Strategies for States to Drive Equitable Vaccine Distribution and Administration
Patricia Boozang, Nina Punukollu, and Michelle Savuto, Manatt Health
As the United States continues to grapple with the COVID-19 pandemic and new variants of the virus that are more transmissible and potentially more likely to result in severe illness or death, widespread vaccination against COVID-19 remains the strongest tool to fight the virus. But while the United States has administered more than 330 million COVID-19 vaccine doses—fully vaccinating 163 million people or 49 percent of the population—efforts to date have not produced equitable outcomes.[1],[2] Rates of COVID-19 vaccination vary widely, with Black, Indigenous and people of color (BIPOC) receiving smaller shares of COVID-19 vaccinations compared with their shares of the total population, despite experiencing disproportionately higher rates of COVID-19 cases, hospitalizations, and deaths.[3],[4] These disparities in vaccination rates among BIPOC as compared to white Americans highlight the longstanding inequities and structural racism that underpin the United States health care delivery system and that contributed to disparities in health outcomes before and during the COVID-19 pandemic.[5]
Recognizing that early vaccine distribution efforts reached those most eager and able to access the vaccines, increasing vaccination take-up requires addressing the wide range of reasons why people have not received a COVID-19 vaccine. This expert perspective shares highlights from a new issue brief, Strategies for States to Drive Equitable Vaccine Distribution and Administration. Drawing on insights learned through discussions with state officials, informed by grassroots community organization input and a review of the literature, the issue brief outlines the key barriers states face in their efforts to increase vaccination rates among BIPOC and highlights strategies states are pursuing in partnership with community-based organizations (CBOs) to address these challenges (summarized in Figure 1). The issue brief also considers future phases of the COVID-19 vaccine rollout and planning, including near-term efforts to vaccinate children and adolescents, as well as longer-term opportunities to build sustainable infrastructure and capacity to advance health equity within state and local public health and health care delivery systems.
A key lesson learned across states is the importance of meaningfully engaging, fostering, and funding close partnerships with CBOs and other community partners in vaccination efforts. Strong community partners can help states understand barriers to vaccine uptake in their communities and implement tailored strategies that address concerns at the individual level, in the near term, while building the necessary structures to reimagine and rebuild a public health system that fosters trust, centers on the community, and addresses long-standing and underlying social drivers of health inequities.
On August 12, State Health and Value Strategies hosted a companion webinar during which experts provide an overview of the strategies states can pursue in partnership with community-based organizations to reduce disparities in COVID-19 vaccine uptake, and in the longer term, to build a more equitable and sustainable public health system. States and their community partners are implementing a broad range of distribution and outreach strategies to improve vaccine equity and are looking to build sustainable infrastructure and capacity to advance health equity within state and local public health and health care delivery systems. This webinar shared the lessons learned from a larger project between the Rockefeller Foundation, Families USA, and State Health and Value Strategies’ program partners Manatt Health and Health Equity Solutions.
[1] Centers for Disease Control and Prevention. 2021. “COVID-19 Vaccinations in the United States.” https://covid.cdc.gov/covid-data-tracker/#vaccinations.
[2] Centers for Disease Control and Prevention. 2021. “COVID-19 Vaccinations in the United States.” https://covid.cdc.gov/covid-data-tracker/#vaccinations.
[3] Artiga, Samantha, Corallo, Bradley, Pham, Olivia. 2020. “Racial Disparities in COVID-19: Key Findings from Available Data and Analysis.” Kaiser Family Foundation, August 17. Accessed July 22, 2021. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-covid-19-key-findings-available-data-analysis/.
[4] Artiga, Samantha, Corallo, Bradley, Pham, Olivia. 2020. Racial Disparities in COVID-19: Key Findings from Available Data and Analysis.
[5] Berkowitz, Seth A, Crystal Wiley Cené, Avik Chatterjee. 2020. “Covid-19 and Health Equity — Time to Think Big.” New England Journal of Medicine 383, no. 12 (2020). Accessed July 22, 2021. doi:10.1056/NEJMp2021209.