Thread by @ChomiloMD

Today’s MN #COVIDVaccine announcement is disappointing & largely fails to move the needle on equity.

I think understanding why & how it could likely worsen inequity requires a recap.

On 1/14 MN opened up vaccination to 65+ w/no subprioritization. What have we learned since?
🧵

https://twitter.com/md4healthequity/status/1365023674336743426

1️⃣ There was no federal stockpile (as the previous WH administration HHS had eluded) to support this decision.

So now ~1 million Minnesotans believed they were at the front of the line but MN was getting ~60,000 new doses/week & still had not completed everyone in phase 1A

2️⃣ A new administration came in with equity as a priority & recommended expanding eligibility even more... but no new guidance around subprioritization for any groups incl those 65+

& still not enough shots to meet demand = scarce resource allocation

verywellhealth.com/biden-covid-19…

3️⃣ We got preliminary national data on vaccination rates by race/ethnicity. We are not off to a good start. @cdcgov’s MMWR noted that the % of Americans initially vaccinated who were Black was ⬇️ relative to % of persons who are Black among phase 1a.

cdc.gov/mmwr/volumes/7…

4️⃣ Next was news regarding that among those 65+
Hispanic
Native American
& Black adults
had nearly 2x the #COVID19 death rate compared to white adults

kff.org/medicare/repor…

5️⃣ Then a report about the ⬇️ in lifespan among all Americans due to #COVID19 - but
3x worse for Black men &
2x worse for Black women & Hispanic men

pbs.org/newshour/healt…

6️⃣ @ewrigleyfield & JP Leider have a paper pending that shows, based on @mnhealth death certificate data & excluding LTC deaths -
65+ covers only 64% of Black, 49% of Native American & 45% of Latino Minnesotan deaths, vs 88% of white Minnesotan deaths

Here are age adjusted rates

7️⃣Meanwhile one of the leading public health experts has been warning of a coming #COVID19 hurricane bc of the rise of #B117 #COVID19 variants.

Vaccination is the shelter from this storm for our highest risk Minnesotans.

mprnews.org/episode/2021/0…

8️⃣& we have multiple community groups & leaders stressing the importance to our elected officials of subprioritization in realizing a commitment to equity

@State_SupportMN - mnlegalservices.org/legal-services…

.@mdhealthequity + leaders from over a dozen community & physician organizations & nearly 350 health professionals & several elected officials - startribune.com/minnesota-fall…

And we the Interim director of UMN Center for Bioethics - m.startribune.com/editorial-coun…

9️⃣Yet so far our allocation equity response (allocation, not engagement) has been
- FQHCs
- teachers & child care workers

But no data on those groups & no public guidance to health systems or local public health on how to ethically & equitably prioritize #COVIDvaccines among 65+

So to recap, the announcement today
- Maintains status quo for the next month - which is producing racially inequitable results
- keeps BIPOC communities outside looking in if/when an anticipated #COVID19 variant hurricane hits
- Improves transparency but..

Today’s announcement fails to cover how, with our #COVIDVaccine allocation, over the next month we will:
- promote justice
- mitigate existing health inequities

2 of 4 principles we have been repeatedly told were how we “vaccinate for impact”

health.state.mn.us/diseases/coron…

With a looming storm why aren’t we sheltering Minnesotans most exposed to, & by, #COVID19, by prioritizing their vaccination?

There’s still time. We are not only fighting #Covid_19 but setting the precedent for the next pandemic. Let’s not bake in inequities any further.
🪡