The Covid mass vaccination program in the U.S. began on Dec. 14, 2020, when a nurse at a hospital in Queens, N.Y., received a shot on live television.
But more than two months later, a major health clinic based in North Birmingham, Ala. — which focused on lower-income, Black and Latino residents — still had not given a single vaccine dose. The clinic, Alabama Regional Medical Services, was not able to give shots because it had not received any from the state supply.
The reasons were a matter of dispute. Alabama officials insisted that other Birmingham clinics had signed up first, exhausting the initial supply. Some officials in North Birmingham, however, believed that the state’s white, Republican leadership was ignoring heavily nonwhite, Democratic neighborhoods. “The long and short of it,” Chris Mosley, who oversaw outreach for the clinic, told me, “was that the Black neighborhoods didn’t have vaccines and the white areas did.”
Birmingham may have been an extreme case, but it was also part of a pattern. Around the U.S., many Black and Latino communities had limited early access to the Covid vaccines. That lack of access — combined with greater vaccine hesitancy among some people of color — contributed to racial gaps in vaccination and, by extension, large racial gaps in Covid death rates. In today’s newsletter, I want to tell you the story of what ended up happening in Birmingham, as a way of revisiting the larger issue of Covid and race.
By late February 2021, Mosley was able to use his political contacts to alert the Biden administration to his clinic’s lack of vaccines. His plea for help arrived when White House aides, then in their first weeks in office, were looking for ways to narrow the racial gap in vaccinations. “The natural social history of many diseases is that they tend toward inequality, unless you intentionally combat it,” said Dr. Cameron Webb, a pandemic adviser in the Biden administration.
The Trump administration had seemed uninterested in combating those inequities, leaving it up to states. President Biden made closing the gaps a priority. “We built our Covid response with equity at the heart of it,” Ron Klain, the White House chief of staff, told me.
The administration diverted some vaccine doses from state stockpiles directly to community health clinics. It created a working group across agencies to spread successful ideas. It put federal clinics in Black and Latino neighborhoods. It also helped local organizations set up clinics at churches, barbershops and beauty salons. “In more affluent communities,” Webb said, “people had choices about where they felt confident getting vaccinated.”
As Mosley said, “People would call me and say, ‘I hear you’ve got vaccines over there. Can we get some?’” He added, “It’s turned around in a major way.” In the spring of 2021, several months into the mass vaccination program, white Americans were significantly more likely to have been vaccinated than Black or Latino Americans. By late 2021, the Hispanic rate was higher than the white rate, and the Black rate was almost as high as the white rate, according to the C.D.C. As a result, the racial gap in death rates has also disappeared.
That disappearance is arguably one of Biden’s biggest accomplishments — one that would not have happened, to be clear, without passionate advocacy and hard work by many community health officials. In a country with deep racial inequities, where Covid was initially another tragic example, the virus is no longer disproportionately harming Black and Hispanic Americans.
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