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Tracking of Missouri vaccine equity is hampered by flawed data

Throughout the COVID-19 vaccination effort, public health officials and politicians have insisted that providing shots equitably across racial and ethnic groups is a top priority.

But it’s been left up to states to decide how to do that and to collect racial and ethnic data on vaccinated individuals so states can track how well they’re doing reaching all groups. The gaps and inconsistencies in the data have made it difficult to understand who’s actually getting shots.

Just as an uneven approach to containing the coronavirus led to a greater toll for Blacks and Latinos, the inconsistent data guiding vaccination efforts may be leaving the same groups out on vaccines, said Dr. Kirsten Bibbins-Domingo, an epidemiologist at the University of California-San Francisco.

“At the very least, we need the same uniform standards that every state is using, and every location that administers vaccine is using, so that we can have some comparisons and design better strategies to reach the populations we’re trying to reach,” Bibbins-Domingo said.

Now that federal, state and local governments are easing mask requirements and ending other measures to prevent the spread of the virus, efforts to boost vaccination rates for underserved groups are even more urgent.

A quartet of singers takes the place of a choir at a physically distanced service at St. James United Methodist Church in Kansas City, Mo., during the COVID-19 coronavirus pandemic. Photo courtesy Kaiser Health News

At St. James United Methodist Church, a cornerstone for many Black residents of Kansas City, Mo., in-person services recently resumed after being online for more than a year. St. James has also been hosting vaccination events.

“People are really grieving not only the loss of their loved ones, but the loss of a whole year,” said Yvette Richards, St. James’ director of community connection. “A loss of being lonely, a loss being at home, not being able to come to church. Not being able to go out into the community.”

Missouri’s population is 11% African-American, but COVID-19 cases among African-Americans accounted for 25% of the total cases for the state, according to an analysis by KFF.

Richards said St. James had lost many congregants to the coronavirus, and the empty pews where they once sat on Sundays serve as stark reminders of all this group has been through during the pandemic.

Missouri’s public data appear to show robust data on vaccination rates broken down by race and ethnicity. But several groups are seen lagging far behind on vaccinations, including African-Americans, who appear to have a vaccination rate of just 17.6%, just over half of the 33% rate for the state as a whole.

To Dr. Rex Archer, director of the Kansas City health department, one number is a giveaway that these figures aren’t right. They show a completed vaccination rate of 64% for “multiracial” Missourians. Such an exceptionally high rate for one group beggars belief, according to Archer.

“So, there’s some huge problem with the way the state is collecting race and ethnicity under COVID vaccination,” Archer said.

Missouri state officials have acknowledged since February that the data are wrong, but they haven’t managed to fix the problem – or even explain exactly what’s causing it. Archer suggested the inflated multiracial rate was probably due to different racial information being reported when individuals receive first and second shots.

Other problems have been detected, including missing racial and ethnic data for many people who have been vaccinated, and the use of multiple categories such as “other” and “unknown.”

The Rev. Emmanuel Cleaver III welcomes congregants to St. James United Methodist Church in Kansas City, Mo., where in-person services were paused for more than a year due to the COVID-19 pandemic. Photo courtesy Kaiser Health News

Local leaders and health officials in Missouri are scrambling to boost vaccination rates, especially among vulnerable populations, after Gov. Mike Parson recently announced steps to urge residents back to working in person.

Parson, a Republican, ordered state workers back to the office in May and said he would end additional federal pandemic-related benefits for unemployed workers in June, despite vaccination rates across the state’s being well below what Missouri health experts had hoped to achieve.

Jackson County, which includes most of Kansas City, authorized $5 million in federal CARES funding last month to increase vaccinations in six ZIP codes with large Black populations and low vaccination rates. The project will address problems of both access and hesitancy and focus on reaching out to individuals and neighborhoods.

Although many of the state’s vaccination efforts have involved large mass events, St. James Pastor Jackie McCall said she had been talking with many in her church and community who need encouragement to have faith in the vaccines.

“So let’s go ahead and let’s trust,” McCall told congregants. “Let’s trust the process. Let’s trust God. Let’s trust the science.”

This story is part of a reporting partnership that includes KCURNPR and KHN.

Staff is home to The NorthSider and The SouthSider weekly community newspapers. The SouthSider publishes 25,000 copies every Tuesday. The NorthSider publishes 25,000 copies every Thursday. They are distributed at over 600 locations across St. Louis.

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