Most COVID-19 vaccines are going to white people, even though the pandemic has ravaged communities of color

• Black people and other racial and ethnic minorities in the US have been hit hard by the coronavirus pandemic, but white people have so far gotten most of the COVID-19 shots, according to state data reviewed by Business Insider.
• Business Insider reviewed vaccination data for six states that have high percentages of Black residents and that publish the information by race.
• In each of the six states, vaccinations for Black people and other minorities lagged behind vaccinations for white people. That gap was widest in North Carolina.
• While there is not enough information to draw strong conclusions from the data, the stark differences in vaccination rates raise questions about how states plan to ensure vaccines are distributed equitably to the most vulnerable Americans.

Even though Black people, Hispanic people, and other minorities have been hit hard by the COVID-19 pandemic, many of the first coronavirus vaccines in the US have gone to white people.

Business Insider reviewed vaccine data from the 10 states with the most Black residents as a percentage of their populations. Six of those states publish vaccination data by race. In all six, vaccinations for Black people and other minorities lagged behind vaccinations for white people.

In three of those states, a disproportionate number of shots went to white people relative to their share of the state's population, while the other three didn't provide enough data to make a comparison.

The vaccination shortfall for people of color is striking because a growing body of research indicates that Black Americans and Black healthcare workers have made up a disproportionate number of coronavirus cases and deaths.

It also raises questions about what states are doing to ensure vaccines are going to the most vulnerable Americans. Public-health experts have warned that failing to get shots to those who need them most could worsen the racial disparities already exacerbated by the pandemic.

"How we ensure those who are disproportionately affected are getting access to the vaccine is something that many of us who are working in the health-equity space have been talking about since the beginning of the pandemic," said Dr. Utibe Essien, an assistant professor at the University of Pittsburgh School of Medicine.

"We knew that, unfortunately, our health system is really set up to, rather than ensure equitable care, to ensure inequitable care," he said.

To be sure, it's early in the COVID-19 vaccine rollout, and vaccinations are going slower than planned. Roughly 5.9 million people have received the first dose of the two-dose vaccines. But it's another concerning sign that the effort to curb the pandemic could leave behind some of the people most vulnerable to the coronavirus.

'Work to do'

Among the six states whose data Business Insider analyzed, three showed that a disproportionate number of shots had gone to white people relative to their share of the state's population, while vaccinations trailed for Black people and other minorities. Data in the other three states was less complete.

The racial disparity was the widest in North Carolina, where, as of Friday, 80% of 109,799 shots had gone to white people, according to the state's vaccine dashboard. Just 10% of the vaccines were provided to Black people, and about 11% were given to people of other races, including Asians, Pacific Islanders, American Indians, and Alaska Natives.

Roughly 21% of North Carolina's population is Black. It's unclear how many of the state's healthcare workers and long-term-care residents are minorities, however.

In a press conference on December 30, Dr. Mandy Cohen, the secretary of the North Carolina Department of Health and Human Services, said that while it was early in the vaccination campaign, "there is definitely work to do to make sure that we are getting that equitable distribution."

Cohen said the state was working with community organizations and other leaders to reach historically marginalized populations.

Data from Mississippi showed a similar trend. As of Friday, white people made up about 65% of the state's 30,691 vaccinations, while Black people made up 18% and people of other races made up 15%. About 37% of Mississippi's population is Black.

In Maryland, 61% of 98,536 vaccines had gone to white people, about 15% had gone to Black people, and about 24% had gone to people of other races, according to the state's dashboard. Maryland's population is about 30% Black.

A spokesman for the Maryland Department of Health said it was "working diligently to ensure equity in vaccine distribution." The health department is working on a communications and community-outreach campaign designed to reach minority and vulnerable populations.

The vaccination rates raise questions about how states plan to ensure COVID-19 shots are distributed equitably

In most states, shots are going first to healthcare workers and to residents and staff members at long-term-care facilities.

In 2019, the healthcare industry was about 60% white, according to the Kaiser Family Foundation. As of 2017, about 75% of nursing-home residents were white, according to federal data.

In 2019, about 40% of healthcare workers were people of color, including 16% who were Black, 13% who were Hispanic, and 7% who were Asian, according to KFF.

About 60% of the US population identifies as white and not Hispanic or Latino, while about 13% identifies as Black, census data shows.

The demographics of healthcare workers vary across occupations and settings, however. In 2019, Black and Hispanic workers made up larger shares of aides, personal care workers, direct contact workers, and home healthcare workers, KFF said. Black people also made up a larger share of workers in skilled nursing facilities and other residential-care settings.

Read more: Filipinos make up 4% of nurses in the US, but 31.5% of nurse deaths from COVID-19

It's hard to draw strong conclusions from the states' vaccination data, given that we don't know the demographics of the groups of people eligible to be vaccinated in each state, said Samantha Artiga, the director of the Racial Equity and Health Policy Program at KFF.

A state's population demographics don't necessarily reflect the demographics of its healthcare workers and long-term-care residents getting the first wave of vaccines. Insider couldn't find data about the races and ethnicities of healthcare workers in each state.

Many states aren't providing information on coronavirus vaccinations by race or are reporting spotty data. In Tennessee, for instance, race was listed as unknown for 46% of vaccinations. In Virginia, race wasn't reported for about 60% of recipients.

Black Americans are among those hardest hit by the COVID-19 pandemic - and those most hesitant about getting a shot

In a recent KFF poll, about a third of Black respondents indicated they would probably or definitely not get a COVID-19 vaccine, compared with about a quarter of all respondents.

That hesitancy among Black Americans stems from a long history of racial discrimination and mistreatment by the US healthcare system, Essien said. Stopping the spread of the coronavirus will require as much as 85% of the US population to get vaccinated, according to Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases. That's why it's important to understand and address any hesitancy to get the shot, Essien said.

"We need to continue to worry that if there is such a huge group of people who are not willing to be vaccinated, what does that mean for the future of herd immunity as we are all hoping to achieve?" Essien said.

Language and cultural barriers also could stand in the way of minorities getting COVID-19 shots.

Dr. Yvonne Maldonado, a professor of pediatrics and epidemiology at Stanford who advises a Centers for Disease Control and Prevention committee that makes recommendations on who should be prioritized for a vaccine, said that while there is a broad array of racial and ethnic minorities within healthcare eligible for the first shots, states and hospitals need to find ways to reach workers who may have trouble understanding and accessing the vaccine. Those may include housekeepers and food-service workers in healthcare.

"You can't just say, 'Here's a vaccine, go get it,'" she said. "If you do that, then it's really up to the individuals to actually have time and understand and read, and have materials in a language they can understand. Most of these workers are not going to have the opportunity."

• Read more:
• Primary-care clinics hope to play a big role in vaccinating Americans, but some don't know when they'll receive coronavirus shots. 3 major chains lay out how they're preparing despite little information.
• What it's like to get the COVID-19 vaccine, according to some of the first healthcare workers to receive it
• 'This is game time': Hospitals across the country are gearing up to give the first COVID-19 shots to millions of healthcare workers
• Most nursing home residents in the US remain unvaccinated despite national plans to prioritize the elderly