Vaccine Inequity, How Pandemic Becomes Endemic

As of April 27th, Anthony Fauci has announced the United States moving out of the pandemic phase into what has been called by many the endemic phase. Over the course of the pandemic vaccines have been made and logistics strained in order to immunize the largest number of people. These practical concerns have been compounded by preexisting struggles, health inaccessibility and comorbidities. 

Inequity

To add to the many who avoid vaccination by choice there are many Americans who live in areas with underdeveloped health infrastructure. Even with vaccine efforts 60% of Americans and 75% of US children have had COVID-19 in some form. This increased rate of childhood infection in US children corresponds to those children being less vaccinated than their elders. 

COVID-19 in babies and children – Mayo Clinic

This under vaccination has its consequences as unvaccinated children from 5 to 11 years old were hospitalized with COVID at twice the rate of vaccinated children during the winter Omicron variant surge according to the Centers for Disease Control and Prevention. Along with just age there are racial disparities in COVID-19 vaccination that are indicated by a CDC study using data from 14 states. The C.D.C. report offered some of the strongest evidence to date that racial disparities in childhood vaccination might be leaving Black children more exposed to severe illness from COVID.

While the states that report racial vaccination data are few an analysis by the Kaiser Family Foundation found that vaccination rates ordered highest to lowest are Asian, White, Hispanic and Black in that order.

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Endemic; The Color of Health

The factors that lead to some communities being vaccinated or not are the same as those leading to general ill-health. Lack of access generated from poverty, discrimination or suspicion of the medical system contributes to the higher rates of obesity, addiction and infant mortality in non-white communities in the US. According to the Brooking’s institute, 33% of all Latinos were uninsured in the US prior to the ACA (affordable care act) and infant mortality for Black people is double that of White people.  Differences like these in healthcare coverage contributed heavily to negative health outcomes pre-pandemic and now make those communities more susceptible to infection even when controlling for vaccination numbers.

The COVID Racial Data Tracker | The COVID Tracking Project

Much like Dr. Fauci, EU officials said that the EU was moving out of the emergency phase of the pandemic. While there is some truth to this; regions within European and other countries still struggle with new strains and outbreaks. Much the same can be said for regions of the US with a high population of racial and ethnic minorities. These regions will likely develop endemic COVID due to the lack of adequate healthcare and risk being the origin of any new strains of COVID that originate in the US. This likelihood of infection also poses the risk of tempting governments into simply isolating these regions and driving them deeper into poverty and so continuing the cycle of poor health. Why would China bother with medical treatment in Xinjiang if they could just restrict travel to and from the region?

If the US, or any country for that matter, would like to maintain control of their cases of COVID these endemic regions will need to be resolved. Health outcomes need to be improved for everyone within a country unless these endemic regions will fester. While researchers and medical professionals often focus on the mechanics of health, even this field isn’t divorced from politics and human prejudice.

Author

Eduardo Longoria

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