. India’s daily case average has dropped to less than 12,000—down from more than 90,000 in September. At the peak of the pandemic, health care systems were overwhelmed, with shortages of hospital beds and oxygen cylinders being reported across the country. India’s official COVID-19 tally, now at nearly 11 million, surged to No. 2 in the world, behind the U.S (where it remains to this day).

In a Feb. 4 press conference, the Indian Council of Medical Research said that more than 20% of subjects over age 18 from across the country tested in late December and early January had antibodies for the coronavirus that causes COVID-19, meaning they likely had the disease and recovered. Similar studies in Mumbai and Delhi showed even higher levels of antibodies—up to 56%, according to Delhi’s health minister. Several health workers interviewed by TIME said they contracted COVID-19, and were less concerned about getting the vaccine immediately because they believe they have immunity.

But health experts warn India is far from herd immunity. And many worry that people not taking vaccines seriously might not bode well for India, given that other countries’ later waves of COVID-19 were even more severe than those early in the pandemic. Already, Maharashtra, the worst-hit state in the country, has seen a COVID-19 spike in recent days, with daily casesabove 5,000 on Feb. 18 for the first in two and a half months

‘The worst is not over yet’

On a global level too, the tendency to let the guard down might hamper efforts to bring the pandemic under control. Experts say vaccination is necessary not only to get long-term immunity but to also reduce the potential for new mutations, which are largely behind recent surges in cases in the U.K and Brazil.

“High vaccination coverage rate reduces the potential for new variants,” says Griffin of the University of Queensland. “The more cases we have in circulation, the more chances there are of generating mutations that confer some kind of benefit to the virus.”

Even in countries like the U.S. and the U.K., where vaccination started during a surge in cases, there is a risk that people lose enthusiasm once cases decline. Experts emphasize the need for better communication with the public to ensure that vaccination drives don’t slow down with COVID-19 case counts.

“There isn’t any time to wait because the worst is not over yet,” says Agarwal of Johns Hopkins. “Despite the fatigue, ramping up the vaccination is the only and best weapon we have against what might otherwise be a very long winter.”

Source: India’s Vaccine Rollout Stumbles as COVID-19 Cases Decline. That’s Bad News for the Rest of the World

Across The South, COVID-19 Vaccine Sites Missing From Black And Hispanic Neighborhoods

Not surprising. Hope someone will do a similar analysis for Canada (once we have a full supply of vaccines):

Georgia Washington, 79, can’t drive. Whenever she needs to go somewhere, she asks her daughter or her friends to pick her up.

She has lived in the northern part of Baton Rouge, a predominantly Black area of Louisiana’s capital, since 1973. There aren’t many resources there, including medical facilities. So when Washington fell ill with COVID-19 last March, she had to get a ride 20 minutes south to get medical attention.

Washington doesn’t want to fall sick again, so she was eager to get vaccinated, which is in line with federal health recommendations. But she faced the same challenge she did last year: finding a local provider, this time for a vaccine. She tried for weeks, checking at pharmacies in the area. And she was put on a waiting list.

Georgia Washington has lived in Southern Heights, a predominantly Black neighborhood in the northern part of Baton Rouge, La., since 1973. After falling ill with COVID-19 last year, Washington was eager to get vaccinated, which is in line with federal health recommendations. But Washington again had difficulty finding a local provider, this time to get a vaccine.

“I’ve got lots of patience,” Washington said. “I just want to get it over with.”

Communities of color have been disproportionately harmed by the COVID-19 pandemic. Now they’re at risk of being left behind in the vaccine rollout.

Using data from several states that have published their own maps and lists of where vaccination sites are located, NPR identified disparities in the locations of vaccination sites in major cities across the Southern U.S. — with most sites placed in whiter neighborhoods.

NPR found this disparity by looking at Census Bureau statistics of non-Hispanic white residents and mapping where the vaccine sites were. NPR identified counties where vaccine sites tended to be in census tracts — roughly equivalent to neighborhoods — that had a higher percentage of white residents, compared with the census-tract average in that county. Reporters attempted to confirm the findings with health officials in nine counties across six states where the differences were most dramatic: Travis and Bastrop counties, Texas; East Baton Rouge Parish, La.; Hinds County, Miss.; Mobile County, Ala.; Chatham County, Ga.; DeKalb County, Ga.; Fulton County, Ga.; and Richland County, South Carolina.

The reasons are both unique to each place and common across the region: The health care locations that are logical places to distribute a vaccine tend to be located in the more affluent and whiter parts of town where medical infrastructure already exists. That presents a challenge for public health officials who are relying on what’s already in place to mount a quick vaccination campaign.

It’s a problem that exists not just in the South but across the country. A team of researchers at the West Health Policy Center and the University of Pittsburgh found nearly two dozen urban counties where Black residents would need to travel farther than white residents to a potential vaccination site — unless health officials act to narrow the disparities.

“We’re hopeful there will be new facilities that are stood up,” says Dr. Utibe Essien, an assistant professor of medicine at the University of Pittsburgh who studies health disparities and worked on the research team. “But what we saw play out with COVID testing was there were new facilities that came up, but they relied on existing infrastructure.”

“This is structural and foundational to the racial disparities in our country.”

Troubles getting vaccinated in Black neighborhoods

In the part of Baton Rouge where Georgia Washington lives, there is just one Walgreens where COVID-19 vaccines can be found.

Ever since an interstate was built through Baton Rouge in the 1960s, the population in the northern part of the city has struggled with housing, food insecurity, poverty and crime. These inequities have always fueled disparities in health care in Baton Rouge. The vaccine rollout is just the latest example.

“When you go to north Baton Rouge, there are very few [health care] choices. And then how many of those are participating in the vaccine program?” said Tasha Clark-Amar, CEO of the East Baton Rouge Council on Aging.

Clark-Amar runs about two dozen senior centers around the city, and her organization stepped up to fill the pharmacy gap by obtaining and providing vaccines. Clark-Amar’s group organized a pop-up clinic in mid-January, giving out around 1,000 doses that it secured from the grocery chain Albertsons. But another time, a community health clinic planned to give Clark-Amar around 150 doses for seniors — except the clinic couldn’t deliver on that promise and she had to cancel the pop-up event at the last minute.

“I was livid. I was so angry and frustrated,” she said. “Thirty-five of the people we had registered are between the ages of 80 and 99. Now you tell me, how am I supposed to pick?”

Clark-Amar has been able to schedule other pop-up events. In fact, that’s how Washington was finally able to get a vaccine. She went to one of the council’s pop-up events at a local community center in late January.

Clark-Amar says this patchwork of resources is part of life in many underresourced Black communities.

In the next state over, people are facing similar challenges. In Hinds County, Miss., where the state capital of Jackson sits, there’s only one major drive-through site, which is where the state is sending the vast majority of doses. The state added the site in late January, weeks after it had already put two drive-throughs in the wealthier, whiter suburbs just outside the city.

“It took us a little bit of time to get it logistically set up to make sure we had a Hinds County site,” Mississippi’s state epidemiologist, Dr. Paul Byers, acknowledged at a recent news conference. “But we were always planning to do that. And we are glad that we have that now.”

There’s still a problem for the residents of Hinds County, nearly three-quarters of whom are Black: The vaccination site is north of downtown Jackson in a neighborhood that is 89% white and already has more medical facilities. It’s close to a 30-minute drive from the more rural parts of the county, where many Black residents live.

In Alabama, the state has consistently ranked near the bottom in vaccine distribution since the rollout began.

But in terms of where the vaccine is available, NPR’s analysis found a disparity in one of the state’s largest counties. In Mobile County, 18 vaccination sites are listed on the Alabama Department of Public Health webpage. Fourteen are located in the whiter half of neighborhoods in the county.

Rendi Murphree, director of the Bureau of Disease Surveillance and Environmental Services at the Mobile County Health Department, said it has been hard for the county to get any vaccines at all. She also said distribution is based on which sites have the capacity to store vaccines at very low temperatures.

Joe Womack, a native of a historically Black neighborhood known locally as Africatown, said Black communities in the northern part of Mobile have always dealt with poverty, pollution and health disparities.

“It’s been a struggle ever since the ’70s,” said Womack, president of the Africatown community group C.H.E.S.S.

Beyond the South

Because of the need for a quick rollout, vaccination sites are largely dependent on the health care infrastructure already in place. Places such as pharmacies, clinics and hospitals make convenient sites for vaccines to be administered.

But the locations of those facilities can be inconvenient for millions of Americans. Those are the findings from a team of researchers at the nonpartisan West Health Policy Center and the University of Pittsburgh who analyzed the distance that Americans live from these types of places.

In 23 of the nation’s urban counties, the researchers found, Black residents were less likely than white residents to be within a mile of a site that could potentially distribute vaccines. In just these counties, they estimated 2.4 million Black residents were farther than a mile.

“We worry this is going to exacerbate disparities in outcomes even more now,” says Inmaculada Hernandez, an assistant professor of pharmacy and therapeutics at the University of Pittsburgh who analyzed the data. “The limitations of existing infrastructure in counties are very different.”

And it’s not just in urban areas. In more than 250 other U.S. counties, the researchers found, Black residents were less likely than white residents to live within 10 miles driving distance of a site. Hernandez estimates the true number of places with this disparity to be higher, since the researchers only estimated based on a sample of county residents. Georgia and Virginia top the list of states with the most counties that have this disparity.

The Georgia Department of Public Health declined to comment on the University of Pittsburgh study. The Virginia Department of Health pointed to plans to deploy the National Guard to assist with vaccinations, as well as mass vaccination sites it set up at places like a convention center, a raceway complex and a vacated department store.

“A long history of racism”

The effects of this gap, coupled with historical trust issues between Black Americans and health care providers, are already reflected in the nationwide data showing who’s getting vaccinated. According to a Centers for Disease Control and Prevention analysis published this week — which included race data on half of those who were vaccinated in the first month of the vaccination campaign — Blacks are lagging behind in vaccination rates, even when accounting for the demographics of health care workers and others who were in top priority groups.

Thomas LaVeist, a dean and health care equity researcher at Tulane University in New Orleans, says medical deserts go back into the early evolution of health care.

“But I do think that the South is perhaps more of a problem than some other parts of the country,” says LaVeist, who is also co-chair of the Louisiana COVID-19 Health Equity Task Force. “Part of that is a long history of racism, Jim Crow and, in some cases, intentional actions that were taken to ensure that some communities did not have access to health care and other resources, while others did.”

And it’s not just Black neighborhoods having trouble getting access. In Texas, with its large population of recent immigrants, the problem of location and convenience is interwoven with a lack of trust.

Texas health officials recently designated several vaccination “hubs” around the state after advocates and local officials raised concerns about the state’s initial plan to rely heavily on chain grocery stores and pharmacies to distribute the vaccine. The hubs will make their own decisions about where to distribute the vaccines they are allocated.

But as the Texas Tribune reported, when Dallas County tried to take it a step further by prioritizing ZIP codes where mostly Blacks and Hispanics live, state officials threatened to withhold doses.

The way that hubs allocate their vaccines is an especially important issue in smaller counties like Bastrop County, east of Austin.

The state’s list of providers in the county shows they are almost all clustered around State Highway 71 — mostly in the city of Bastrop — which is far from the rural county’s outskirts, where many Latinos live.

Edie Clark, a leader with a local faith-based nonprofit, said her group is worried for neighborhoods like Stony Point, which is a small immigrant community in the county.

Clark said members of the Stony Point community are still reeling from events a few years ago when the Sheriff’s Department turned over roughly a dozen residents to Immigration and Customs Enforcement for deportation. Many of those arrested were pulled over for minor traffic violations, like a broken taillight.

“They have a lot of distrust and fear of giving their information out without knowing it’s not going to be used against them,” she said.

Clark said it’s tough to imagine that a lot of people in Stony Point will drive to get vaccinated in the city of Bastrop when they won’t even drive there to get groceries. The U.S. Department of Homeland Security announced this week that immigration agencies will not make immigration enforcement arrests at vaccination sites.

Fast or fair

Reaching long-neglected communities takes time — and in the race to get vaccines to as many people as possible, time is in short supply.

Still, when the CDC outlined four ethical principles for the allocation of vaccines, two of them included equitable and fair distribution. CDC spokesperson Kristen Nordlund said, “Vaccine allocation strategies should aim to both reduce existing disparities and to not create new disparities.”

But the pressure to get the vaccine out quickly means not everyone follows those principles. In South Carolina, the board of the state’s Department of Health and Environmental Control shunned a proposal last week that would have factored age and “social vulnerability” metrics into its vaccine allocations. It opted instead to distribute solely by county population, citing a need for speed.

“I think when you look at speed, certainly, it’s probably a lot easier and faster and quicker to do those calculations when it’s just based on per capita,” said Nick Davidson, the South Carolina health department’s senior deputy for public health.

In Georgia, the high demand for COVID-19 vaccinations has left little opportunity for providers to build up new infrastructure to supplement what already exists or to work with members of historically marginalized communities on any hesitations they might have about getting vaccinated.

That’s why the Good Samaritan Health Center in Atlanta has been saving a handful of its vaccination appointments for people who might want to meet with a health care provider at the clinic to ask questions before rolling up their sleeves.

“And at the end of most of those conversations, the person says, ‘You know what? That was what I really needed. And now I’m ready to be vaccinated,’ ” said Breanna Lathrop, the clinic’s chief operating officer.

Even for those eager to get the vaccine, it’s hard to find in certain parts of the city. Only one of Atlanta’s five large-scale county vaccination sites falls in the Black neighborhoods south of Interstate 20 — and that outlier sits in a shopping mall directly adjacent to the interstate on the outskirts of the city. Many of the smaller vaccination sites that are in those Black neighborhoods are grocery store pharmacies, which receive a much lower number of doses than what can be found at hospitals and the county sites.

A few hours away in Savannah, Ga., NPR’s analysis shows just one of Chatham County’s half-dozen vaccination sites is located in a majority-Black neighborhood. That didn’t surprise Nichele Hoskins. She’s assistant director of a local YMCA-led coalition called Healthy Savannah and works to flatten out health disparities among people of color.

“In order to get people vaccinated, you’re going to have to have that kind of trust,” Hoskins said, noting it can seem a tedious process. “If you’ve ever done retail, it’s going to take a little bit of hand-selling.”

The Coastal Health District in Savannah, of course, can’t take each patient by the hand. The health director, Dr. Lawton Davis, says it’s tough to formalize a plan targeting Black residents, who make up about 42% of Chatham County’s population. So far, the Coastal Health District has reached out to two Black churches and a community health center in a predominantly Black neighborhood to arrange mobile vaccination clinics. It’s also using an existing hurricane evacuation registry of people with disabilities and health issues to help identify neglected neighborhoods around Savannah.

“There simply is not enough vaccine to go around,” Davis says. “I don’t have a formal document that says this is, you know, step A, B, C and D, but we have had reasonably in-depth discussions and we have, shall we say, a game plan on how we think this will go.”

There are other options in a public health game plan.

“Alternative facilities come to mind,” Jeni Hebert-Beirne, who leads the Collaboratory for Health Justice at the University of Illinois at Chicago’s School of Public Health, wrote in an email to NPR. “Public libraries (an important source of free wifi), community centers/park districts, faith-based organizations, barber/beauty shops. These are places that people regularly convene/gather and places where people are more likely to feel they belong.”

Shivani Patel, a researcher tracking COVID-19 health equity issues at Emory University in Atlanta, is quick to acknowledge that the problem is too large for a state’s public health system to solve on its own. Like many across the country, Georgia’s public health system has seen funding cuts in recent years that have reduced its capacity to respond to the pandemic.

Washington is also promising new support for states: A million more doses weekly are on their way to pharmacies, and the White House’s COVID-19 czar said, “[Pharmacy] sites are selected based on their ability to reach some of the populations most at risk.” The new sites are expected to start receiving the doses next week.

“Every day is potentially more lives lost,” Patel said. “This is extremely urgent.”

WWNO’s Shalina Chatlani is a health care reporter for NPR’s Gulf States Newsroom; she reported from Baton Rouge, Louisiana. KUT reporter Ashley Lopez reported from Bastrop, Texas. WABE reporter Sam Whitehead reported from Atlanta.

Methodology: NPR gathered addresses of permanent vaccination sites from state websites. NPR verified these sites by contacting county and state health officials in the nine counties mentioned in this report. Officials were offered the opportunity to review the findings and point to additional testing sites. What counts as a vaccination site varies by state. NPR geocoded vaccination site locations using the Google Geocoding API joined with Census Bureau shapefiles to determine what census tracts they were within. For each county, the analysis included only census tracts within the county’s official boundaries. The Census Bureau provided demographic data per census tract. The main demographic measure referenced in this story was the percentage of the population that identifies as “white alone,” not Hispanic or Latino. For percent white, NPR calculated the number of sites for tracts above and below the median county’s percentage of white residents. Medians referenced are medians of census tracts and are not population totals, and may therefore differ slightly from population totals.

Source: Across The South, COVID-19 Vaccine Sites Missing From Black And Hispanic Neighborhoods