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Should minority communities in Utah be prioritized for vaccine?

Marlon Armirez collects saliva for COVID-19 testing through the Wellness Bus and a University of Utah Health medical team at the Utah State Fairpark in Salt Lake City on Tuesday, Dec. 29, 2020.
Marlon Armirez collects saliva for COVID-19 testing through the Wellness Bus and a University of Utah Health medical team at the Utah State Fairpark in Salt Lake City on Tuesday, Dec. 29, 2020.
Kristin Murphy, Deseret News

Families in Utah are generally withstanding COVID-19’s economic and health impacts better than those in many other states, according to a new national study that calls for prioritizing the needs of racially diverse communities hardest-hit by the pandemic and ensuring access to the vaccines.

But it’s not clear if Utah’s minority communities will be prioritized to get vaccinated against the deadly virus.

Latinos and Hispanics make up just over 14% of the state’s population but account for nearly 23% of the coronavirus cases and have recorded the second-highest number of deaths — 213, according to the most recent count.

Several communities on the west side of Salt Lake City have been declared hot spots.

In contrast, 78% of Utahns are white, but less than 61% of those who tested positive and 816 who died from the virus fall into that demographic. Pacific Islanders are the only racial or ethnic group other than Latinos and Hispanics in Utah whose caseload is larger, at 2.6%, than their share of the population, 1.6%.

So far, those in line for the vaccines that began to be distributed in mid-December in Utah are front-line hospital and other health care workers, including on tribal reservations, as well as long-term care facility residents and staff. Teachers and school staff, and first responders are up next, followed later by those 75 or older.

Racial and ethnic minorities at higher risk are on the list of groups still being considered for priority status, along with those who have underlying medical conditions; tribal communities; those younger than 75 but still considered older; and prisoners, homeless shelter occupants and others living in congregant settings.

“It’s really difficult to say who goes first,” said Utah House Minority Assistant Whip Angela Romero, D-Salt Lake City, who’s working with the Utah Department of Health alongside other lawmakers whose constituents have been disproportionately impacted to ensure testing and other coronavirus services reach the state’s hot spots.

Romero said she supports using age to determine who gets priority in the second phase of vaccinations, likely to begin in mid-February, rather than adding racial and ethnic groups to the priority list.

“I think everyone wants to make sure everyone has access to the vaccine and it’s really difficult when prioritizing, There’s always a group of individuals who need access. So for us, it’s hard to pit one group against another group. For us, it’s about making sure that people, when it is their time to get the vaccine, they get the vaccine,” she said.

Her concern isn’t about prioritization but “more is about access. And my concern is about people actually getting the vaccine because of the history of communities of color in the United States and trust of government.”

The recently released 22-page policy report from the Annie E. Casey Foundation, titled “Kids, Families and COVID-19, Pandemic Pain Points and the Urgent Need to Respond,” found that the number of Utahns affected by three of four areas of identified concern were below the national average.

Seven percent of Utah adults with children in their homes, surveyed by the U.S. Census Bureau between mid-September and mid-October, said they didn’t have enough food — half of the national average — while 12% had little or no confidence they could make their mortgage or rent payment on time, compared to 18% nationwide.

Nine percent of Utah adults living with children said they didn’t have health insurance, also below the national average of 12%. But when it comes to the mental health struggles associated with the coronavirus, 20% of Utahns surveyed said they felt down, depressed or hopeless, compared to an average of 21% nationally.

“While we’re doing better than many states on the indicators, we still know that there are parents who are struggling during this pandemic. and they’re going to be struggling when the pandemic is over,” said Terry Haven, deputy director of the Voices for Utah Children advocacy group.

Haven said there’s work to be done.

“For us, the report shows really how urgent state and federal intervention is to the well-being of families with kids,” she said. Haven said the coronavirus pandemic has brought to light issues such the need for adequate health care for children and their parents, including coronavirus vaccines.

“We have to make sure that those people who have to work, who have to be out in the public, are safe,” she said, particularly workers in grocery stores, meatpacking plants and other jobs often seen as essential. “We have to make sure they’re OK, and that the kids who depend on them can depend on them.”

The report’s recommendations begin by advising policymakers: “Put racial and ethnic equity first in response efforts” while making sure the “process is informed by the diverse perspectives of those hardest hit by the crisis and created in partnership with communities.”

Also included is a call for lawmakers to guarantee that COVID-19 vaccines will be made available to everybody “without cost as a factor. In addition to following established public health measures, this will help contain the coronavirus and protect the health of kids and families.”

Josie Valdez, a longtime activist and former vice chairwoman of the Utah Democratic Party, said prioritizing essential workers, especially those “who clean the rooms and make the food” and do other jobs deemed critical to keeping society going, might be a way to ensure the communities hurt the most by COVID-19 get vaccinated sooner.

“We know we’ve been disproportionately affected as people of color, basically because of health disparities that have existed for years,” Valdez said, citing the effects of poverty on diet that has led to high rates of diabetes, heart disease and other problems, while large, multi-generational households have made it easier for the virus to spread.

Then there are, Valdez said, “the issues and problems of reverse discrimination, so one of the things we’re looking at is making sure we identify the priorities for the vaccine in a way that is equitable for everybody” and doesn’t require bringing up race, ethnicity or immigration status.

However, the only group the state has said won’t be considered going forward are Utahns who could be deemed essential workers beyond those in health care, education and emergency services who have already been identified.

“If you want to think about essential workers, and think who’s really essential, oh, gosh, the list goes up,” said Rep. Ray Ward, R-Bountiful, a medical doctor and a member of an advisory panel recommending who should be prioritized for the second phase of vaccine distribution.

It’s the same issue as attempting to determine what makes someone high risk for the virus, he said, something he expects to see added to the priority list if criteria can be put in place that’s simple to use and avoids making “that group be so big as to make it meaningless.”

Ward said age is the best way to prioritize people for the vaccine.

“Age is still the thing that makes the biggest difference,” he said, because the people who are the most vulnerable to the virus, and the most likely to be hospitalized and die are older. “My guess is we will save the most lives of the most people, including the minority groups, by having it be by age and by risk factors.”

Whether there should be other prioritization “is a question you can debate for decades,” Ward said, time that health officials don’t have. “Four months from now, whoever wants it will be able to get it. So we have this narrow window, where we don’t have that, where there’s a very limited supply of vaccine.”

What’s missing, too, is data to show where deployment would be most effective, he said.

“We don’t have data to prove this or that other pathway is the best one to help out any of us, or any individual community which is certainly deserving that we may want to help,” Ward said, adding that any “decision also has to be made in a way that is practical to actually carry out.”