Are Black Residents Being Vaccinated More Slowly in Florida?

Local health-care leaders had warned of a racial gap in the early days of Miami-Dade's vaccination effort. Jackson CEO Carlos Migoya told county commissioners last week that the system was not working Black communities.

Two Black women standing side by side.
(TNS) - The relief of seeing his father and uncle get their COVID-19 vaccines came with some discouraging news for Dr. Hansel Tookes. Both men were upset at how few fellow Black people were getting their shots.
"My dad was despondent over this, asking me, 'What are you doing about this?', knowing that it's the kind of thing that keeps me up at night," said Tookes, a University of Miami physician and professor who has pioneered health equity in the city.
Statistics released this week by Florida's COVID operation show the Tookes family experienced a fairly typical day in a vaccine operation that has steadily left Black residents behind.
Of the roughly 138,000 people who have gotten the vaccines in Miami-Dade, just 8,265 — or 6% — identified as Black, according to the latest state data, released Thursday. Excluding the 19,200 or so people who were marked as "unknown" race, that's still just 7% of the total, compared to the overall portion of Miami-Dade that is black — 16.7%, according to U.S. Census data.
Stark racial disparities in vaccine distribution appear to be a problem in neighboring Broward County, too. Though the county is 30% Black, just 10% of the 95,618 people who received vaccines and marked down a race identified as Black.
Local healthcare leaders had already warned of a racial gap in the early days of Miami-Dade's vaccination effort. Jackson CEO Carlos Migoya told county commissioners last week that the system was not working for the county's Black communities.
"What we found is we have not, through the normal appointment process, have not been getting enough people of color. Principally Black. Because we have gotten a fair amount of Hispanics," Migoya said.
Migoya said about 2,000 people received vaccinations in the first wave of appointments made through churches, with a "very large" chunk of the doses going to Black residents. Jackson also started allowing employees at the hospital, one of Miami-Dade's largest employers, to offer vaccination appointments to up to two relatives ages 65 and over in an effort to reach people not getting the chance for appointments through the online portal.
On Sunday, a state vaccination operation was set up at the Second Baptist Church in South Miami-Dade to vaccinate 600 people in an effort Commissioner Kionne McGhee said he helped arrange with Florida's Emergency Management Division.
Commissioner Keon Hardemon, who represents some Miami neighborhoods with large Black populations, said the church outreach won't be enough.
"There are a great number of people in this community that do not attend church," he said. "We have to find other ways to reach the Black community."
The lack of access for Black people comes even though the Black population, especially older Black men, are known to suffer disproportionately high death rates from COVID.
In Miami-Dade, 2.9% of Black residents with COVID have died of the disease, according to the health department, compared to a death rate of 1.8% for whites. In Broward, 1.89% of Black residents with COVID have died of the disease compared to 1.3% for whites. But the hospitalization rate has been nearly twice as high for Black residents diagnosed with COVID — 8.7% of all cases — than it has been for white residents, about 4.4% of all cases.
Much of the current vaccination process favors people with easy access to the internet and the time to pounce on reservation windows that often begin midday and can last less than 30 minutes before vaccination slots are filled online. For the county's vaccine supply, the administration of Mayor Daniella Levine Cava will sometimes rely on the mayor's Twitter feed to announce the reopening of the reservation site for small batches of appointments — a kind of pop-up vaccination opportunity available only to the most media-engaged of Miami-Dade's residents.
Barry Bloom, an infectious disease expert at Harvard T.H. Chan School of Public Health, described that system of alerting vaccine availability on social media channels as "mind boggling" and not grounded in any public health principles.
"It's absolutely biased against low-income vulnerable populations," Bloom said. "It's a guaranteed intrinsic bias."
On Thursday, Levine Cava noted the county has also sent mobile vaccination operations to provide shots to residents of public housing who are 65 and older. Visiting the complexes, she said it was clear the online system for vaccination slots at drive-through locations was going to leave behind large chunks of the population.
"All the people in line I spoke to hadn't attempted to get an appointment anywhere else. They didn't have cars. They don't use the internet," she said. Levine Cava also said some vaccinations made through the county website were for state Health Department vaccination clinics in some under-served neighborhoods, including Perrine in South Miami-Dade, Little Haiti and the area around Jackson known as the Health District. "It's very valuable to go where people live."
She said the main challenge facing the county for improving vaccination rates in Black neighborhoods is the lack of supply of doses. Miami-Dade had to shut down vaccination sites this week after being told Florida wasn't sending the county government more doses. That challenge of limited supply was also amplified by a state priority on injecting as many people as possible in a short period of time.
"We were definitely told at the beginning we had to use up the supply within the week," she said. "The message wasn't: Go out and find the people that are under-served. The drive-thrus are very efficient."
Levine Cava said part of the county's outreach strategy is tapping well-known Black residents, including community leaders, pastors and others, to promote the vaccine and try to reduce skepticism among some when it comes to injections. "We certainly have the distrust, particularly in the Black community," she said. "This has to be addressed through trusted intermediaries."
Tookes started the state's first needle exchange and has a free clinic in Overtown, where he regularly cares for Black Miami residents with little healthcare access. Even with his daily interaction with the healthcare system's racial gaps, he said the vaccine disparity represented a "worst nightmare" in terms of how bad the divide could be.
He suspects the divide comes from a string of factors, starting with appointments at the sites being driven by social media alerts and online forms, but also including historical mistrust in the county's Black communities.
Even at his clinic — an oasis of healthcare in an under-served area — Tookes said he doesn't have access to the vaccine. As recently as Wednesday, Tookes said he was answering questions about vaccine, and helping clients overcome their skepticism.
"They're right on the precipice, but then they ask me: 'How do I sign up?' " Tookes said. "Right now, my answer is you have to set an alert on Twitter, then wait for the alert, then sign up, and that's not ideal."
Miami Herald Staff Writer Daniel Chang contributed to this report.
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