As the pace of vaccine distribution speeds up following major eligibility expansions, a larger share of first doses in New Orleans — a majority Black city — is going to white residents, state data shows.
On March 9, Gov. John Bel Edwards announced that anyone over the age of 16 with a wide list of pre-existing conditions would be eligible for the vaccine. By many estimates, that expansion covered 70 percent or more of New Orleans adults. And on March 18, an expansive list of front-line workers, including food service employees, grocery store workers, and construction workers were made eligible.
At the same time, mass vaccination sites, neighborhood events, and growing availability at pharmacies have expanded options for sign-ups.
Up to that change, roughly the same proportion of first doses had gone to Black and white New Orleanians. Louisiana Department of Health data on New Orleans from March 9 showed that 45 percent of first doses had gone to Black residents, and 44 percent to white residents. The state does not report parish-level data for any other race or ethnicity.
But since eligibility expanded, a much smaller share of first vaccines have gone to Black people. Between March 9 and March 22, 33,000 more people have started vaccinations in New Orleans. Thirty-six percent of them are Black, while 53 percent are white, according to state data. In total, about 47 percent of vaccines initiated in New Orleans have gone to white people — who represent about 34 percent of the city’s population — and 42 percent to Black people — who represent 60 percent of the city’s population.
Statewide, 26.6 percent of first doses have gone to Black residents. The state as a whole is about 32 percent Black.
City leadership has emphasized the need for racial equity in their vaccination plans, since non-white residents have born the brunt of COVID deaths, hospitalizations, and job losses.
“It is imperative as a city, that those at the highest risk of death have access to the life-saving intervention that is a vaccine,” Dr. Jennifer Avegno, New Orleans’ Health Director, said at a March 9 press conference.
“This is a general trend we are seeing every time new eligibility criteria open,” Sarah Babcock, the New Orleans Health Department director of communications, told The Lens on Friday.
Babcock said that based on what the Health Department hears from providers, the trend is likely due to overlapping access issues.
“When new eligibility criteria open, our demand skyrockets, while supply stays the same,” she said. When that happens, people who have flexible jobs, and more time to hunt for appointments, tend to fill up available slots. “They can call 17 different providers to get an appointment really quickly,” or sign up online. “That’s generally going to be a whiter group of people.”
The city’s hotline for convention center appointments has had wait times longer than 10 minutes, and as social media forums, like NOLA Vaccine Hunters on Facebook, and Louisiana Vaccine Alerts on Twitter, demonstrate, finding open appointments at other sites can be full-time work. State officials have argued against a centralized sign-up system wouldn’t help the issue, saying that if it were to go down, it would create more chaos than the current system.
The city of New Orleans runs its own neighborhood vaccine sites, administering 400 to 600 doses a week. In a March 16 press conference, New Orleans Office of Homeland Security and Emergency Preparedness spokesperson Laura Mellem said that more than 60 percent of those doses were going to people of color.
She also said that more than half of doses distributed at the Ernest N. Morial Convention Center vaccination site, a partnership between the city and LCMC Health, had gone to people of color.
Babcock said that the number of vaccines going to national chains, like CVS, Walmart, and Walgreens, may be contributing to the trend.
The city doesn’t have as much input in how doses at national chains are distributed.
“Those chains reach a lot of people,” she said. “Unlike your independent pharmacies and the Health Department who are trying to specifically target groups, [they] are just opening appointments to anyone, and don’t necessarily have the same equity lens that other partners do.”
Even at CrescentCare, a federally qualified health center that serves a low-income population, vaccine sign-ups have tended white.
“Our patients are exactly who should be prioritized for getting the vaccines,” Katherine Conner, CrescentCare’s vaccine manager, said but they aren’t filling up the spots. About 58 percent of CrescentCare’s patients are Black, but “only about 40 percent of the people that we’re vaccinating are Black.”
Because of state guidelines, the clinic can’t restrict sign-ups to its long-term patients, although it can reach out to them to ask them to sign up.
But “when they open up the eligibility, or when there’s a press conference, we get hundreds of calls in an hour,” Conner said. Those callers tend to be whiter than CrescentCare’s patients.
Conner also said she’s been finding that many CrescentCare patients aren’t aware that they’re eligible. The clinic has started reaching out to patients to communicate that information directly, both over text and in telemedicine appointments. “We recognize that some of our patients don’t know when eligibility changes. They’re not necessarily able to catch that press conference if they’re at work.”
Babcock said that the city believes information access issues are part of the larger racial inequities, and pointed to similar outreach campaigns by the city. According to a 2019 city of New Orleans digital equity overview, between 20 and 33 percent of households don’t have home internet, and people who are “low-income, minority, female, elderly, minor, or live with a disability” are less likely to have internet access.
“As we do outreach into small neighborhoods, going to churches to try to find people, we’re still finding people who don’t know that they’re eligible,” she said.
Babcock briefly brought up the question of hesitancy, saying that “initially, there was a lot of talk about hesitancy among Black residents, but as we go, we’re seeing less and less of that.” A recent survey from NPR/PBS NewsHour/Marist has found that, at least nationally, hesitancy is about equal in Black and white populations, and is highest among Republican men.
A WWNO/WRKF analysis published last Thursday suggests that elements of those attitudes hold true in Louisiana: White people in Republican-voting parishes are undervaccinated compared to the state as a whole. The analysis also found that Black people are under-vaccinated in 57 out of 64 parishes.
“We’ve continued to support the Convention Center, and support healthcare providers to expand out into the community,” Babcock said, including providing staffing for Saturday vaccine events at CrescentCare, and helping Franklin Avenue Baptist Church with scheduling for drive-through events.
Last Thursday, LDH also announced a new initiative to get more vaccines into undervaccinated communities. The initiative, called “Bring Back Louisiana,” will begin holding community vaccine drives in partnership with local groups in April.
“We’re going to be marrying data that shows which communities are doing better and worse, and what their social vulnerability is, with actual access to the vaccine,” said Dr. Joseph Kanter, the assistant state health officer, in a press conference last Thursday. “So imagine canvassing efforts, knocking on doors and reaching into communities, not only to engage and talk about the vaccine … but to offer to sign people up for an event.”
NOLA Ready is one of those local partners, and City Hall spokesperson LaTonya Norton said in a statement that “NOLA Ready outreach staff have been working with local organizations and volunteers to go door-to-door in neighborhoods spreading information about COVID vaccines and appointments,” and that the program might be expanded. However, she directed further questions about the shape of the program in New Orleans to LDH, which did not answer questions by publication.
Conner, of CrescentCare, said that those kinds of partnerships with community organizations would be key to getting vaccines to more people of color. But, she said that CrescentCare’s efforts to do that have been slowed by unpredictable deliveries. “It’s hard to go to a church and say, we want to vaccinate 100 people,” she said, when they don’t know how many doses they’ll get until the last minute. The issue, she said, is the same as it’s been for months: she needs more supply.