In Missouri and Other States, Flawed Data Makes Tracking Vaccine Fairness Difficult | Best States

Throughout the COVID-19 vaccination effort, public health officials and politicians have insisted that providing vaccines equitably between racial and ethnic groups is a top priority.

But it was left to states to decide how to proceed and to collect racial and ethnic data on individuals vaccinated so that states could track how well they are reaching all groups. Gaps and inconsistencies in the data made it difficult to understand who gets shot.

Just as an uneven approach to containing the coronavirus has resulted in greater casualties for black and Latino communities, the inconsistent data guiding vaccination efforts may leave the same groups out on vaccines, Dr Kirsten Bibbins said. Domingo, epidemiologist at the University of California-San Francisco.

“At the very least, we need the same consistent standards that every state uses and every place that administers the vaccine uses, so that we can have comparisons and design better strategies to reach the populations we are trying to reach.” , says Bibbins-Domingo.

Now that federal, state and local governments are easing mask requirements and ending other measures to prevent the spread of the virus, efforts to increase vaccination rates in underserved communities are even more urgent.

At St. James United Methodist Church, a cornerstone for many members of the black community in Kansas City, Missouri, in-person services recently resumed after being online for over a year. St. James has also organized vaccination events designed to reach residents of the neighborhood.

“People genuinely mourn not only the loss of loved ones, but the loss of an entire year, the loss of being alone, the loss of being at home, of not being able to come to church. be able to get out into the community, ”said Yvette Richards, director of community links at St. James.

Missouri’s population is 11% African American, but COVID-19 cases among African Americans accounted for 25% of total cases for the state, according to a Analysis by KFF.

Richards said St. James has lost many worshipers to the coronavirus, and the empty benches they once sat on on Sundays are a stark reminder of how much this community went through during the pandemic.

Missouri’s COVID-19 public data appears to show strong data on vaccination rates disaggregated by race and ethnicity. But several groups are lagging far behind on immunization, including African Americans, who appear to have an immunization rate of just 17.6%, nearly half the rate of 33% for the state in its own right. together.

For Dr. Rex Archer, director of the Kansas City Health Department, a number indicates that this data is not correct. It shows a completed vaccination rate of 64% for “multiracial” Missourians. Such an unusually high rate for a group is beyond comprehension, according to Archer.

“So there is a huge problem with the way the state collects race and ethnicity as part of the covid vaccination,” Archer said.

Missouri state officials have recognized since February that this data is flawed, but have failed to correct it or explain exactly what is causing it. Archer suggested that the swollen multiracial rate is likely due to the different racial data reported when individuals receive the first and second hits.

Other issues were detected, including missing racial and ethnic data for many people who were vaccinated and the use of multiple categories such as “other” and “unknown”.

The state also noted that it used national racial percentages in the state’s immunization data rather than actual percentages based on the state’s population. For example, earlier in the vaccination effort, the state used national racial data, which shows nearly 6% of the population is Asian, even though Missouri’s population is 2.2% Asian.

Health officials are working to target vaccination campaigns in communities with low rates, but Archer said state data is providing little help.

“I mean, we have to look at it, but there are too many variables to be something we can depend on,” Archer said.

Although racial and ethnic categories are clearly defined in national US Census data, the same data is not collected uniformly by states.

For example, South Carolina immunization data aggregates Asians, Native Americans, and Pacific Islanders into one category. In Utah, residents can choose more than one breed. Wyoming does not report any racial or ethnic data for vaccinations at all.

Bibbins-Domingo said missing or inconsistent data doesn’t necessarily mean equity tracking is a lost cause. Immunization rates for census tracts where racial and ethnic data are known can be used as a proxy to estimate vaccine allocations.

However, Bibbins-Domingo argued that the pandemic has shed light on racial data issues that have persisted in U.S. public health for far too long.

“What I’m hoping is that our lessons in covid really get us all thinking about the infrastructure we need in our state and nationally to make sure we’re ready next time around,” said Bibbins-Domingo. “Data is our friend.”

Missouri local leaders and health officials are scrambling to increase immunization rates, especially among vulnerable communities, after Republican Gov. Mike Parson recently announced measures to get residents back to work in person.

Parson ordered state employees to return to office in May and said he would end additional federal pandemic-related benefits for the unemployed in June, although vaccination rates in the state are much lower to what the Missouri health experts had hoped to achieve.

Jackson County, Missouri, which includes most of Kansas City, last month authorized $ 5 million in federal CARES funding to increase vaccinations in six zip codes with large black populations and low vaccination rates. . The project will address access and reluctance issues and will focus on reaching individuals and neighborhoods.

Although many of the state’s immunization efforts have involved large mass events, Pastor St. James Jackie McCall said she has spoken to many in her church and community who need encouragement. to have confidence in vaccines.

“So let’s go ahead and trust ourselves,” McCall told the faithful. “Trust the process. Trust God. Trust science.”

This story is part of a reporting partnership that includes KCUR, NPR and KHN.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Together with Policy Analysis and Polling, KHN is one of the three main operational programs of KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization that provides information on health issues to the nation.

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