Across the New Orleans region, coronavirus vaccinations are lagging in neighborhoods that are poorer and Blacker than those around them while the most affluent areas are getting shots at rates well above the norm.
New data show a familiar pattern: People living in the same parts of Jefferson, Orleans and St. Tammany parishes that are on the low end of metrics such as poverty and health are also less likely to be vaccinated three months after inoculations became available.
“We looked at the holes in the map and realized they were the same area, the areas with high social vulnerability, least access to transportation, a workforce that couldn’t take off to get tested” earlier in the pandemic, New Orleans Health Director Jennifer Avegno said.
“Unfortunately that’s the systemic inequity in American health care, that the same demographics that are able to acquire vaccines easily are the same demographics that are able to acquire primary care, preventative care more easily and have longer life expectancy,” she said. “As long as the system is profoundly inequitable and you are not deliberately trying to undo that, you will continue to have a system that serves no one.”
New Orleans and Louisiana officials are trying to reduce the disparities, something they say will be aided by the greater availability of vaccines, more outreach and vaccination sites in communities.
On a sunny, blustery Monday in New Orleans, Tonya Freeman Brown donned a neon yellow vest and started knocking on doors in the Hoffman Triangl…
But for now, the disparities in all three parishes are as stark as they are geographically close, according to an analysis of newly released Louisiana Department of Health data showing vaccination rates by census tract.
Some parts of Gert Town, for example, have seen fewer than 7% of their residents receive a single dose of the vaccine. In areas of nearby Mid-City, more than 40% of residents have received a shot.
Though New Orleans has eight of the top 10 most-vaccinated tracts in the state, it also has several that fall near the bottom of the statewide rankings.
Experts blame the disparities on a variety of factors: poverty, an inability to take time off from work to get a vaccination, difficulties scheduling appointments without internet access and other hurdles.
Starting Monday, March 29, anyone 16 and over is eligible for a coronavirus vaccine in Louisiana.
“You could swap out COVID vaccinations and put in hypertension. You could put in homicide. You could put in cardiovascular disease or any health outcome, and it’s the same communities,” said Thomas LaVeist, dean of Tulane University's School of Public Health and Tropical Medicine. “It absolutely puts to the lie that there are genetic reasons for racial disparities in health outcomes. You see it's the same communities that have health problems. It’s something that’s happening in the community, or some aspect of that community.”
Only about 15.5% of people living in census tracts with the lowest vaccination rates in New Orleans have had at least one dose of the vaccine, according to an analysis of the date by The Times-Picayune | The New Orleans Advocate. Those tracts, which make up the bottom fifth of the rankings, are half as likely to be have been vaccinated as the population of the city as a whole and only a third as likely as those living in the tracts that make up the top 20%.
Almost 80% of the residents in the tracts that make up the bottom fifth of the rankings are Black, 20 points higher than the population as a whole and more than 5.6 times the percentage of Black residents in the most-vaccinated tracts. For the city as a whole, Black residents are half as likely to have been vaccinated as their White neighbors.
The U.S. plans to “loan” a limited number of vaccines to Canada and Mexico.
The least-vaccinated areas have a poverty rate of 33%, more than three times as high as those with the highest rate of injections. More than half of households in the lowest group do not have broadband internet, a necessity in many cases for scheduling appointments, and a more than a quarter are without their own vehicle.
The statistics are remarkably similar in Jefferson: The bottom fifth of tracts have a 15.7% vaccination rate, compared the top fifth with a 43% rate. Residents in the least-vaccinated tracts are more than twice as likely to be Black as the parish as a whole and only one in five is White. They, too, have low rates of internet access and high rates of households without vehicles.
In St. Tammany, the differences are slightly less stark but still present. The least-vaccinated tracts have only 1 in 10 residents who have received their first shot, compared to about 1 in 3 in the most-vaccinated tracts. Those lagging behind have a poverty rate of 22.3%, twice as high those where the highest percentage of the population has been vaccinated. In the low-vaccine areas, more than 40% of people don’t have broadband access.
So far the demand for vaccinations has exceeded the supply, making it unlikely that any specific area of the city or state has hit a ceiling caused by residents hesitant or hostile to vaccination, analysts said. “We have not exhausted all the people who want the vaccine yet, but that last mile is going to be hard,” LaVeist said.
Efforts to combat some of these disparities have been bottlenecked by the lack of doses, something that hampered efforts to set up vaccination sites, said Charles Stoecker, a Tulane health economist who has done vaccination work for the Centers for Disease Control and Prevention and the World Health Organization. He said a successful program involves sending vans to neighborhoods to get people vaccinated, having advertisements and QR codes at bus stops to help people sign up for appointments and other outreach efforts.
“We haven’t really seen that yet because of supply. I think if we have this conversation in another month and they’re not doing that, we would be more worried,” Stoecker said.
Some such efforts are underway in New Orleans, which has set up vaccine sites in neighborhoods and seen door-knockers going to spread the about vaccines and sign people up. But Avegno said a bigger push will be coming in the next week as the Johnson & Johnson vaccine becomes more available.
Unlike those produced by Moderna and Pfizer, which have dominated the vaccination effort so far, the Johnson & Johnson shot does not have difficult-to-achieve refrigeration requirements, meaning it can be more easily distributed in communities. And it requires only one dose, which could aid in vaccinating populations that might find it difficult to take time off of work twice in the space of a month for the Moderna or Pfizer shots.
“This going last mile, going door to door in areas of greatest need, is something we started several months ago, and we’re going to have to keep doing it until that map looks all the same color,” Avegno said.
