Through much of the COVID-19 pandemic, Black and Latino people have suffered disproportionately from the virus, and health experts have worried that these communities could struggle with low vaccination rates unless steps are taken to ensure fair access.
Missouri’s vaccination campaign has been underway for more than a month, but analysis by KCUR found that the state’s data on who’s getting vaccines is incomplete and health departments in some of the state’s largest counties don’t have access to local data that would show if the vaccine is being equitably distributed.
Health care advocates say the state is already losing valuable time to get some of its most vulnerable residents protected from the virus. And the inability to get demographic data by county undermines public confidence and hurts the ability of local health departments to assess vaccine distribution, according to the Kansas City Health Department.
Five health departments told KCUR they don’t have access to this data, and two departments said staff reached out to the state for local data but had yet to receive it.
“You want to sound the alarm as soon as possible so that you can make sure that the outcome is one that is equitable,” said Kansas City Councilwoman and Black Health Care Coalition president Melissa Robinson.
Vaccine supply is limited, and Missouri has one of the lowest vaccination rates per capita in the nation, according to The New York Times. Gov. Mike Parson has pushed back on reporting that Missouri has been slow to administer doses. In January, he said the low numbers resulted from delays in inputting the data. Parson urged patience, noting that supply is limited so not everyone who is eligible will be able to get a shot immediately.
Lisa Cox, a spokeswoman for the Missouri Department of Health and Senior Services, said the state Bureau of Immunizations “has no knowledge” of counties requesting local data.
“I am not sure who they are requesting access/information from, but I’m waiting to hear back from other bureaus within our Division of Community and Public Health to see if their requests were circulated elsewhere,” Cox said in an email Wednesday.
Requests to expand a health department’s access to additional data are typically granted, according to Cox.
‘I’m terrified’
For Angela Carney, who lives in Jackson County, the threat of COVID-19 seems particularly urgent and scary.
“People like me are dying every day,” Carney said.
Carney, 56, is Black and has been diagnosed with multiple conditions, including chronic obstructive pulmonary disease, diabetes and kidney disease, that put her at increased risk for severe COVID-19 illness. A former nurse, she has contacted her doctor and her pharmacist and enrolled in her local health department’s vaccine notification program but has been unable to get a vaccination appointment.
“I’m terrified,” Carney said. “I’m terrified I will catch it and die.”
Though several groups, including health care workers, seniors and people with serious chronic health conditions are now eligible to receive COVID-19 vaccines in Missouri, vaccinators across the state say they are severely limited by low vaccine supplies.
The vaccine data recently added to Missouri’s COVID-19 dashboard paints a complex picture of who’s receiving vaccines. On Tuesday, it showed that roughly 2% of Missouri’s Black residents were vaccinated compared with about 5% of white residents.
A far larger percentage of people who identified as multi-racial, 16.8%, has been vaccinated, according to the data. However, the data do not include racial breakdowns for about 5% of the more than 400,000 Missouri residents who have received at least one dose. Cox did not respond to specific questions about the data.
In Kansas City, Truman Medical Centers/University Health started vaccinating health care workers in mid-December. About 10% of the people vaccinated by the safety-net provider were Black and 4% were Hispanic or Latino, according to data provided to KCUR.
Black residents make up about a third of Kansas City’s population, while 11% are Hispanic or Latino.
“The number of diverse recipients is increasing now that [the] vaccine is open to community members over 65 or with existing conditions,” Truman spokeswoman Leslie Carto said in an email. “TMC/UH is committed to not only taking the vaccine to people most disproportionately affected by the virus, but also sharing education to encourage vaccination among diverse communities.”
Data woes
Vaccination data is entered into the ShowMeVax system — in some cases by the state health department — but that doesn’t mean local health departments are able to generate reports showing local vaccination rates by race.
“We are required to enter data into a state database, but the second we enter it, it's no longer our data. It's the property of the state,” Kansas City Health Department deputy director Frank Thompson said. “And they get to dictate how, when and if we access that data.”
Thompson said the city raised this issue with the state “a couple of weeks ago.”
“It impedes on our ability to really monitor how we're deploying that vaccine and to make sure that it is being deployed equitably,” Thompson said. “And then from the public's perspective, because we're not able to give them that information, it undermines their confidence and their assurance that the vaccine is being distributed in an equitable manner.”
Even getting basic information, like the total number of people vaccinated in Kansas City, has been a challenge. Kansas City Health Department spokeswoman Michelle Pekarsky reached out to the state on Jan. 6 to get that data.
“I think it builds enthusiasm for the vaccination, and shows proof that progress is being made, even though our message to the general public continues to be ‘be patient,’” Pekarsky said in an email obtained by KCUR.
Cox responded with optimism, saying she shared Kansas City’s request with the person who built the public health dashboard. About three weeks later, the state unveiled a vaccine tracking dashboard. While it shows county-level data on vaccines administered, it doesn’t include totals for Kansas City or St. Louis, which have their own health departments.
To this day, the Kansas City Health Department still doesn’t have data showing how many residents have received a vaccine. The department is stretched thin, but it plans to devote resources to tracking demographic information.
“It’s going to be difficult to go backwards to ones we’ve already done and inputted into ShowMeVax but we will have it moving forward,” Pekarsky told KCUR in a text message.
The Kansas City, Jackson County, St. Charles, Platte and Columbia/Boone County health departments said their staffs currently can’t pull that data.
“In theory, we should be able to pull data from the state’s records, however, that functionality isn’t working at this time,” Jackson County Health Department spokeswoman Kayla Parker said in an email. “We put in a request to both have our own reports sent to us and have this issue fixed for the future. This was submitted last week.”
The Department of Health and Senior Services is “unaware of any issues with someone not having access to pull the data,” according to Cox.
“There has only been one local health department (Franklin County) who has contacted our Bureau of Immunizations regarding data in their county back in December and it was provided,” Cox said in an email. “... We have calls available for local public health agencies multiple times per week, and we will be sure to make it clear in future communications that this assistance is available if needed.”
The ShowMeVax software was created by Envision Technology Partners, a Colorado-based company that other states have used to track immunizations. CEO Steve Murchie said in an email that the company wasn’t aware of any issues.
“The capability to do county-based aggregate reporting, and a more detailed, de-identified patient-level ad hoc query with demographics, has been in the system since go-live a year ago,” Murchie said.
In the meantime, people like Angela Carney are waiting to get vaccinated. Getting vaccinated would likely cause her to make only small changes to her daily routine in the short run. But Carney said it would allow her to live without the fear and anxiety that have plagued her for months.
“Vaccines don’t prevent you from catching anything. They help you fight it,” Carney says. “And that’s what I need. I need at least a fighting chance.”
