Covid vaccination

A woman from the University of Charleston gives a senior citizen a Covid-19 vaccine t the Charleston Convention Center and Coliseum in February 2021

Something journalists need to better convey to our audiences: Because of demographic realities, prioritizing age in Covid-19 vaccination efforts is akin to prioritizing white Americans.

White people live longer on average than other racial groups, which is partly why the above 65 population is 77 percent non-Hispanic white, while the nation overall is 60 percent non-Hispanic white. Simple math means that places a higher percentage of white people at front of the line, even if that’s not the intent. It is one of the many subtle, often unacknowledged ways race affects decisions we make, unintended effects that can sometimes mean the difference between life or death.

The vaccination debate has been focused on which groups should be second and third in line because the first group was obvious: frontline medical workers and the elderly in potential coronavirus hotspots, such as nursing homes. That’s where journalists must redouble efforts to understand the complex interplay of age and race and convey that complexity to our audiences.

While the unintended consequences can be serious, there’s no reason to think what’s happening is akin to Jim Crow-era laws and practices, such as forcing Black people to guess the number of jellybeans in a jar before allowing them to vote, which were purposefully designed to leave Black people behind while concealing that intent. Because of the racial history that got us here, race will always be more complex than it seems on the surface. Its effect on healthcare and other policies must always be grappled with and accounted for — without suggesting age and race priorities are in competition. And one of the unfortunate complications we face is the legacy of medical racism, which has led to about half of Black Americans to voice reluctance about getting vaccinated, if not outright saying they don’t plan to get it. That, too, is why race must be factored into our decisions in order to give us the best chance to overcome that distrust.

A December 5 New York Times article about Covid vaccination priorities, which does a solid job laying out the stakes, included this quote:

“Harald Schmidt, an expert in ethics and health policy at the University of Pennsylvania, said that it is reasonable to put essential workers ahead of older adults, given their risks, and that they are disproportionately minorities. ‘Older populations are whiter,’ Dr. Schmidt said. ‘Society is structured in a way that enables them to live longer. Instead of giving additional health benefits to those who already had more of them, we can start to level the playing field a bit.’”

Schmidt was arguing that, given longstanding healthcare and racial disparities, people of color should also be prioritized for vaccination, in addition to prioritizing around age. His quote, though embedded in a thorough article that lays out the difficulty of getting vaccination prioritization right, launched an intense round in a culture war that is often built upon racial misunderstanding or misinterpretation.

In the online magazine Persuasion, Yascha Mounk, an associate professor of the practice of international affairs at Johns Hopkins University as well as the founder and editor of Persuasion, suggested such a focus would be sacrificing elderly white people on the altar of social justice.

For The Detroit News, under the headline “Are some people ‘too white’ to get Covid-19 vaccine?”, Michael Graham pulled together a string of such reactions for a piece he began this way: “Are teachers “too white” to get early, priority access to the COVID-19 vaccine?”

He ended his piece with this question: “But it’s precisely that addition of race into the health-risk mix that many Americans find troubling. Why not simply distribute the limited vaccine based on the single metric of preventing the most deaths?”

“Should social justice take precedence over science?” he also asked in the piece.

Leave aside the hard-to-define reference to “social justice.” It is neither unscientific nor discrimination against white people to consider race as a factor in discussions about vaccination priorities. Again, the elderly, particularly in nursing homes, have largely been prioritized for what are obvious, rational, scientifically-sound reasons: Covid deaths are disproportionately high among the elderly, which is why there is little serious debate among journalists or medical and health policy experts that they need to be prioritized during vaccine distribution efforts. They are at greatest risk of real harm or death.

But because of the disparate racial distribution among various age groups, that also necessarily means white people, in the aggregate, are being prioritized. It may be one of the reasons an under-discussed but disturbing development is unfolding—that while Covid is also killing Black and brown Americans at disproportionate rates, Black and brown Americans are being disproportionately left behind by Covid vaccination efforts.

In Chicago, for instance, about 38 percent of those killed by Covid are Black, but Black residents there make up only 15 percent of those vaccinated. It’s the reverse for white residents there, with white people making up 20 percent of Covid deaths but 53 percent of those who have received the first shot against Covid.

Kaiser Health News has found similar developments across the country, with white Americans being vaccinated at two to three times the rate of Black people in the 16 states that have released data by race.

There’s no reason to believe black and brown people are purposefully being left behind by early vaccination efforts. State and national health officials have clearly been grappling with how best to juggle conflicting priorities and have not ignored the racial component.

Several articles, including by The Washington Post and The New York Times, have explained that struggle well. The Times article that featured Harald Schmidt, for example, also included this: “But to protect older people more at risk, [Harald Schmidt] called on the C.D.C. committee to also integrate the agency’s own ‘social vulnerability index.’ The index includes 15 measures derived from the census, such as overcrowded housing, lack of vehicle access and poverty, to determine how urgently a community needs health support, with the goal of reducing inequities.”

While the elderly are at greater risk of Covid, the healthiest and wealthiest older Americans who can limit their contact with strangers aren’t among the most vulnerable — and the healthiest and wealthiest among that group is largely white. The same can be said of Black and brown Americans — not all are at equal risk.

The nation’s longstanding health disparities disadvantage people of color and has led to a heightened skepticism of medicine among those groups. Covid has essentially exposed shifting racial demographics that often correlate with age, as well as the effects of a long history of racial discrimination in medicine, housing and work-life experiences. The data is incomplete but has been consistent — because of the way early vaccination efforts have unfolded, some of those most vulnerable to the ravages of that disease have been left behind while other vulnerable groups have been prioritized.

Early vaccination efforts are retrenching deep-seated racial disparities in a way that can seem as though white lives are more valued than Black and brown ones—even if that isn’t the intent. Journalists should help our audiences better understand what could — or should — be done about that conundrum.

The best way to make that happen is to be careful not to suggest, even inadvertently, that age and race are competitors in vaccination efforts, because they aren’t. Eliminating headlines asking if teachers are too white to get priority access to Covid-19 vaccines would be a good place to start. And when an expert such as Schmidt says, “Older populations are whiter,” we have to anticipate the reaction and give him space to explain more fully what he is suggesting — and deploy follow-up questions that will make clear what he isn’t.

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