Why we need vaccination equity

As eligibility for and access to the COVID-19 vaccine expand to more Minnesotans, racial disparities in vaccination rates are increasing. So are myths that strategies to vaccinate more equitably aren't needed.

This is of immense concern due to the disproportionate impact COVID-19 continues to have on Black, Indigenous, Latinx and Asian populations. The state of Minnesota's COVID-19 vaccination data by race and ethnicity already show that we are seeing vaccination rates in communities of color at about half the rate of whites even though mortality in some populations of color can be as much as five times higher.

Given these gaps, there's no question how important vaccine equity continues to be. Key strategies underway include prioritizing ZIP codes most affected, partnering with community organizations to aid in vaccine confidence and immunizations and broadening vaccine registration beyond digital platforms to include phone and in-person options.

But ensuring equity will also require us all — especially those of us in health care and public health — to confront the myths that continue to persist when it comes to vaccine equity, vaccine confidence and other barriers. As the chief medical officers of Minnesota's nonprofit health plans, we want to dispel these myths as we work with our public health leaders, providers and community partners to ensure equitable vaccinations. Let's start by addressing the following myths and facts:

Myth: Communities of color don't want to get the vaccine. If there's any inequity, it's by choice.

Fact: We must acknowledge historical trauma because it is real — brought on by our nation's history of unethical medical practices. That has understandably prompted distrust among those communities and contributes to lower vaccine confidence. It is our responsibility as a health care community to rebuild trust. We hope that by listening to and partnering with them, being transparent, answering questions and demonstrating sustained commitment to the health of all Minnesotans, we'll ensure the equitable vaccination of all.

Myth: The state is already prioritizing people in long-term care facilities, people ages 65-plus and front-line workers. There are many people of color in those populations, so we don't need an equity strategy for vaccines.

Fact: Vaccine distribution that prioritizes by age alone worsens the disproportionate toll of COVID-19 on Black, Indigenous, Asian and Latinx populations. The majority of these communities are younger and are at higher risk of exposure and death from COVID-19. Additionally, a colorblind vaccine strategy for front-line workers doesn't automatically mean people of color will be vaccinated at the same rate as whites. We need a vaccine strategy that reaches at-risk communities where they are, fights misinformation, reduces barriers to access and then responds when these communities tell us what they need to develop confidence in the vaccine.

Myth: We need to look at science, not race or ethnicity, to inform our vaccine strategy.

Fact: Minnesota's COVID-19 vaccination tracker shows that while communities of color are dying at a significantly higher rate than whites, they have lower vaccination rates. Our strategy needs to address what's already evident — the need to target and increase vaccinations in Black, Indigenous, Latinx and Asian communities.

Myth: Once everyone is vaccinated, it won't matter who came first.

Fact: If we don't develop a strategy that targets and increases vaccination rates for communities of color, they will continue to suffer COVID-19 illnesses and deaths disproportionately.

Myth: The COVID vaccine really isn't a safe or effective option for anyone.

Fact: Being vaccinated significantly reduces people's chances of getting sick from COVID, while helping to prevent infection in others. While no vaccine is 100% effective or safe, people are far better off getting the vaccine. It is our best chance at beating the pandemic, getting back to normal and refocusing on our goals. These are all reasons why we need vaccine equity.

Separating facts from myths is only one step toward achieving vaccine equity. Now we must ramp up efforts to partner with the state and community to develop and support strategies that ensure equitable distribution of the vaccine, address historical trauma and structural racism, and ensure culturally appropriate support for communities so that we build trust, increase vaccine confidence and improve the health of all Minnesotans.

Patrick Courneya is chief health plan medical officer at HealthPartners. Julia Joseph-Di Caprio is chief medical officer at UCare. John Mach is chief medical officer at Medica. Abigail Miller is chief medical officer at PreferredOne. Lucas Nesse is CEO, Minnesota Council of Health Plans. Mark Steffen is chief medical officer at Blue Cross and Blue Shield of Minnesota.