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Minnesota struggles to measure vaccine inequities

12February 2021

Minnesota may never have a clear picture of whether coronavirus vaccines were equitably distributed to residents.

Current state law restricts how health officials can collect and disseminate information about the race and ethnicity of the people who are vaccinated. Leaders in Minnesota’s communities of color say that needs to change.

“We need to track who has been vaccinated and more importantly who has not,” said Rep. Rena Moran, DFL-St. Paul, co-chair of the Legislature’s United Black Caucus.

Moran and her colleagues urged the Minnesota Department of Health to release the limited demographic information they have collected. Lawmakers also said they would consider updating the law, which now requires people who receive vaccines to give permission before information about their race and ethnicity can be collected and shared.

“Minnesota’s COVID-19 vaccination strategy needs a heavy dose of racial and health equity,” Minnesota Doctors for Health Equity, a statewide coalition of physicians, wrote in a letter to state leaders this week. “Efficiency and speed cannot stand as excuses to push equity aside.”

Jan Malcolm, state health commissioner, acknowledged Minnesota needed to do a better job ensuring communities of color have equal access to vaccine. Malcolm added that the state Department of Health was currently reviewing the limited data it has collected and plans to make it public soon.

Malcolm said it was “a very important point and a very fair critique” to say that racial disparities around vaccine access exist and that the state needs to do more to correct them.

As of Thursday, Minnesota had vaccinated roughly 600,000 people out of a total population of more than 5.6 million.

WHY IT MATTERS

The coronavirus pandemic has had a disproportionate impact on people of color across the United States and in Minnesota. Black and Hispanic Minnesotans are more likely to contract COVID-19 than their white neighbors.

Health officials say part of the reason is people of color are more likely to work in sectors where it is difficult to control exposure to the coronavirus. They are also less likely to have jobs that provide paid sick time.

Residents from racial and ethnic minority groups also are more likely to be uninsured than their white peers. Often, a lack of insurances means people do not have a regular health care provider.

Minnesotans of color have experienced fewer COVID-19 deaths per capita than white residents. Their populations skew much younger on average than white residents and COVID-19 is particularly deathly for older people.

Nevertheless, a review of all fatalities in 2020 shows the death rate for Minnesotans of color rose more sharply than that of white residents.

WHAT CAN BE DONE?

Minnesota is far from alone in its struggle to track whether the coronavirus vaccine is being equitably distributed. Despite requiring states to sign data-sharing pledges in order to receive vaccine, the federal Centers for Disease Control and Prevention has racial data on just over 50 percent of vaccine recipients.

To address questions about equity and vaccine access, President Joe Biden’s administration has pledged to send more doses to federally funded health centers in underserved communities.

Gov. Tim Walz says Minnesota is already part of that effort. He noted that many states also have raised concerns with the White House about providing vaccine in communities that employ a lot of workers in the meat-processing industry.

“It is both a racial equity issue and an economic issue for a lot of states,” Walz said. “This is a legitimate concern.”

MORE: Minnesota doctor urges his Black community to get COVID vaccines

Walz noted that Minnesota’s 11 American Indian tribal nations have done “a fantastic job” administering vaccine.

State officials acknowledge that with vaccine so limited, the scramble to get an appointment often favors those with resources such as reliable internet access and time.

The Minnesota Doctors for Health Equity say there is much more the state can do. Their Feb. 8 letter urges state officials to prioritize vaccinating people who are living in congregate settings, those who are homeless and other groups that have been “historically marginalized.”

“Deployment infrastructure must prioritize vaccination of marginalized populations, emphasize data transparency with regard to sociodemographic characteristics of vaccine recipients, and promote community-engaged outreach efforts,” the doctors’ letter says.

WHAT’S NEXT?

Health Commissioner Malcolm says her department is examining what information vaccine providers can collect and provide to the state under current law. Health officials are also exploring other ways to better understand the demographics of those who are being vaccinated.

“Getting better data is critical,” Malcolm said, noting that health officials could use it to answer important questions about Minnesota’s vaccine rollout.

“Who is signing up? What’s the proportion of people who are getting access to those sites? How can we do a better job of outreach into those communities to help people get connected with where there is vaccine?” Malcolm said were all questions the state needs to answer.

State Rep. Mohamud Noor, DFL-Minneapolis, noted that the state Department of Health collected data on the more than 226,000 seniors who signed up for a vaccine lottery in January. While only a small number of them got vaccine appointments, the information could be useful for lawmakers to understand how large vaccination disparities might be.

“If we can get that data, we can see where gaps exist,” Noor said.

READ THE DOCTORS’ LETTER

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