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Long shots: Across N.C., minorities less likely to receive the COVID-19 vaccine

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Eddie Sweeney of Greensboro and Kimble Capel, a registered nurse with Guilford County Health and Human Services, talk for a moment before he receives his second COVID-19 vaccination at the county's vaccination clinic at Mount Zion Baptist Church in Greensboro on Thursday.

CHARLOTTE — Minority communities in all corners of North Carolina continue to be underrepresented, in some cases at alarming rates, when it comes to getting coronavirus vaccines, an Observer analysis of new state data found.

At issue is the rate at which people of different races and ethnicities are getting the COVID-19 vaccine compared with their overall population in a given county. The Observer's analysis of state data released last Friday found significant racial and ethnic disparities in urban, suburban and rural counties, and from the coast to the mountains.

Among the findings:

• Black people are underrepresented in at least 77 of 100 counties.

• Such disparities even appear in six counties where Black people comprise the majority of the population: Bertie, Hertford, Edgecombe, Northampton, Halifax and Warren.

• White people were most overrepresented in the vaccine rollout compared with the overall population in Guilford, Swain, Mecklenburg and Durham counties.

• Hispanic residents are underrepresented in at least 93 of 100 counties.

• And in the 27 counties where Hispanics account for 10% or more of the population, they are underrepresented in 26 counties.

What's more, Black and Latino communities also have been disproportionately affected by the COVID-19 pandemic, health experts say.

State leaders have bemoaned the racial and ethnic disparity for weeks now, while vowing to continue to combat it.

At a news conference last week, Gov. Roy Cooper said Black people accounted for 18% of those vaccinated in North Carolina last week, up from 11% four weeks ago.

"This is an improvement, but there is more work to be done when North Carolina's population is 22% Black," Cooper said. "We're working to address those inequities. We can start by making sure every community has access to these vaccines."

New data, big concerns

For its analysis, the Observer reviewed first-dose vaccination rates by race and ethnicity for all 100 counties, in data reported to the state as of Feb. 4.

In some cases, the state did not have data for every race or ethnicity category per county, either because the population size is so small there were privacy concerns or not enough demographic information was provided to the state. But based on the population and reported vaccination rates of other races, the Observer was able to estimate if there appeared to be an underrepresentation of a minority group in some of those counties.

The details offer a snapshot in time for vaccination rates by race and ethnicity at the county level, in the midst of the vaccine rollout.

Asian residents represent a small slice of the state's total population. But in counties with the highest Asian population rate — Guilford, Orange, Wake and Mecklenburg — all were underrepresented in vaccine participation.

Or consider Duplin County, north of Wilmington, about an hour from the coast. It had the greatest disparity of any county when it came to the rate in which Hispanics were getting vaccinated. Hispanic people comprise 22% of the population there, but just 2% of those vaccinated so far.

Héctor Vaca isn't surprised to hear that.

"It's terrible," said Vaca, the organizing director of Charlotte-based Action NC, which advocates for social equality. "It has a lot to do with the system and the way it's designed."

By that, he means the system was designed to prioritize white people, leaving marginalized communities left out.

That echoes the thoughts of Black leaders. Charlotte-Mecklenburg NAACP President Corine Mack and the Rev. Willie Keaton told the Observer they weren't surprised there was a disparity in vaccine access.

Keaton called it a "manifestation of institutional racism."

"We have a divide when it comes to access," Keaton said. "We shouldn't be surprised. It's just reality."

In Charlotte, Vaca said, local entities like hospital system Novant Health have been working to address the inequities. But the state and federal government need to make a greater effort to address the issue, he said.

"We're always an afterthought, especially immigrants," he said. "We need our government to step it up."

Working to ease tensions

The state is now asking local providers to prioritize equity by ensuring vaccines go to marginalized communities at rates that meet or exceed the county's population estimates for those groups.

In Charlotte, hospital systems Atrium Health and Novant Health have both launched initiatives targeting vaccines to marginalized communities.

Atrium's mobile effort has vaccinated more than 1,800 people — 61% of those were Black and 10% were Latinx. And Novant hosted a vaccination event last week, partnering with Park Church, one of Charlotte's largest African-American churches.

Mecklenburg County's health department is also working to get more vaccines to marginalized communities through clinics, a top official said.

In the Triangle, 16 Raleigh churches held mass vaccine events recently to whittle away at the disparity. The partnership between WakeMed and Wake County Public Health provided 1,700 vaccinations at churches and a community center in southeast Raleigh.

"By placing it in the community ... it eases the tensions and the concerns of the community," Pastor Joe Stevenson of Macedonia New Life Church said.

Mistrust and access

There are a number of potential reasons for vaccine disparity among marginalized communities.

Access to transportation can be an issue. And some people in marginalized communities may not have had access to health care resources in the past, or don't have a regular primary care physician.

Novant Health is targeting vaccines to marginalized communities by making sure materials are translated into Spanish, and setting up community vaccination events.

"The state and all the health care systems are working on that," said Dr. David Priest, an infectious disease expert with the health provider. "I think that's going to get better, but it certainly is a part of everyone's strategy."

And some may be hesitant to take the vaccine due to mistrust, Black leaders have said.

"Some Black and brown citizens may mistrust the vaccine," said Charles Evans, president of the N.C. Association of Black County Officials. "And I understand why, based on long-standing and continuing racial and ethnic injustice in our health care system. I trust the vaccines because they have been tested — they are safe and effective.

"If we are going to gain control of our lives, we need to get vaccinated."

But Vaca said that while some people may be hesitant to get a vaccine, that is not the only reason for inequity. In fact, most people Vaca hears from say they want the vaccine.

But access limitations will still remain, Vaca said. That's why the state's initiatives to increase equity will be so important in the coming weeks.

"Once they have access to it, we start seeing more equity," he said. "We start seeing more fairness."

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