Recently we published a post, Uniting Health Equity and Vaccinations: Considerations for Working with Black Populations by Lola Akintobi, which outlined health equity considerations that leaders nationwide should prioritize in COVID-19 vaccination rollout. The inequitable distribution of vaccines continues to take a toll on Black people nationwide, further exacerbating racial health inequities. As an example of how inequitable vaccine access is playing out on a state level, we share this powerful blog from the North Carolina Justice Center Health Advocacy Project.

There is no shortage of finger pointing when it comes to problems that have slowed North Carolina’s initial vaccine rollout. Between evolving federal guidance, a limited vaccine supply, and a stretched-thin public health workforce – our state’s rollout has faced a host of challenges. 

As we approach phase 3 of North Carolina’s vaccine distribution, one shortcoming remains especially pronounced – the inequitable distribution of shots. While African Americans make up 22% of the state’s population, Black people only received 15% of North Carolina’s first phase of vaccine doses and just 11% of the second round.  

<p><br />Much news reporting has blamed the Black community for this shortcoming, citing vaccine hesitancy and skepticism as leading reasons for the racial disparities in the distribution of the vaccine. </p>
<p>This simplistic justification ignores the deadly impact of systemic and institutional racism that continues to leave people of color with unequal access to services, more vulnerable to chronic illness, and more likely to be without health insurance. </p>
<p>In the latest brief by the Health Advocacy Project, “<a href=Equity, North Carolina and the Vaccine,” Senior Policy Analyst William Munn argues a fairer analysis for understanding the race gap in vaccination uptake must include analysis of the ongoing impacts of racism and white supremacy within our healthcare systems. 

In the brief, Munn interviews eight African Americans from southeastern NC, central NC, and the Piedmont. Their testimonials speak of a range of concerns including an absence of infrastructure, historic underinvestment, and skepticism of the Trump administration’s fast-tracked vaccine development. Each of the respondents knew several individuals who have contracted COVID-19. Those whom respondents knew had died of the virus were overwhelmingly people of color.

Audio segments capture and portray different emotions among interviewees, from fearful to hopeful. But the connecting thread among respondents is the way their lived experiences and answers have been shaped by decades of raciall animus or racially indifferent federal and state level policy choices. Munn connects this legacy of harmful policy decisions with the pervasive discrimination and neglect of the Black community in our healthcare system presently. 

Have historically discriminatory health policies created barriers of distrust within the Black community? Absolutely. But Munn suggests this distrust isn’t the root problem – the root of the problem is the legacy of racist policies. 

“Whether it is disparate COVID-19 outcomes due to pre-existing conditions or race-based vaccination disparity, the foundations of both phenomena are rooted in an ideology that assumes some Americans are disposable while others are valued,” Munn said. “Only after this dogma is thoroughly exfoliated from the bedrock of American policy making will we be able to take real steps toward reforming our healthcare system, finally addressing the inequities that have cultivated harm and beginning the process of repairing trust between North Carolina’s Black community and the leaders charged with delivering equitable quality of life outcomes.”

Read the report.