Giving everyone a fair shot: Health officials focus on equity in vaccine distribution

Social Vulnerability Index used to identify populations in need of resources

MADISON, Wis. – From the lost memories of what could have been to the painful new ones, there’s nothing fair about COVID-19.

“This is a terrible crisis. We’ve lost over half a million people,” said Tiffany Green, assistant professor of population health sciences at UW-Madison. “That number keeps me up at night.”

For some, the virus has been especially unfair.

“I think we do have to consider groups that have been disproportionately affected by COVID relative to their share of the population,” Green said. “We know the Hispanic population is more likely to get COVID relative to non-Hispanic whites, that Black Wisconsinites are more likely to be hospitalized and Native American Wisconsinites are more likely to die from COVID-19.”

Green points to structural factors always lurking, further exposed during the pandemic.

“We are seeing a lot of people that want the vaccine and can’t get it,” Green said. “This is a reflection of low supply, but it’s also a reflection of differences in access to care.”

“Our communities of color have been hospitalized and dying at much higher rates than any other community,” said Shiva Bidar-Sielaff, vice president and chief diversity officer at UW Health. “The reasons behind that are reasons of structural racism that continue to exist in our country today, and the one and only moral way to respond to that is by making sure that, now that we have one way of preventing COVID-19, the vaccine, we ensure those that have suffered the most have the most access.”

UW Health focus on racial equity

While Bidar-Sielaff said UW Health is still evaluating how it will tackle equitable vaccine distribution as Phase 1B eligibility expands in March, it’s already been a focus.

“We at UW Health are very committed to using a racial equity lens in our vaccine prioritization,” she said.

So far, that has meant sending the first round of 1B vaccine invitations for those 65 and older to higher risk patients, including Black, Latinx and Native American patients, Bidar-Sielaff said. When determining who of their Phase 1A employees to vaccinate with the first round of doses, they used an algorithm taking into account age and the Social Vulnerability Index, a tool provided by the CDC for times of disaster.

“The Social Vulnerability Index is one way to really be able to determine those who are potentially at higher risk,” Bidar-Sielaff said. “Generally speaking, at higher risk of hospitalization, death, being affected by any kind of emergency.”

The SVI takes into account factors such as socioeconomic status, minority status, disability, age, housing and transportation access over zip codes and counties.

Rock County public health officials meet vulnerable populations where they are

When set to a map at the county level, the SVI shows Rock County at a moderate to high level of vulnerability, one of the highest in southern Wisconsin. Rock County public health officials see it play out specifically in urban settings such as Janesville and Beloit.

“Poverty, race, language, disease burden, age, lack of access to transportation and housing are considered in our vaccination efforts,” said Alison Chouinard, community health education coordinator and vaccination coordinator with the Rock County Public Health Department.

They’re able to identify neighborhoods where extra resources are needed. They focus on homebound and vulnerable senior living populations, as well.

“The more we can communicate specifically to specific neighborhoods, those that are more vulnerable, it increases their access to more appointments,” Public Health Supervisor Kelsey Cordova said. “We’re able to specifically target and bring resources to communities without necessarily putting them higher on the list.”

That can mean bringing vaccine information directly to local businesses and leaders.

“We’re looking at meeting people where they are in their communities where they live, including churches and community centers,” Public Health Supervisor Lori Soderberg said.

However, it’s not a one-way street. Cordova stressed the importance of listening.

“Whatever barriers we identify through listening to communities, we’re able to mitigate them,” she said.

Public vaccination site opens at Blackhawk in Janesville

Janesville is now home to Wisconsin’s first public regional vaccination site at Blackhawk Technical College, where community testing is also offered – a service Rock County public health officials stress is still critical, along with precautions such as masking and distancing.

The vaccination site will start with the goal of vaccinating 1,000 people each week

“The State has seen the need we have in Rock County,” Soderberg said.

The Wisconsin Department of Health Services has a number of considerations when it comes to vaccine distribution across the state, including the SVI, according to its media team.

Rethinking health care before the next pandemic

“I think we are making good efforts, particularly with putting vaccine centers in places like Rock County that rely on community-centered health care providers,” Green said, adding that the state as a whole can do better.

As the pandemic numbers keep her up at night, she’s thinking about a more fair tomorrow for vulnerable populations.

“I think it’s very important … (we) look at making long-term investments in public health infrastructure, so that when the next pandemic comes, and it will, we are prepared,” Green said.