HHS offers best practices for improving COVID-19 vaccine equity

COVID-19 vaccine providers need to take more steps to ensure equitable distribution of vaccines, the Health and Human Services Department’s Office of Civil Rights recommended in a Wednesday advisory.

OCR recommended vaccine providers to maintain accurate data collection, partner with community organizations, strategically locate vaccination sites and more to ensure equitable distribution of vaccines. Providers should review policies to make sure they facilitate equal access. Instructions on how to get appointments and information on vaccine availability should be clear and written in an appropriate language for the community providers are trying to reach.

Data is another crucial part of vaccine equity, and providers should track demographic data on who has received shots to keep track of access, OCR advised. Providers should consider disaggregating data for racial and ethnic minorities, especially Asian and Pacific Islander communities.

Community-based organizations like faith-based groups and civic associations can help providers design culturally competent communication on vaccines, including frequently-asked question sheets, OCR said. Targeted outreach to people with low internet access and within immigrant communities is especially important. Engagement with immigrant communities should emphasize that immigration authorities generally don’t carry out enforcement operations at or near healthcare facilities.

Additionally, placing vaccination sites directly within communities of color could also help make vaccine distribution more equitable. Providers can even partner with property managers and senior living facilities to bring vaccine clinics into housing developments.

OCR released the guidance on the heels of President Joe Biden’s latest mitigation plan for the COVID-19 omicron variant, which calls for all Americans to be fully vaccinated against COVID-19 and receive a booster shot if eligible. About 62% of Americans are currently vaccinated, and about 31% of fully vaccinated people have gotten boosters.

“If you’re not fully vaccinated, you have good reason to be concerned. You’re at a high risk of getting sick,” Biden said Tuesday.

Vaccination—and booster—rates for Black and Latino people still lag behind those of white people, but disparities in first doses have lessened since vaccine rollout began, according to the Kaiser Family Foundation. Since March 2021, 51% of Black Americans and 56% of Hispanic Americans have received at least their first vaccine dose, compared to 58% of white Americans. Seventy-seven percent of Asian Americans have gotten at least one dose of the COVID-19 vaccine.

Vaccine equity has been a concern since before shots were even authorized last year. Hospitals, state agencies and other providers have worked to build community partnerships and improve access. The federal government has given out billions of dollars in grants to states and community organizations to facilitate equitable vaccine distribution.

A history of discrimination has heightened health disparities and limited access to care, which have in turn contributed to the disproportionate toll of the virus on Black, Native American, Latino and Asian and Pacific Islander communities. Research also shows Black and Latino people are more likely to delay or refuse the vaccine because of that history of discrimination and related medial mistrust, as well as increased exposure to misinformation and concerns about side effects, OCR says.

OCR reminds providers that state or local healthcare authorities may not legally establish policies that allow priority access to vaccines based on race, color or national origin without a legitimate nondiscriminatory reason.

This also applies to vaccine administration methods, OCR says. Strict requirements to book vaccine appointments online could limit access, regardless of the policy’s intent. Descriminiation could also look like longer wait times or worse distribution facilities in Black communities compared to white ones, according to OCR’s guidance. By law, providers also have to make information available to all customers information on non-discrimination laws and how to file a discrimination complaint.