The COVID-19 vaccines are designed to protect everyone who receives the shots, regardless of race, gender, age, body type, but they are not getting to all groups in Harford County in an equitable manner, according to the local health officer.
“These are vaccines that are just molecules,” Dr. David Bishai said Tuesday. “The health system could have features of racism, but a molecule is a molecule.”
Bishai took part in a virtual forum with more than 200 members of the Harford Community College community Tuesday afternoon.
“Vaccines will play a large role in our ability to begin the process of reopening our campus,” HCC President Theresa B. Felder said during her welcoming remarks.
Felder noted that she is “especially grateful and impressed with Dr. Bishai’s desire to ensure that the most at-risk members of our community have access to vaccines, in an effort to ensure equity in our community.”
Bishai discussed the current state of vaccine distribution in Harford County, with an emphasis on how Black residents are getting the shots at a much smaller rate compared to white residents. The disease of COVID-19 is affecting Black and Hispanic residents at much greater rates than white residents of Harford, which mirrors disparities nationwide, and similar racial disparities are happening in vaccination rates nationwide.
“[There is] evidence that there are emerging disparities that are going to have a major effect on our ability to control the disease,” Bishai said.
He presented a chart showing the number of vaccines given by the Harford County Health Department, local hospitals and private pharmacies since January, with the health department dispensing the largest amount at close to 8,000, followed by University of Maryland Upper Chesapeake Health at about 6,000. Private providers such as the pharmacy at the Giant supermarket north of Bel Air are at the smallest end of the spectrum currently, with only a few hundred dispensed.
Bishai said he expects that spectrum to reverse as the state supplies more and more vaccines to private pharmacies and opens additional mass vaccination sites around the state. He does not expect a mass vaccination site to open in Harford County, however, despite a recent suggestion from county officials for the state to use Ripken Stadium in Aberdeen as such.
“By the end of the year, this bar chart will be completely turned around, [with] dozens of local pharmacies vaccinating the vast majority of the people in our county,” he said, adding that he expects the health department will account for about 20% of vaccines given countywide.
A yellow line was drawn across that same bar graph, showing the rate of white people getting the vaccine versus Black people.
The line shows about 10 white people for every one Black person at the health department and hospital level, which is similar to Harford County’s racial demographics, but it shoots up to an 18:1 ratio at the private pharmacy level. Bishai stressed that it is still early for pharmacies, though.
He also provided a breakdown by ZIP code to show which communities have the most people getting vaccinated. About 12% of people countywide have received a first dose of the two-shot vaccine, a rate that is above 15% in Bel Air and 14 to 15% in Fallston and Forest Hill. Rates are much lower in northern and southern Harford, though, such as below 10% in Whiteford and the lowest at 5% in Edgewood — Bishai said Edgewood is the community “most concerning” to him.
Another disparity shows in the rates of people who have signed up to be vaccinated. Out of the more than 32,000 people in Harford who have signed up to get a shot, about 17% are in Fallston, compared to about 6% in Edgewood.
“There’s a disparity in who I’m covering, and there is also a disparity in who is asking to be vaccinated,” Bishai said.
The health officer noted structural issues in how COVID-19 has affected different groups of people, and that many minorities have to go to work in person and “have not had the luxury of staying home, teleworking.” He also noted challenges in getting protective equipment at work, plus living conditions “that lead to more people moving in and out of their living quarters,” as well as lack of access to COVID-19 testing and medical care.
“There might also be the same structural reasons for the willingness to get vaccinated, due to this history of not being treated fairly by the health system,” he said.
Bishai stressed that the vaccine is an “anti-racist molecule,” based on messenger RNA that provides instructions to the immune system on how to make antibodies that protect a person from being infected by the novel coronavirus. He compared the messenger RNA to a Post-it note, or an order for a restaurant kitchen that can be shredded after the instructions are read, leaving no long-term side effects so far.
“This a molecule that can fix the impact of racism, and it troubles me that it’s not being allowed to do the work that it’s designed to do, because this is a vaccine that makes all people not get sick,” Bishai said.
Another major issue to getting people vaccinated is supply and the availability of appointments to get a shot. Statewide, about 2.5 million people who are in the 1A through 1C priority group have expressed a desire to get the vaccine, but there is only enough current supply to cover about 700,000 people, according to Bishai.
Vaccines made by Pfizer/BioNTech and Moderna, both of which require two doses several weeks apart, are currently available after getting emergency use authorization from the federal government in December. A third vaccine, a single-shot dose made by Johnson & Johnson, is being evaluated for emergency use. If that single-shot vaccine is approved, it could greatly improve the supply of doses available for Marylanders, Bishai noted.
“We would hope to get hundreds of millions of new Johnson & Johnson vaccines into the mix,” he said.
Those currently eligible for the vaccine include groups such as first responders, health care workers, teachers and other education staff and people 65 and older. The next group would be people younger than 65 who have chronic health conditions, followed by the general public. Bishai said July would be “a good guess” on his part as to when the general public could get vaccinated.
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He noted that the health department is able to vaccinate about 280 to 300 people a day, so it will “take a long time” to work through the more than 32,000 who have already signed up.
Those who want a vaccine appointment should visit the state’s website and enter their ZIP code to find a site nearby. A search Tuesday using the term “Edgewood” shows multiple sites where people can sign up for an appointment, include Walgreens pharmacies in Forest Hill, Bel Air, Abingdon, Joppa, Edgewood, Belcamp and Aberdeen, as well as the Giant on Rock Spring Road north of Bel Air and a CVS store in Havre de Grace.
Bishai acknowledged that people will have to check the website multiple times before a vaccine appointment is available, noting that “this repetitive process of going to [the website] is how people get vaccine appointments in Harford County” at the present time.
People also can call the health department to register — their main number is 410-838-1500 — plus a Facebook group, Harford Citizens Crush COVID-19, has been established to promote younger people calling their older relatives to encourage them to sign up or helping them get appointments.
Bishai also encouraged people to sign up for appointments in multiple locations, and if an appointment becomes available at a pharmacy before it is available through the health department, people should take the first available appointment.
As more people get vaccines through private providers, health department staff can spend their time finding people for whom outreach has not been successful.
“I will be able to focus on the disparities,” Bishai said. “It’s what the health department is designed for.”