SC has yet to post race, ethnicity data on COVID-19 vaccine progress. Are there disparities?
Update: The S.C. Department of Health and Environmental Control began to release vaccine demographic data on Feb. 15.
South Carolina has yet to publish a demographic breakdown of people vaccinated against COVID-19 in the Palmetto State, while dozens of other state health departments already release daily or weekly vaccine data by race, ethnicity, gender or age group.
The S.C. public has no way of knowing the percentage of Black or white South Carolinians inoculated thus far. And there’s no way to calculate the rate of vaccinations among Latino residents.
Those figures are particularly important given COVID-19’s disproportionately large impact on communities of color since the pandemic began.
Laura Renwick, a spokeswoman for the S.C. Department of Health and Environmental Control, in a Tuesday statement wrote that DHEC plans to launch a public vaccine data portal “in the coming weeks.”
The online portal will include race, ethnicity, gender and age group information, she wrote.
Renwick added that DHEC wants to provide an accurate picture of its vaccine distribution since mid-December. The agency, she wrote, is working to “pull together” state-specific demographic data that are housed in a federal software platform that tracks vaccinations at long-term care facilities.
Health experts in interviews Thursday, though, said it’s crucial that states release demographic data “sooner rather than later” to promote public trust in the rollout, help address vaccine hesitancy and analyze any planning shortfalls.
Vaccine disparities are already being reported around the United States.
Twenty-nine states as of Thursday had published some form of demographic data, including North Carolina and Tennessee, according to an Island Packet and Beaufort Gazette review of health department websites.
South Carolina and 20 other states had not.
“I think they’re behind the curve now,” said Dr. Georges C. Benjamin, executive director of the American Public Health Association. “If they’re not doing it, they ought to be able to get it done in a couple weeks.”
‘You don’t know what you don’t know’
It’s difficult to judge the effectiveness of South Carolina’s vaccination campaign without demographic data from the state, partly because the Centers for Disease Control and Prevention hasn’t released that type of information yet, either.
DHEC has repeatedly said it’s committed to an equitable rollout, but statewide dose totals for the Pfizer-BioNTech and Moderna vaccines, along with facility-level allocation numbers, only provide a glimpse into who’s getting inoculated.
“It’s extremely important to capture and correlate and release data by age, race, gender and ethnicity,” Benjamin said. “If you’re doing a good job vaccinating all populations, and you tell people that you’re doing it, then you’re much more likely to get them to comply with other public health interventions. If they don’t trust you, they think you’re hiding information, why would they comply with you? They won’t.”
South Carolina is using a phased approach to distribution. Health care workers, people 70 or older, some hospital inpatients and long-term care residents and staff qualify for shots during the earliest phase of the state’s plan, which is ongoing.
Up to 308,375 people in the state have received their first dose of Pfizer or Moderna’s vaccines, data show.
The second stage of distribution, called Phase 1b, will likely include essential workers such as teachers, grocery store employees, agricultural workers and others. Phase 1b is expected to begin sometime this spring. Later phases will include the general public.
“DHEC and its partners continue to work to get the vaccine into as many people’s arms quickly, safely, equitably and ethically,” Dr. Brannon Traxler, the agency’s interim director of public health, told reporters Thursday.
But other health departments are already reporting vaccine disparities, including some with rollout plans that are similar to South Carolina’s.
Only 11% of those vaccinated with a first dose in North Carolina so far have been Black, and 2% have been Hispanic, according to state data that excludes shots administered at long-term care facilities through a federal program.
White people, meanwhile, have accounted for 82% of first dose recipients in the state.
More than 119,000 Black people in North Carolina have contracted the coronavirus since early 2020, totaling 20% of cases in the state. Hispanic residents have accounted for 23% of cases.
North Carolina is currently vaccinating health care workers, long-term care residents and staff and people 65 or older.
Louisiana, which has yet to publish ethnicity data, says about 10% of those inoculated with at least one dose have been Black, even though Black residents make up 39% of COVID-19 deaths in the state.
More than 32% of Louisiana’s vaccine recipients have been white (race is “unknown” for about 21% of its recipients).
Louisiana is inoculating health care employees, people 70 or older and residents at nursing homes and assisted living facilities.
In Mississippi — which recently expanded its vaccine pool to include people 16 to 64 years old with a range of underlying health conditions — 69% of vaccine recipients have been white and 16% have been Black. Only 1% have been Hispanic (ethnicity is unknown for 14% of recipients).
Those percentages are important to monitor, considering COVID-19’s nationwide impact on communities of color, health experts say.
Black people have died of the coronavirus at 1.5 times the rate of white people in the United States, according to The COVID Racial Data Tracker. And 123 deaths have been reported per 100,000 Hispanic or Latino residents since early last year, in comparison to 100 deaths recorded per 100,000 white people.
In South Carolina, Black residents have accounted for 36.5% of all coronavirus hospitalizations since the start of the pandemic, but made up an estimated 27% of the population in 2019, according to U.S. Census Bureau data. Black people as of Thursday also accounted for 28.2% of COVID-19 deaths in the state.
Many people of color are essential workers at a higher risk of exposure to the coronavirus, experts have noted. And long-standing inequities in health care, housing, education and the U.S. economy have contributed to the pandemic’s death rates, according to the CDC.
But it’s still impossible to say how many South Carolinians of color have been inoculated against the pathogen.
“You don’t know what you don’t know,” said Uchechi Mitchell, a health inequity researcher and professor at the University of Chicago at Illinois’ School of Public Health. “It is definitely a social justice issue to improve access to these (vaccine) datasets for the communities.”
‘That builds trust’
Vaccine demographic data could help states quickly identify whether the people most at risk of contracting the coronavirus have access to shots, Mitchell said.
“Maybe you are not on the right track,” she said. “The only way for you to course-correct is if you have data showing that you’re not necessarily achieving the goals that you set out for yourself as an agency.”
But publicly releasing the data has other benefits, according to health experts.
Residents may use the information to decide they should call local elected leaders to demand better access to vaccines, Mitchell said.
State officials could also share the data with different health departments, she said, to learn what’s working and what’s not around the country.
Benjamin, of the American Public Health Association, added that disclosing demographic data might confirm some vaccine disparities, but after fixing those issues or adjusting distribution plans, states could point to their work as proof that public health officials care about underrepresented groups.
“That builds trust,” which is important in the early stages of the vaccination campaign, he said.
Vaccine hesitancy, Benjamin stressed, is already being reported nationwide, including in long-term care settings.
Tricia Neuman, executive director of the Kaiser Family Foundation’s Program on Medicare Policy, in a December interview said staff at nursing homes and assisted living facilities are disproportionately people of color, women and lower-income workers.
“Communities of color have well-grounded concerns about being first up in the rollout of a vaccine, and all of those questions have to be answered head on and honestly and directly, so that people do feel safe and comfortable,” Neuman said.
Black residents and other historically marginalized communities in the United States have faced racism in the nation’s health care system for decades.
Many remain wary of the medical establishment, pointing to infamous cases of exploitation that still reverberate today, including the Tuskegee Study.
That experiment began in 1932 after researchers at the U.S. Public Health Service, working with the Tuskegee Institute, recruited 600 Black men in rural Alabama for a project to study syphilis. Roughly 400 of them had the disease.
Yet even after penicillin was recommended as syphilis’ standard treatment in the 1940s, doctors continued to give the men placebos, and let some of them go blind, die or suffer from other serious health complications.
The Kaiser Family Foundation in a December poll found that 35% of Black adults in the U.S. say they definitely or probably wouldn’t get a COVID-19 vaccine.
Roughly 48% of Black Americans, meanwhile, say they aren’t confident that the development of a vaccine took the needs of Black people into account, according to the poll. And 36% of Hispanic adults say the same about the needs of Hispanic people, the poll found.
About a quarter of all U.S. residents say they definitely or probably wouldn’t get inoculated, the foundation reported last month.
DHEC’s plan
At the beginning of the pandemic, some states struggled to quickly report all COVID-19 testing data, Benjamin said, partly due to a patchwork of collection methods.
DHEC seems to be dealing with similar issues now as it works to release more vaccine information.
Renwick, the agency’s spokeswoman, on Thursday wrote that the CDC’s new Vaccine Administration Management System, or VAMS, requires people to input their race, ethnicity, gender and date of birth when registering for an appointment. S.C. hospitals use VAMS to schedule shots.
Data in VAMS are eventually funneled into the Statewide Immunization Online Network, or SIMON, which is South Carolina’s vaccine registry. Pharmacies in the state send COVID-19 vaccine data directly into SIMON, Renwick wrote.
But data collected as part of the CDC’s Pharmacy Partnership for Long-Term Care Program are housed in a national software platform called Tiberius, Renwick wrote.
CVS and Walgreens, through the CDC program, have been running hundreds of vaccine clinics at the state’s nursing homes and assisted living facilities.
“We’re working to pull together demographics for the long-term care vaccination efforts,” Renwick wrote, “since nearly 40,000 South Carolinians have been vaccinated through that effort and should be represented in our total statewide picture.”
The new vaccine data portal, Renwick wrote, will “unify all the data sources,” including information from Tiberius. (North Carolina, for example, on its vaccine website says its demographic information doesn’t include Tiberius data collected through the CDC program.)
Renwick didn’t provide a launch date for the portal, writing that it will go live “in the coming weeks.”
“I understand not rushing it, because bad data in is bad data out,” said Mitchell, the health inequity researcher and professor. “But it comes part and parcel with the marketing campaigns that you put forth, where you send out the vaccine, what hospitals get them first.
“We need data. That’s what helps us figure out how well we’re doing.”
Editor’s note: Data in this story are current as of early Friday.
BEHIND THE STORY
MOREHow we did this story
The Island Packet and Beaufort Gazette reviewed state government web pages late Thursday to determine which health departments have published demographic data on COVID-19 vaccinations.
The following states as of Thursday had started to regularly publish some form of demographic data (race, ethnicity, gender or age group): Alaska, Colorado, Delaware, Florida, Indiana, Kansas, Louisiana, Maine, Massachusetts, Maryland, Michigan, Minnesota, Missouri, Mississippi, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Vermont, Virginia, West Virginia and Wisconsin.
The following states had not: Alabama, Arizona, Arkansas, California, Connecticut, Georgia, Hawaii, Idaho, Illinois, Iowa, Kentucky, Montana, Nevada, New Hampshire, New Mexico, New York, Oklahoma, South Carolina, Utah, Washington and Wyoming.
Data referenced in this story are current as of early Friday.
This story was originally published January 29, 2021 at 3:00 PM.
