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EGACY Yesterday. Today. Tomorrow.
WEDNESDAYS • Dec. 23, 2020
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Richmond & Hampton Roads
12/26/20- 01/01/21
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COVID Burden Creates Vaccine Quandary JOSEPH WILLIAMS
Amid relentless pandemic that for months has cast a leaden pall over her work, Dr. Ebony Hilton in early December received the equivalent of a golden ticket. An anesthesiologist and critical care physician at the University of Virginia Medical Center, Hilton, 38, was notified she’d be among the first in the nation to get a new, federally approved emergency vaccine to protect her against COVID-19. Soon after she received the notice, Hilton, who is Black, posted a video about it on YouTube, practically radiating optimism. “We’re finally, I’m hoping, nearing as a nation a light the end of the tunnel,” she said. Hilton’s excitement, however, is tempered by harsh reality: People of color have been hit hard by the novel coronavirus, and Black Americans have died of COVID-19 at a rate roughly three times higher than whites. Experts agree the virus has exposed health disparities hidden in plain sight, linked to the lingering effects of racism and inequality in the U.S. Yet finding a way to get a potentially game-changing vaccine – the result of a multibillion-dollar race to invent a drug that can stop a global pandemic – into the arms of a demographic that’s among those who need it most is a conundrum that would vex King Solomon himself. “This is an unprecedented, unprecedented mass vaccination campaign. We’ve never done this,”
says Hemi Tewarson, a visiting senior policy fellow at the Duke University Margolis Center for Health Policy. While the country has had national inoculation campaigns for polio and the flu, she says, the global pandemic – combined with relatively small quantities of a precious vaccine – has raised the stakes to an extraordinary level. And as the pandemic grinds on – killing thousands of people a day nationwide, swamping hospitals and funeral homes, and doing serious damage to the national economy – there isn’t much time for debate. “Millions of Americans across the country are going to need to get this vaccine,” and quickly, Tewarson says. Earlier this month, a Centers for Disease Control and Prevention advisory committee recommended that front-line health workers and residents of long-term care facilities such as nursing homes should get vaccinated first. Such recommendations help guide health policy in the U.S. Still, it’s up to states to draft their own inoculation plans for their share of available vaccine doses, raising thorny questions about who’s next in line. “There are 50 states with 50 allocation schemes,” says Dr. Chris Beyrer, an epidemiologist and professor at the Johns Hopkins Bloomberg School of Public Health. But putting communities of color ahead of other groups for the vaccine is good public health practice, Beyrer says: They are
Sandra Lindsay canaries in the COVID-19 coal mine. “If the uptake is low, the impact will be low,” Beyrer says. And given the complex plans to nationally distribute a groundbreaking vaccine that’s already in short supply, he says, “the devil is in the details.” Ahead of the vaccine rollout, the CDC’s Advisory Committee on Immunization Practices acknowledged that mitigating racial inequities should be a factor in distributing the vaccine, and said allocation strategies “should aim to both reduce existing disparities and to not create new disparities.” CDC Director Dr. Robert Redfield underscored the need in a statement accepting the committee’s initial recommendation for priority
groups, encouraging a future call to prioritize older people in multigenerational households. “Often our Hispanic, Black and Tribal Nations families care for their elderly in multigenerational households and they are also at significant risk,” Redfield said. Indeed, a recent National Governors Association, Margolis Center and COVID Collaborative survey found that “many states have incorporated health equity principles in their vaccination plans to varying degrees.” “For example, North Carolina specifically cited historically marginalized populations as an early-phase critical population
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*** Merry Christmas and Happy Holidays ***