By Brian McNeill

The Research Institute for Social Equity in the L. Douglas Wilder School of Government and Public Affairs at VCU is providing support to Virginia’s efforts to promote equitable distribution of the COVID-19 vaccine to disproportionately impacted populations, such as the Black and Hispanic/Latino communities.

As of March 23, the Centers for Disease Control and Prevention reported that race and ethnicity were known for just over half of the 84 million people who had received at least one dose of the vaccine. Of these, nearly two-thirds were white (66%), 8% were Black and 9% were Hispanic/Latino. Yet the pandemic has disproportionately affected Black and Hispanic/Latino people in terms of exposure to the virus, illness, hospitalization and death resulting from COVID-19.

The Wilder School institute, known as RISE, is seeking to address the disparity between those who receive the COVID-19 vaccine and those who need it most. It is providing the Virginia Department of Emergency Management with research on equitable vaccine allocation policies and strategies and designing a community-based vaccination program with a focus on equity.

The project is being conducted in close consultation with the Virginia Health Equity Leadership Taskforce, a component of the Health Equity Work Group of Virginia’s Unified Command, which oversees the commonwealth’s response to COVID-19.

“We want to be helpful with the Virginia Department of Emergency Management and the state leadership at large in thinking through the question: What does vaccination equity mean for the commonwealth of Virginia?” said Susan T. Gooden, Ph.D., dean of the Wilder School and a leading scholar in equity and policy, who is leading the project alongside Nakeina E. Douglas-Glenn, Ph.D., an associate professor and director of the Grace E. Harris Leadership Institute, also in the Wilder School.

Curtis Brown, state coordinator of emergency management at the Virginia Department of Emergency Management, said RISE has been “instrumental in conducting research and building community connections to help us center our vaccine allocation strategies on equity.”

“The COVID-19 pandemic has disproportionately impacted Black and brown communities, and it’s imperative that we equitably distribute vaccines to these communities,” said Brown, who earned his certificate and master’s degree in homeland security and emergency preparedness at the Wilder School.

“The research and community-vaccination plans the VCU team has developed are starting to be implemented in a few cities throughout the commonwealth and we are rapidly expanding to ramp up community outreach and engagement,” Brown said. “RISE contributions have been invaluable throughout this process and support our efforts to equitably respond to this [crisis].”

Janice Underwood, Ph.D., chief diversity officer to Gov. Ralph Northam, said RISE’s contributions are a valuable component of Virginia’s vaccine equity efforts.

“The Virginia COVID-19 Equity Leadership Team has worked for more than a year to thread equity throughout the state's COVID response, and our recent collaboration with the VCU RISE team has helped to further inform our work as we turn our attention to equitable vaccine distribution and community engagement,” Underwood said.

At a Wilder School event on March 17, State Health Commissioner M. Norman Oliver, M.D., said equity is at the center of everything Virginia is doing to fight COVID-19 and that RISE’s work is assisting the state with ramping up its efforts.

“We have asked for and received some really excellent work by Dr. Gooden and Dr. Douglas-Glenn, looking at strategies for improving that equitable vaccination of our population,” Oliver said. “And using that strategy, we’ve employed a consulting and contracting team that is now deploying across the commonwealth. Boots on the ground in all 35 of our health districts to work with local health departments, leaders of local jurisdictions, community-based organizations, faith leaders and others to do the work that is necessary to reach out to Black and brown people in the commonwealth and draw them into our vaccination effort.”

RISE has developed draft plans to build capacity and for standing up community vaccination sites. It has also recommended an approach to vaccine allocation that aligns rates of vaccination with relative rates of infection.

“What we’re trying to do is to pull equity all the way through and follow the data when developing vaccination strategies,” Gooden said. “So for example, currently in the commonwealth of Virginia, 6% of Latinos have received the vaccine, although they represent 17% of the cases. So they are more than three times likely to have contracted the coronavirus and almost three times less likely to have been vaccinated. Conversely, 70% of all those who have been vaccinated so far in Virginia have been white, although they represent 52% of the cases.”

“So if we have a relative rate of vaccination that’s aligned with our relative rate of infection and death, that’s a more equitable approach and it’s similar to the approach that we’ve taken with those who live in long-term care facilities and the elderly,” she said.

Looking ahead, RISE will be conducting research into vaccine hesitancy in Virginia and the reasons some groups might be reluctant about being vaccinated.

A Wilder School poll released in January found that 71% of Virginians expressed a willingness to take the COVID-19 vaccine. But significant numbers of certain groups were hesitant.

For example, 47% of respondents in northwest Virginia and 46% of respondents in western Virginia said they were not too likely or not at all likely to get the vaccine. Additionally, 42% of those with a family income under $50,000 and 40% of Republicans said they were unlikely to take it. The poll also found that 30% of whites and 27% of minorities said they were not too likely or not at all likely to get vaccinated.

RISE is planning to hold focus groups to dig deeper into the reasons behind the hesitancy to inform the state’s strategy for encouraging vaccine uptake.

“There may very different reasons for vaccine hesitancy,” Gooden said. “The reasons why rural individuals might not want to take the vaccine may be very different than why Latinos might not want to take the vaccine. The state can align its strategy by having a deeper understanding of vaccine hesitancy and how we can overcome that.”

Gooden, who also serves on the state health equity task force, taught a graduate course last summer on “Social Equity, COVID-19, and the Commonwealth of Virginia.” The students researched equity in the pandemic, and shared their presentations with members of the task force.

Douglas-Glenn spoke with a journalist in January about the racial implications of the COVID-19 vaccine distribution. Brown, state coordinator of emergency management, soon reached out and said he wanted to advance racial equity as a significant component of Virginia’s vaccine distribution plan.

“He wanted to add racial equity as a significant dimension,” Douglas-Glenn said. “Sometimes when [people] talk about equity, it’s not necessarily solution driven. It’s really focused on equity as a problem. … RISE is really helping to center equity in our policy conversations and in our community conversations, as opposed to making it one-off or a secondhand component of those experiences. It’s helping to center equity in these conversations and really moving towards solutions.”

Douglas-Glenn added that RISE’s work with Virginia on vaccine equity exemplifies VCU’s efforts to engage the community in its scholarship, bringing academic and community partners together to improve health and well-being.

“From a university perspective, this aligns with VCU’s [focus on] community engaged scholarship, and really thinking about the way that our scholarship informs our engagement with the communities,” she said. “Our goal here is to be a partner in this space.”

Gooden said RISE’s work is part of the legacy of the Wilder School’s namesake, former Gov. L. Douglas Wilder, who has been in public service since 1969. “That legacy permeates the Wilder School and our approach and our prioritization and focus on equity.”

RISE was formally created relatively recently, Gooden said, but the Wilder School has long had faculty members recognized in terms of their social equity prominence and expertise.

“To have a state agency look to us to assist in one of the most challenging projects and challenging set of problems the nation and indeed the world has faced, speaks volumes for the trust that we have built with them and for the shared commitment to really rolling up our sleeves and doing the work that needs to be done for all Virginians,” Gooden said.

To learn more about VCU Health efforts to address barriers and create opportunities for our neighbors to lead healthy lives, see “Community Impact.”