California may include “historical injustice” as a factor in determining the distribution of coronavirus vaccines, a sign of social justice considerations entering the public health effort.
The idea was first introduced to California’s Community Vaccine Advisory Committee on Nov. 25 by Virginia Hedrick, according to NPR.
Hedrick is executive director of the California Consortium for Urban Indian Health. A member of the Yurok Tribe, she pointed out that Native Americans are 4 times more likely to be hospitalized for COVID-19 and twice as likely to die from it than white people.
She said it is important to consider that Native Americans suffered high rates of illness and death from diseases such as measles and smallpox when the first European settlers arrived here.
“So, some would say that it was an unintentional spread of infectious disease upon contact. Others would say it was absolutely intentional,” Hedrick told NPR. “When we think about the historical injustice of this nation, of California, isn’t now the time to say that for the first time we prioritized indigenous people? We started to make reparations in the way that we handled and treated the indigenous people of this continent?”
At the second meeting of CVAC, Dr. Nadine Burke Harris, California’s surgeon general and co-chairwoman of the committee, made it clear that Hedrick’s message had gotten through.
“We, of course, want to be evidence based. We, of course, want to use the highest standards of rigor,” Burke Harris said. “And at the same time, we want to reflect what we’re hearing from this group.”
Burke Harris sought to include “equity” as a consideration for how vaccines are distributed in California, with equity defined as “efforts to address avoidable inequalities and historical and contemporary injustices.”
But Lawrence Gostin, professor of global health law at Georgetown University, said that using historical injustice could be construed as affirmative action. With the Supreme Court putting tougher restrictions on how affirmative action can be used in higher education, he said that federal courts could be hostile to its use in public health.
California echoes the proposal the federal Advisory Committee on Immunization Practices has made to prioritize essential workers after healthcare workers and nursing home residents are vaccinated. The deciding factor for proposing essential workers over people with high-risk medical conditions and those aged 65 and older was “mitigating health inequities.”
In practice, that means fighting long-standing systemic health and social inequities among racial and ethnic minorities. Prioritizing essential workers would do that, according to the ACIP, since black people and Latinos are more likely to contract and die from COVID-19 than white people and because a much larger proportion of essential workers are minorities as compared to those aged 65 and older.
