Vaccinated America is leaving the most vulnerable people behind

Unvaccinated people are not randomly distributed. They tend to cluster together, socially and geographically, enabling the emergence of localized COVID-19 outbreaks. Partly, these clusters exist because vaccine skepticism grows within cultural and political divides, and spreads through social networks. But they also exist because decades of systemic racism have pushed communities of color into poor neighborhoods and low-paying jobs, making it harder for them to access health care in general, and now vaccines in particular. “This rhetoric of personal responsibility seems to be tied to the notion that everyone in America who wants to be vaccinated can get a vaccine: You walk to your nearest Walgreens and get your shot,” Gavin Yamey, a global-health expert at Duke, told me. “The reality is very different.” People who live in poor communities might not be near vaccination sites, or have transportation options for reaching one. Those working in hourly jobs might be unable to take time off to visit a clinic, or to recover from side effects. Those who lack internet access or regular health-care providers might struggle to schedule appointments. Predictably, the new pockets of immune vulnerability map onto old pockets of social vulnerability. According to a Kaiser Family Foundation survey, a third of unvaccinated Hispanic adults want a vaccine as soon as possible—twice the proportion of unvaccinated whites. But 52 percent of this eager group were worried that they might need to miss work because of the reputed side effects, and 43 percent feared that getting vaccinated could jeopardize their immigration status or their families’. Unsurprisingly then, among the states that track racial data for vaccinations, just 32 percent of Hispanic Americans had received at least one dose by May 24, compared with 43 percent of white people.