Do African Americans in Louisiana have equal access to the vaccine? We can’t say

State doesn’t know the race of over half of those vaccinated

Dr. Obi Nnedu, Infectious Disease specialist, receives his COVID-19 vaccine injection at Ochsner Medical Center in Jefferson on Monday, Dec. 14, 2020. (Photo provided by Ochsner Health)

Louisiana doesn’t know the race or ethnicity of more than half of the people who have received a COVID-19 vaccine shot in the state, making it difficult to determine whether minorities are underrepresented in vaccine distribution — as some have feared would happen.

In total, 33 percent of people who received at least one shot of the vaccine identified as White, 10 percent identified as Black, 1 percent identified as Asian and less than 1 percent identified as Native American or Hawaiian.

But more than a third of people, 36 percent, are identified as “other” in the race category, and for another 20 percent of vaccine recipients, the race and ethnicity wasn’t recorded at all, according to data provided by the Louisiana Department of Health. That means that Louisiana doesn’t have reliable race data on 56 percent of the 273,000 people it says have received at least one dose of a vaccine so far.

The state also hasn’t been tracking how many Latino people receive the vaccine at all, because the federal government hasn’t required it to do so, said Aly Neel, spokeswoman for the Louisiana Department of Health. Just over five percent of the state population is Hispanic, according to the U.S. Census.

The state does hope to collect more granular data moving forward. For example, Louisiana will start tracking whether vaccine recipients are Hispanic in the future, Neel said.

Louisiana also isn’t the only state struggling to collect vaccine demographic data based on race and ethnicity. Tennessee, Virginia, Delaware and Pennsylvania don’t know the race of over half of their vaccine recipients, according to the Kaiser Family Foundation. Texas — a state with a significant Latino population — isn’t tracking vaccine recipients by Hispanic ethnicity either.

Still, in Louisiana, data regarding the gender and age of the recipients is far more complete. About 61 percent of the people who have received at least one shot of the vaccine are identified as women and 39 percent are identified as men. Less than 1 percent of the vaccine recipients are identified as an “unknown” gender. 

The state also says it knows the age range of basically every person who has gotten the vaccine, according to the data provided. Fifty-five percent of people who have received one shot of the vaccine are age 70 and above. This makes sense, given that people age 70 and above make up one of the largest cohorts of folks who qualify for vaccination so far.

But with the race and ethnicity of such a large percentage of people who have received a vaccine shot being unknown, it’s hard to determine whether Black people and other minorities are receiving it in the numbers that they should, said Thomas LaVeist, dean of Tulane University’s School of Public Health and Tropical Medicine. LaVeist is also the co-chair of the state’s COVID-19 Health Equity Task Force. 

“I don’t think this proves inequity and I don’t think it’s right to interpret the data that way,” he said in an interview Thursday. “The jury is still out on it.”

Joe Kanter, the state’s top medical officer, says the demographic information is poor because hospitals and pharmacies aren’t prioritizing the tracking of it. 

“We have no way to track this unless we get the good information,” Kanter said at a press conference Friday.

Earlier in the week, the Department of Health sent a memo to the hospitals, pharmacies and other entities distributing the vaccine reminding them to record the race of vaccine recipients into the federal database that tracks vaccine distribution.

“It is the expectation of LDH that providers will accurately enter the self-reported race of patients/recipients into [the federal database]; routinely selecting other as a default in the race field is not acceptable and will hinder the state’s ability to understand and address inequities in vaccine distribution,” the memo read.

On Friday afternoon, the health equity task force was told that part of the problem was different hospitals and pharmacies were using different words and formats to distinguish race. One provider used “African” instead of “African American” or “Black” as an identity. Louisiana Department of Health has now clarified what language should be used by all providers when it comes to race and ethnicity, LaVeist said.

But even if there was more accurate data being collected on who is receiving the vaccine, it would still be difficult to determine whether it’s been distributed equitably. Only about 900,000 people of Louisiana’s 4.6 million-person population are eligible to receive the vaccine right now. It’s limited mostly to health care workers, nursing home residents, and people age 70 and above — and the state does not know what percentage of those people identify as African American or another minority. 

Black people make up about a third of Louisiana’s population in general, but they likely make up a smaller percentage of the people who qualify to receive the vaccine, LaVeist said. For example, Black people have shorter lifespans due to current health care inequities, and make up a small percentage of the state’s population 70 years and older, LaVeist said.

There is also concern that the Black community, in particular, might be reluctant to receive the COVID-19 vaccine. Government entities have a history of conducting experiments on the Black community, which has sowed distrust. Black patients are also not treated as well by health care providers in general, which can make them skeptical of care, LaVeist said.

National surveys show the Black community is more hesitant to receive the COVID-19 vaccine. In a June survey by the Louisiana Public Health Institute, 49 percent of Black respondents said they would take the vaccine, compared to 59 percent of White respondents.

In order to achieve herd immunity to COVID-19, experts have been saying around 70 percent of the population — maybe even a higher percentage — must get the vaccine. In Louisiana, it would be difficult to get a vaccination rate of 70 percent or higher if a significant portion of the Black community refuses to take it.

The Black community has also been disproportionately affected by the pandemic. Forty percent of the nearly 8,500 people who have died of COVID-19 in Louisiana were African American.