One of the most critical challenges of the COVID-19 pandemic was vaccine distribution. Today countries around the globe have reached high percentages of vaccinations; however, research suggests that despite global efforts to address equitable access, vaccinations would become one of the most revealing outcomes of structural racism and a public health failure.
The discipline of public health has defined itself over the years as one of promotion, prevention and community protection. As an advocate for the discipline and definition, I can say it still stands post-COVID recovery. The unwavering trauma of the COVID-19 virus on the globe has placed public health and its scholars at the front of every line of human existence: from economic (e.g., stock market) to cultural and psychological. The urgency for public health is real, and the discipline is feeling it. We are in a public health crisis.
I am certain that almost everyone would agree that in order to acquire high vaccination rates in individuals and across communities, vaccine equity would have to be the goal for everyone involved, starting with no preferential access, knowledge or funding. Further, according to the CDC, COVID-19 has disproportionally affected racial/ethnic minority groups and persons who are economically and socially disadvantaged. Thus, ensuring equitable COVID-19 vaccine coverage is a national priority.
History tells no lies about the structural racism that seeps through the crevices of American structures — in particular, the healthcare system. Vaccine distribution fell deep into a hole that only few could see, yet many knew about. It was the fortunate, misfortune of being in a ravaging pandemic that uncovered a racism already in view — access.
Many have viewed poverty as the catalyst for inequities in access to care, but even more blame structural racism as the foundation.
Vaccine equity will cost lives, one report suggests. Although a vaccine was developed at warp speed, it failed to be administered with the same urgency and ethics. In the U.S. over 431 million doses have been administered. Countries and regions with the highest incomes are getting vaccinated more than 10 times faster than those with the lowest. Thus, we can see that where vaccines are distributed widely, numbers of infection and death are being reduced.
Delays in vaccination place vulnerable populations at increased risk, not just in health but economically. The cost of inequitable vaccine distribution is high, individually as well as at a societal level. So, I think it is fair to say, this is more than unjust, it is on the edge of inhumane.
Since the U.S. Food Drug and Administration (FDA) authorized the first vaccine, skepticism has loomed over its acceptance among communities — in particular, the African American community. Although the vaccine was created with safety and efficacy, the speed with which it was brought to fruition brought on doubt and concerns around its safety. These concerns were paramount in the equity of distribution and access.
Although issues of vaccine-distribution equity remain a considerable challenge, millions have received at least one vaccination. The lag in the rollout has presented a huge opportunity for public health officials to address and correct. It is a window we as a country can not afford to blindly close. The world as a collective shares in the responsibility in how vaccine distribution has been handled. I am a firm believer that what affects one, affects us all.
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