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A 5-Point Plan for Improving Vaccination Efforts in Communities of Color

An illustration of a group of people of mixed race and age wearing face masks.

Malte Mueller/Getty

Key Takeaways

  • The COVID-19 pandemic has disproportionately affected Black, Indigenous, and People of Color (BIPOC) in the United States.
  • A new report provides a blueprint for fair and equitable COVID-19 vaccine distribution in BIPOC communities. It includes a five-point plan to help elected and appointed officials build trust and lay groundwork for rectifying health disparities.
  • Experts say that the pandemic should be a catalyst for creating meaningful social change going forward.

According to the Centers for Disease Control and Prevention (CDC), longstanding disparities have resulted in the COVID-19 pandemic disproportionately affecting Black, Indigenous, and People of Color (BIPOC) in the United States.

In a joint effort by Johns Hopkins and Texas State universities, a new report is advocating for fair and equitable COVID-19 vaccine distribution to ease the burden on BIPOC communities. The report also expresses the urgency of addressing the inequalities these communities face.

“This is an opportunity, especially now, with the federal government and states to start putting their money where their mouth is,” Emily Brunson, MPH, PhD, associate professor of anthropology at Texas State University, tells Verywell. “They want COVID fixed. We’re telling them this is the only way to fix it with these communities who aren’t going to trust anything less than this."

Emily Brunson, MPH, PhD

We feel that as vaccination is rolling out, that issues of equity are not being paid attention to in the way that they need to be or the way that they could be.

— Emily Brunson, MPH, PhD

With increased investment, Brunson says that "you can really turn around and change things so that the health of the country is literally better moving forward.”

Brunson is co-chair for the Working Group on Equity in COVID-19 Vaccination, which released the report. It's the first of several that the group has planned.

“We feel that as vaccination is rolling out, that issues of equity are not being paid attention to in the way that they need to be or the way that they could be," Brunson says.

The report offers a five-point plan to help elected and appointed officials create and carry out vaccination efforts in BIPOC communities to prevent further adversity brought on by the pandemic.

The five key principles are:

  • Iteration
  • Involvement
  • Information
  • Investment
  • Integration

Iteration

For the first principle of iteration, Brunson says that building trust is crucial. Trust can be forged through listening first, rather than just telling people in marginalized communities to get vaccinated. 

“Their healthcare needs have been for decades overlooked,” Brunson says, “but they’ve been asking for help with certain things and have been told that there’s no funding for that, or just dismissed and not paid attention to. That has to change. There needs to be some active listening and then figuring out ways that they can work together moving forward.”

Involvement

For the involvement principle, Brunson says that trust can also be forged when community advocates become active collaborators, allowing communities to own the vaccination process.

To achieve these, Brunson says that “public health needs to engage with these representatives" in BIPOC communities.

Information

Advocates are effective ways to convey vaccine information, the third key principle of the report. Verywell spoke to an advocate on the national level, Sandra Lindsay, MS, MBA, RN, CCRN-K, NE-BC, director of nursing for critical care at Northwell Health’s Long Island Jewish Medical Center in Queens, New York.

Lindsay, who was born in Jamaica and has been a nurse in the U.S. for 26 years, volunteered to be the first person in the states to receive the vaccine once rollout began. 

Sandra Lindsay, MSN, MBA, RN, CCRN, NE-BC

I know that just me taking the vaccine—just one woman, a Black woman taking the vaccine is not going to erase the centuries of pain and harm that have been done. But I’ve also seen the other side of it—what this virus can do to our community, what it has disproportionately done to our community.

— Sandra Lindsay, MSN, MBA, RN, CCRN, NE-BC

“I know that just me taking the vaccine—just one woman, a Black woman taking the vaccine is not going to erase the centuries of pain and harm that have been done," Lindsay says. "But I’ve also seen the other side of it—what this virus can do to our community, what it has disproportionately done to our community. And I am willing to trust the science.”

Investment

The report's fourth principle, investment, involves making the vaccine rollout more equitable and addressing health disparities. “Public health has been something that has largely been underfunded for decades in the U.S.,” Brunson says. “This isn’t a new thing. This has been an ongoing issue. And the impacts, especially for people of color, have been particularly bad.”

Integration

The final key principle in the report is integration. The plan cautions that an effective vaccination rollout should not be the end goal. Instead, it should be viewed as a catalyst for “meaningful social change.” 

“The pandemic itself is an opportunity to change,” Brunson says. “But we’re at a cultural moment that also will facilitate the type of change that really does need to happen.”

The report also offers opportunities to lay the groundwork for remedying many of the longstanding disparities experienced by BIPOC—especially in health care.

Health Disparities and Barriers to Vaccination

Vaccine equity involves the intricacies of access beyond eligibility in terms of age or underlying conditions. Brunson says that because the federal government did not provide clear guidance to states on the rollout, people in different social situations have been left out. 

Brunson mentions the southern part of Texas as an area of concern. “They have vaccination sites, but in order to get to the vaccination sites, you’ll have to cross a checkpoint. And when you have people who are not here legally, or maybe part of their family is not here legally, that can be prohibitive and not feel safe. And so that is a huge barrier.”

A barrier to an individual is also a barrier for the whole population. “The fact of the matter is, that in terms of vaccination for this disease, it doesn’t matter if someone’s here legally or not," Brunson says. "We need everybody that can be vaccinated to be vaccinated.”

Emily Brunson, MPH, PhD

In terms of vaccination for this disease, it doesn’t matter if someone’s here legally or not. We need everybody that can be vaccinated to be vaccinated.

— Emily Brunson, MPH, PhD

Manuel Pastor, PhD, head of the University of Southern California’s Equity Research Institute, tells Verywell that California has 2.2 to 2.3 million undocumented immigrants. In Los Angeles County, 18% of the population is undocumented or living with an undocumented family member. 

“When you create an atmosphere where undocumented folks fear tapping into a system that might serve them, that creates a chilling effect, not just for them, but for their families," Pastor says. "Don’t you want that entire family protected to protect your family?” 

There are many jobs that undocumented immigrants in California and other states that support the nation’s workforce as a whole. Pastor notes industries such as childcare, agriculture, food service, and eldercare, as examples.

Pastor, who is a member of Govenor Newsom’s COVID-19 Recovery Task Force, says that California has initiatives to promote healthcare equity during the pandemic, including COVID-19 vaccine distribution. 

“When the state unveiled its contract with Blue Cross Blue Shield to become the third party administrator for the distribution of vaccines, there are metrics in there that require that the vaccination profiles look similar in the most economically and socially disadvantaged neighborhoods to those in the county as a whole," Pastor says. "Those are things which coupled with a commitment to not freeze out the undocumented are likely to ensure that they are protected.”

Another concern with vaccine access involves site location and hours. Brunson mentions centralized hubs as a potential barrier. “When you have people where there’s no public transportation, and you have people who are too poor to even put gas in the car that they do own, or they are working three different jobs and there’s no way they can take time off to sit in the line—all these things are related to equity.”

Repairing Broken Trust and Moving Forward

Even when the barriers to vaccine access are removed, centuries of inequality lead to a persisting lack of trust in government and health care in many communities.

Lindsay believes in a path forward to healing and rectifying these disparities. “The first thing we have to do is acknowledge that this happened, and not pretend that it didn’t happen and [make sure] it doesn’t continue to happen in terms of disparities in health care," she says. "Apologize when an apology is necessary and alleviate any harm and suffering moving forward.”

Diversifying Healthcare Providers

Part of the solution lies in addressing the disparities that exist in the administration of health care. Lindsay hopes that more people of color will have the opportunity to go to medical or nursing school, then come back and serve their communities.

For those who are in the healthcare profession and working with communities that face disparities, Lindsay points out what is not helpful. For one, people who do not have information about a community should not lecture its members about exercise or healthy food. For example, a person in a marginalized community might not feel safe going out for a run because they are worried about getting shot.

Open, Real Conversations

What is helpful, and critically important, is having open and real conversations about the COVID-19 vaccine—especially for those who are facing healthcare disparities. “People look at this and say, ‘OK, you don't address our needs normally, and now a vaccine comes and you want us to take it?" Lindsay says. "'Well, what about after COVID is gone, then what will happen?’”

Lindsay has been working on the front lines of the pandemic and wants to speak out about the vaccine. She hopes that she can ease people’s fears and be a trusted and forthright advocate.

“I had no fear going and taking the vaccine,” she says. “My fear was every day I had to come to work without the protection. I’ve never feared my profession, and I’m proud to be a nurse. I hope I never have that feeling again. But since I’ve gotten the vaccine, I am hopeful.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention (CDC). Hospitalization and death by race/ethnicity. Updated February 18, 2021.

  2. Schoch-Spana M, Brunson E, Hosangadi D, Long R, Ravi S, Taylor M, Trotochaud M, Veenema TG on behalf of the Working Group on Equity in COVID-19 Vaccination. Equity in vaccination: a plan to work with communities of color toward COVID-19 recovery and beyond. Baltimore, MD: Johns Hopkins Center for Health Security. Updated February 2021.