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Black People Face Higher COVID Infections & Deaths. Should They Have Lower Age Cutoffs for Vaccines?

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As the U.S. vaccine rollout continues to expand, health justice advocates worry about a racial gap in vaccinations. Black communities have been hard hit by the pandemic, but rates of vaccination in communities of color lag behind largely white communities across the country. Dr. Oni Blackstock, a primary care and HIV physician, argues that age cutoffs should be lowered or removed for Black people in order to speed up inoculations, noting that Black Americans are twice as likely to die from COVID-19 as white Americans and also dying at rates similar to those of white Americans who are 10 years older. “These fixed-age cutoffs that most states implemented did not take into account structural racism’s toll on Black life expectancy in addition to the impact of the pandemic on the life expectancy of Black people in this country,” says Dr. Blackstock.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman, with Juan González.

The U.S. vaccination campaign is getting a new boost today as the first Johnson & Johnson vaccines are administered. According to the White House, nearly 4 million doses of the single-shot vaccine will be initially given out. Johnson & Johnson is the third COVID vaccine to receive FDA emergency approval.

Nearly 20% of adults in the United States have received at least one vaccine shot so far. But there is a wide racial gap in who’s being vaccinated. While Black and Latinx communities have been hardest hit by the pandemic, rates of vaccination in communities of color are lower than largely white communities across the country. Data from the Centers for Disease Control shows just 5% of vaccines have gone to Black Americans, only 11% to Latinx recipients.

This comes as life expectancy in the United States fell by a full year during the first six months of 2020, largely due to the pandemic. It’s the largest drop since World War II. Life expectancy for Black Americans dropped by almost three years, and 1.9 years for Latinx people.

Some doctors are now calling on the CDC and states to give greater priority to communities of color in the vaccine rollout. Doctors Oni and Uché Blackstock are pushing to lower age cutoffs for African Americans. In a recent Washington Post op-ed, they write, “Black Americans are [not only] twice as likely to die of covid-19 as White Americans but also dying at rates similar to those of White Americans who are 10 years older.” They go on: “Moreover, racial [inequities] are most striking at younger ages; for example, Black people ages 45 to 54 are seven times more likely to die of covid-19 than similarly aged White Americans.”

Dr. Oni Blackstock joins us now, primary care and HIV physician, founder and executive director of Health Justice.

It’s great to have you with us. A fascinating op-ed piece you write with your twin sister, also a doctor. Dr. Blackstock, lay out your argument. What age would you like to see Black Americans — the age cutoff for vaccines? And explain further why.

DR. ONI BLACKSTOCK: Good morning, Amy, and thank you so much for having me on.

You know, my sister and I were really compelled to write this op-ed because it appeared that these fixed-age cutoffs that most states implemented did not take into account structural racism’s toll on Black life expectancy, in addition to the impact of the pandemic on the life expectancy of Black people in this country.

And we propose either removing or reducing the age cutoff for Black Americans. In Australia, for instance, they lowered the cutoff for Indigenous Australians to 55 when it was at 70 for non-Indigenous Australians. In Canada, they actually opened up eligibility to all individuals from Indigenous communities in order to increase uptake among Indigenous Canadians. And that has resulted in higher levels of vaccination in Indigenous communities as compared to the general population.

So, you know, we haven’t done exact modeling to say by what amount cutoffs should be reduced, but a reduction or a complete sort of removal of cutoffs for Black people, as well as other people of color, I think, would go a long way towards addressing the vaccine inequities that we see.

AMY GOODMAN: And what kind of response are you getting to this?

DR. ONI BLACKSTOCK: Yeah, so I think many people are not necessarily familiar with some of the issues that we raise in the op-ed. I think some folks are familiar with, for instance, the ways in which redlining and other housing policies which were discriminatory have concentrated poverty in Black communities, have created really high levels of air pollution in Black communities, limited green space and healthy foods, leading to poor health outcomes.

You know, there’s also weathering, which many people may not be familiar with, but this whole idea that living with the day-to-day impact of racism, discriminatory experiences, the cumulative socioeconomic disadvantage associated with racism, all of that actually has an impact on the body. It has a toll, a wear-and-tear effect that results in Black people actually getting many of these conditions, such as high blood pressure and diabetes, that are associated with worse COVID-19 outcomes, getting those at much younger ages than their white counterparts.

So, we’ve gotten, not surprisingly, some pushback, but we’ve also gotten many people who support this and agree that a race-blind or color-blind approach to the vaccine rollout is only going to worsen racial inequities.

AMY GOODMAN: Dr. Blackstock, let’s talk about the Johnson & Johnson vaccine. There are a number of people who are concerned. You know, “I hope I don’t get that vaccine,” they’re saying, even though it is one shot, because they say that it’s got lower efficacy. But can you explain why that actually is not a correct argument, given where it was tested and the time of the variants?

DR. ONI BLACKSTOCK: Right. So, you know, with the authorization of this now third shot for the novel coronavirus, it’s very exciting, but I understand that sort of the messaging around the Johnson & Johnson vaccine hasn’t really addressed people’s concerns.

The Johnson & Johnson vaccine was tested at a time where we saw the emergence of the variant that was first detected in South Africa. There were other variants, as well, that were emerging that were more contagious and potentially more able to evade the vaccine-mediated immune response and, as such, showed a somewhat slower efficacy when it came to preventing overall disease and mild-to-moderate COVID-19 disease. This is in contrast to the Pfizer and Moderna vaccines, which were tested before the emergence of these variants.

What’s really important to note is that all of these vaccines are highly effective in reducing the risk of severe COVID-19 and 100% effective in reducing the risk of hospitalizations and death from COVID-19, which are the outcomes that we really care the most about.

AMY GOODMAN: Let me ask you about the whole issue of vaccine hesitancy. Do you think that it would increase people’s trust if there was actually more information about problems that maybe some people have had? I mean, millions of people have gotten the vaccine. Where are the databases that show maybe what the response is — the allergic response, the whole issue of blood clots, issues like Bell’s palsy, others — that even if you talk more about problems, it might make people more confident that there is research going on that shows the effects of these vaccines, even the short-term effects, since we don’t know the long-term effect, right, because these are all so brand new?

DR. ONI BLACKSTOCK: Right. So, there is a great deal of post-marketing surveillance being done by all of the vaccine makers. So that means once the vaccine has been authorized and rolled out, they are collecting data from many of the people, for instance, who continue to be in these clinical trials, but, as well, we have applications such as the v-safe, which is a CDC app where people can enter any side effects that they have. So far, about 4 million people have entered the range of side effects that they’ve experienced from the vaccine into this app. And most notably, the CDC Director Rochelle Walensky said at a press conference yesterday that most people have reported incredibly mild and short-lived side effects and that serious side effects appear to be incredibly rare. So, we want to make sure that folks are getting that information and are encouraged to take the vaccine and have their confidence in the vaccine increase.

AMY GOODMAN: Dr. Oni Blackstock, you and your twin sister Uché wrote a piece for JAMA. That JAMA journal was in our house from my entire growing up. My father used to read it all the time, The Journal of the American Medical Association, so we called it “Pa-JAMA.”

But anyway, earlier this year, you wrote a piece that was titled “'Serving the People Body and Soul' — Centering Black Communities to Achieve Health Justice.” In it, you write, quote, “If there was ever a moment to ask how we can reenvision what health justice means for Black communities, it is right now. And the response to that question must be both radical and revolutionary. We need to look no further than the health activism legacies of the Black Panther Party and the Young Lords. Both grassroots organizations rose to prominence in the mid- to late-1960s and, despite their short-lived success … made a tremendous impact through their activism, which centered on their communities’ right to self-determination and to health.”

You’re talking right now to one of the co-founders of the Young Lords, Juan González. If you can talk about that effect? And then we’ll get Juan commenting on it, as well.

DR. ONI BLACKSTOCK: Yes, very super excited to be in conversation with one of the founding members of the Young Lords.

Yeah, my sister and I, you know, again, felt very compelled and inspired to write this op-ed, really thinking about what the Black Panther Party and the Young Lords were able to do in terms of really showing the ways in which when communities that are most impacted, communities that are most burdened are allowed to really have their concerns centered and are able to lead and develop initiatives that really understand the ways in which the social conditions, the social — now that we know are called the social determinants of health, how all of those impact health.

So, for instance, I’m sure Juan González was probably familiar and maybe involved in the garbage collective in East Harlem, recognizing the ways in which poor sanitation conditions impact the health of communities. The Black Panther Party, for instance, sort of took up the initiative of sickle cell screenings in the Black community when that was a neglected area. And so, we know that we have so many assets and resources in the communities that are most impacted, and we need those communities to be able to lead.

So, for instance, with the current pandemic, what would be so tremendous is to have grassroots and community-based organizations funded to do education and outreach to navigate residents to vaccine appointments, to give vaccines themselves. And we know that if the Young Lords and Black Panther Party were still as active, we would probably see them really involved in this work very wholeheartedly.

AMY GOODMAN: Juan, did you ever expect your organization, the Young Lords, to be cited in The Journal of the American Medical Association, in a positive way?

JUAN GONZÁLEZ: Well, Amy, certainly not 50 years after we were active in these kinds of health initiatives. And I apologize to Dr. Blackstock, because we had a power outage here in New Jersey, so I missed a portion of this interview.

But, yes, I was the — actually, the minister of education and health with the Young Lords, so it was my responsibility to sort of develop and implement the health initiatives that we had, which included door-to-door lead poison testing for children in East Harlem and the South Bronx, tuberculosis testing, and also a campaign for community control of our local hospitals. I think one of the big reforms that occurred subsequent to our efforts was that the federal government did mandate municipal hospitals to have community advisory boards — not quite the community control we wanted of these health institutions, but at least community advisory boards that could inform the health professionals in terms of the needs of the community. And, of course, we also always supported the unionization of hospital workers, which obviously became a very big movement throughout the ’80s, ’90s and into the new century.

So, I’m really heartened that the health professionals of today understand that we did play some kind of a role as young teenagers and radical activists in the late ’60s and early ’70s trying to create a better health system for America.

DR. ONI BLACKSTOCK: Yes, and your efforts were greatly appreciated. And it was really important for my sister and I to make sure that the name Young Lords and Black Panther Party appeared in such a journal.

AMY GOODMAN: Would you like to talk, Dr. Blackstock — respond to President Biden’s response to AMLO, the president of Mexico, Andrés Manuel López Obrador? They had their virtual summit yesterday, Biden and López Obrador. And this is a reporter who was questioning White House Press Secretary Jen Psaki about the meeting Monday.

KRISTIN FISHER: When the president of Mexico meets with President Biden a little bit later today, he is expected to ask if President Biden would consider sharing part of the U.S. coronavirus vaccine supply with his country. Is this something that President Biden is considering?

PRESS SECRETARY JEN PSAKI: No. The president has made clear that he is focused on ensuring that vaccines are accessible to every American. That is our focus.

AMY GOODMAN: Dr. Blackstock, your response? You talk about what’s equity in the United States. Can you talk about that writ large in the world?

DR. ONI BLACKSTOCK: Yes. So, we’re seeing, you know, many parallels to the situation here in the United States play out globally. Global vaccine equity is critically important. We know that we aren’t safe until all of us is safe. So, it is a moral and ethical issue in terms of the responsibility of higher-income countries, such as United States, to ensure that low- and moderate-income countries have access to the vaccine.

But we also know that the virus knows no boundaries. So, you know, if we see the low- and middle-income countries continuing to have widespread transmission of COVID-19, we can see the emergence of more and more highly transmissible and potentially more deleterious variants that, again, could have an impact on Americans here, people here in the United States. And we just have to realize the ways in which we are interconnected and that we need to not only prioritize Americans for vaccines, but ensure that all of our — all countries around the world, and particularly those that are low- and middle-income, have the same access to the vaccine. The United States has bought, I think, or ordered about 1.3 billion doses of vaccine. That’s enough to vaccinate the population several times over, right? And so, there’s obviously room to ensure that lower-resource countries also have access.

JUAN GONZÁLEZ: And, Dr. Blackstock, I wanted to ask you about an increasingly contentious issue, which is the question of the reopening of public schools. There are, obviously, a growing debate. Many children, especially African American and Latino children and poor children with poor internet access, have essentially lost a year of schooling. And the growing debate between the teachers’ unions, on the one hand, local government officials and distinct groups of middle-class parents who are still getting their children educated, many of them in private schools or even Catholic schools. I’m wondering your sense of the road forward on this issue of the reopening of schools.

DR. ONI BLACKSTOCK: Yes, it has been a very controversial issue and very polarizing. What we do know — you know, I’m here in New York City — we do know that children can go to school safely if the appropriate preventive measures are taken. And so, we need to ensure, obviously, that schools have the support to ensure that children are able to socially distance, they’re able to mask, obviously hand hygiene. Ventilation is incredibly important, but that can be done pretty easily with opening windows, having box fans and the like. And then, you know, contact tracing is obviously really important, as well as access to testing.

We think that teachers should be, obviously, prioritized for vaccination. And we see a number of states doing that right now. And I think some of the challenges that we’ve seen with the school openings have been jurisdictions that have linked school openings to community sort of levels of the virus. But we’ve seen here in New York City that you can still have higher levels of the virus in the community while children are able to go to school safely.

So I think the most important thing that needs to happen is that school, that districts are supported in being able to make whatever changes or modifications they need to make to their physical settings to ensure that both students and teachers are safe and that teachers are prioritized for vaccination.

AMY GOODMAN: Well, Dr. Oni Blackstock, I want to thank you so much for being with us, primary care and HIV physician, founder and executive director of Health Justice. We’ll link to your op-ed column with your twin sister, also a doctor — we’d love to meet your mother — called “Black Americans should face lower age cutoffs to qualify for a vaccine.” Your sister, Dr. Uché Blackstock.

When we come back, “As the Pandemic Raged, Abortion Access Nearly Flickered Out.” Stay with us.

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