Why Alameda County’s Vaccine Rollout is Bound to Fail the Most Vulnerable, and How We can Fix That

Mam speakers in Oakland had a 27% positive antibody test rate.  The highest of any subgroup, but unless they have internet, and email, and speak English, there is no practical way for them to get in line for vaccine.  And they are not alone, the County’s current process relies on signing up on a website, that does some auto translate (which is notoriously inaccurate) for a few languages.  The process itself excludes our most vulnerable families.

The reality is the most privileged, even among the vulnerable, will be first in line, while the most vulnerable and least privileged, probably won’t even know there is a line, much less where their place is, or how to get in it.  This process will not lead to the herd immunity we desire, nor the quickened re-openings of essential resources, like schools, for the students that really need them.

We need to rethink this approach, sacrificing some precision and formality for common sense.

Instead of this rigid, technology-based rollout, we need to physically get into the most affected communities and basically just vaccinate everyone who meet certain criteria.  We need to do this with trusted community providers and in trusted institutions, like schools. 

We know where the highest needs are, this is the County’s map of positivity rates

And this map is from the County’s task force on equity, showing the areas where health is most impacted by outside factors, leading to worse health outcomes.

If you overlap these maps it is pretty clear where the County should be doing geographic targeting.

They should also target the most at risk sub communities, and work with trusted community organizations to actually do vaccinations.  As I mentioned Mam speakers show the highest postivitiy rates, but the sign up form isnt even transated for them.  Even if it were, our most disenfranchised community members often won’t use resources like an online sign up for an appointment.  I repeat.  We need to bring the vaccine to them and deliver it via trusted partners.  Many of these folks will not have access to reliable internet, much less private insurance, or an employer that will sign them up.

I know the County is hustling, and reacting to changing circumstances.  Ialso believe that they want to do a more equitable rollout.  Equity is a lived and implemented experience though, it is not accomplished by a commission or a report, or a process or powerpoint.  And as a living concept it needs to react and evolve based on conditions.

I hope the County can do the same.  The current plan is bound to fail our most vulnerable and will have a high risk and high exposure population circulating in the community in essential jobs.  By taking care of them we take care of the community.

We are here, we have schools that would gladly open for vaccinations, we have community partners who would gladly help spread the word and engage the unengaged.  And we have a community that needs to get vaccinated and desperately needs to get a subset of students back in school.

We are partners in trying to live this equity, let the community help.  And please create a process that responds to the actual community and invites them to participate. 

The last vaccination numbers I saw are below.

Wonder how many Mam speakers were vaccinated, actually I don’t.  I am pretty sure. 

Please partner with the community in making this better.

What do you think?

More Comments