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How California Is Trying — And Struggling — To Reach Vaccination Equity

ARI SHAPIRO, HOST:

All over the country, coronavirus vaccines have disproportionately gone to white, wealthy people, not the Black and brown communities where people have been getting sick and dying in higher numbers. California tried to address that problem. The state set up mass vaccination sites in underserved communities and created special access codes for people living in those areas to book their appointments. Still, the vaccination rates for people of color in cities like Los Angeles lag behind white people in the city. Dr. Paul Adamson is with the UCLA David Geffen School of Medicine and joins us to talk about this.

Welcome.

PAUL ADAMSON: Hi, thanks for having me.

SHAPIRO: You've worked at vaccination sites in LA. Tell us what you see.

ADAMSON: Yeah. So I was at one of the mass vaccination sites here in Los Angeles. It's in Inglewood, which is a community of predominantly Black and Hispanic. I would say most of the people that were vaccinated were largely white, largely elderly. And there were folks, you know, who had family members there bringing them to the appointments. And a lot of the family members talked to me about how difficult it was to get appointments and about how it took, you know, so many of their families to be on their computers all day, refreshing websites in order to get those kind of hard-to-get vaccination appointments.

SHAPIRO: As I mentioned, the state took steps to try to address this problem. I mean, they went so far as to give out special booking codes to neighborhood groups to help less privileged people get these slots. Why didn't those steps work?

ADAMSON: The mass vaccination sites were kind of deliberately put into these communities in order to address these issues around vaccine equity and improving access to the vaccines. But you know, geographic proximity does not necessarily ensure access. And I think we saw this kind of come out with the vaccine access codes, where, you know, the vaccine site's located in the community in a system that is deliberately designed to prioritize those members. But you know, yet - our relying on technology sort of led to these access codes that were then used in wealthier, you know, more affluent, well-connected communities that were then able to take the vaccine slots that were prioritized for those within that community.

SHAPIRO: Based on what you've seen, is this problem of equity solvable? And if so, how do you solve it, given that the things that the state of California has tried apparently haven't worked?

ADAMSON: It's a little bit hard to say. It's a complicated problem, and I don't think there's necessarily a one-size-fits-all approach. I do think there are things that can help, so I think - you know, trying to do a better job of involving our community health centers and our primary care clinics in our vaccination efforts. I think these health organizations have had strong relationships in the communities they serve, and they can be leveraged as part of this vaccination campaign.

And I think we could probably do a better job of ensuring vaccine access in our hardest-hit communities by doing things like distributing vaccines based on zip codes, which would allow us to really focus our efforts on those most vulnerable communities that were hardest-hit by the pandemic - and you know, not just necessarily putting a vaccine clinic in those zip codes, but really trying to do outreach in the zip codes and ensuring that the vaccines are going to the people who live in those communities.

I've seen - also seen these great examples in Los Angeles recently of these pop-up vaccination sites that they've done in local parks, where they've allowed for walk-up appointments for community members, even arranged for transportation from a local senior center. There's been mobile units and vans that can kind of go out to communities that maybe don't have as much access to the vaccination sites, and they could be used to do additional outreach but also offer vaccines there.

SHAPIRO: Is there any hope that the Johnson & Johnson vaccine could help increase the number of Californians who'll get vaccinated now that there will be three in circulation rather than two?

ADAMSON: Yeah, definitely. I think that the Johnson & Johnson vaccine is exciting for a number of different reasons. It has a longer shelf life. You know, you can think about it being used in more rural areas, and maybe it could be used to get out to the farmworkers and meet farmworkers where they are and get them vaccinated. And I think, also, it just adds to the supply that we have. And so anything that adds to the supply that we have is going to be a welcome addition to our vaccination efforts.

SHAPIRO: That's Dr. Paul Adamson, a fellow in infectious diseases at the UCLA David Geffen School of Medicine in Los Angeles.

Thanks a lot.

ADAMSON: Thanks so much for having me. Transcript provided by NPR, Copyright NPR.

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