‘Disadvantage Index’ Considered For COVID-19 Vaccine Distribution In Oregon

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An Oregon advisory committee is considering a “disadvantage index” to fight “systemic racism” through the state’s COVID-19 vaccine distribution.

The committee met Thursday to discuss possible strategies in prioritizing at-risk communities for COVID-19 vaccines and recommended the usage of a “disadvantage index,” which contains more than a dozen measures such as occupation, income, education level, pre-existing conditions and vehicle ownership, the Associated Press reported.

The committee’s recommendation would be part of the state’s wider battle against “systemic racism” by prioritizing “black, indigenous and people of color” (BIPOC) for vaccinations, the committee said.

The designated risk criteria also include certain occupations, living conditions and other groups experiencing “health inequities,” the committee said.

“BIPOC are unfortunately disproportionately represented in a number of these risks,” Public Health Division Director at the Oregon Health Authority, Rachael Banks, said during the Thursday meeting.

The committee consists of 27 members and was reportedly created to guarantee a “fair” vaccine rollout, the Associated Press reported. Members of the committee were chosen from racial and ethnic groups such as tribes, Pacific Islanders and Somali refugees.

“It’s about revealing the structural racism that remains hidden,” health disparity expert and member of the Cherokee Nation of Oklahoma, Kelly Gonzales, told the Associated Press.

“It influences the disparities we experienced before the pandemic and exacerbated the disparities we experienced during the pandemic.”

Critics of race-based vaccine prioritization argue such measures are not constitutional because of the Fourteenth Amendment which guarantees equal rights under the law for all Americans regardless of race, occupation and economic class, The Detroit News reported.

In a Dec. 2 information sheet, the Department of Veteran Affairs (VA) announced it would be using race-based criteria in its vaccine rollout plan, focusing on black, Hispanic, Asian and Native American veterans in particular.

In a Dec. 15  letter to the former Secretary of Veteran Affairs Robert Wilkie, two members of the U.S. Commission on Civil Rights argued the VA’s race-based criteria was “vulnerable to legal challenge” as courts are mandated to apply “strict scrutiny” to policies and laws aiming to prioritize one race over another. While in specific circumstances racial prioritization could be legal, the letter’s authors argue the VA’s vaccine policies fail to meet those circumstances.

In addition to the VA, the Centers for Disease Control and Prevention (CDC) announced it would be putting “essential workers” into high-risk categories with frontline healthcare workers and the elderly because ethnic minorities are “disproportionately represented in many essential industries,” the Daily Caller reported.

Democratic Hawaii Rep. Tulsi Gabbard criticized the CDC’s vaccine approach in a tweet where she described “unelected” CDC bureaucrats as “heartless” and “arrogant”.

Oregon’s potential utilization of a disadvantage index, as opposed to an exclusively race-based approach, could allow the state to avoid legal challenges.

“We’re not able to prioritize services or make decisions based on services solely on somebody’s race or ethnicity. Once again, we’re looking at this in broader factors,” Banks told the committee at Thursday’s meeting.

Any recommendations made by the committee are non-binding legally, leaving the final decision up to Gov. Brown and public health officials.

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