A new research letter published in JAMA Network Open examined the COVID-19 vaccine distribution plans for all 50 states and the District of Columbia. The study found a majority of the vaccine rollout plans lacked diverse representation on the state health committees, along with strategies to reach people living in underserved communities.
Amber Hardeman, MD, MPH, MBA, a resident in the Med-Peds program at Tulane University School of Medicine, was first author of the letter and worked alongside Tulane pulmonary critical care physician Joshua Denson, MD, and researchers from New York University Grossman School of Medicine and the University of Chicago.
The research uncovered that 43 of the 51 plans called for a committee to develop a COVID-19 vaccine distribution plan. Out of those 43 plans, 31 (61%) did not reference any strategies for equitable rollout of the vaccine. Only 8 plans out of all 51 included representatives for minority populations and just over half of the states (51%) collaborated with organizations working with underserved communities.
“This isn’t just a COVID problem,” Hardeman says. “It’s an issue that’s permeated through medicine and access to medicine during the entire history of the United States, and it’s still very prevalent now. It just so happened that this was an international emergency and so many people were getting sick and dying from it, that there needed to be a lot more urgency.”
Studies are increasingly showing that racial and ethnic minorities are disproportionately affected by COVID-19. Centers for Disease Control data show the COVID-19 hospitalization rates among non-Hispanic Black people and Hispanic or Latino people were both about 4.7 times the rate of non-Hispanic white people. Race and ethnicity are risk markers for other underlying conditions that affect health, including socioeconomic status, access to health care, and exposure to the virus related to occupation - such as being a frontline, essential or critical infrastructure worker.
Dr. Hardeman says this report is a step in helping government and health care leaders become more aware of the disparities that exist. This is likely just the beginning of a long career in which she will continually work to improve healthcare for everyone.
“I’m dedicated to improving equity and the outlook of public health internationally, not just in the United States,” Hardeman says. “This is exciting to have done something in my career that can spearhead future projects, and not just projects, but actual change in the medical community.”