In my last posting on preparedness for a post-vaccination world I touched on some of the questions facing employers in general – policy questions that should be considered now for the eventualities of later. But digging a little deeper, there are also questions to consider with respect to support for ensuring access to vaccines by communities of color. All employers have a stake in the issue of enhancing access for minorities to vaccination, but large multi-state employers, those that may be smaller/regional employers with a disproportionate share of minority employees, and of course minority owned businesses all are enhanced stakeholders. Particularly for those businesses that have supported initiatives for diversity and inclusion as a response to the issues of social justice, this is where the rubber meets the road.
Here is the issue. First of all disparities in healthcare have had an overwhelming impact on minority outcomes and causing a disproportionate impact of burden across many disease states. COVID-19 has cast a particularly harsh light on this fact where minorities in the U.S. are dying at younger agents and in greater numbers than non-minorities. Conversely, while vaccine hesitancy has been identified as a factor in the uptake of vaccines, there is a higher reserve of mistrust regarding vaccines on the part of African-Americans. With higher and harsher incidence, and higher mistrust, access to, and education about, COVID-19 vaccines is an imperative – both ethically and from a public health perspective.
However, once a COVID-19 vaccine, or multiple vaccines, are licensed and approved, distribution of the vaccines will be guided by states. The Centers for Disease Control (CDC) directed U.S. health jurisdictions to develop plans for distribution which were submitted and reviewed by the agency. A recent review of these state plans by the Kaiser Family Foundation (KFF) found the following:
- 53 percent of the states had “at least one mention incorporating racial and/or ethnic minorities or health equity considerations in their targeting of priority populations”, meaning that nearly half do not;
- In identifying providers for vaccinations, only one-fourth of the state plans discuss making use of providers needed to reach racial minorities;
- Only half of the plans address communications approaches/needs for outreach to minorities or vulnerable populations;
- Only one-third of the plans mentions the consideration for addressing vaccine misinformation, but even those that did lacked specific strategies for countering misinformation
- In addition, states indicated that there were limitations in collecting ethnicity data on vaccinated individuals.
That there are deficits in these plans comes as no surprise given the gravity of the situation and the compressed timeframe for response. So what should businesses be considering? Given the high level of need and the considerable gaps there are some public affairs opportunities that may serve to help the situation.
- Large employers may wish to review state plans in which they are doing business to assess the deficits that may exist with respect to their employees with particular regard to minority issues related to vaccination. A list of the state plans compiled by KFF can be found here.
- Identify the gaps in planning and communications that might be addressed through employer-based programs:
- Development of mechanisms to address vaccine misinformation and enhance education – or alternatively programs that curate third-party information and make it available;
- Assess potential of public/private partnerships that might address state or regional planning and communications deficits;
- Perform company-specific research of employee knowledge, attitudes and beliefs around vaccination to inform messaging and program development;
- Leverage public affairs clout to pressure state health officials to address gaps in planning and communications vis a vis minorities;
- Consider public statements of support (op-eds, paid advertising) for addressing healthcare disparities in COVID care and vaccination programs and seek and enter into coalitions with other employers.
How well we come out of this will depend on how well we manage the vaccination of enough people to actually make a difference in the course of the pandemic. Anything that falls short for any of us, falls short for all of us.