Despite Oklahoma ranking near the top 10 in coronavirus vaccine distribution across the country, early data have shown disparities in who is getting the in-demand inoculations.
In its most recent epidemiology and surveillance report, the Oklahoma State Department of Health demographic data indicated a lower rate of vaccinations among Black, Latino, Asian and American Indian groups than whites.
Of the Oklahomans who have gotten the COVID-19 vaccine, about 2.6% identified as Black and 2.5% as Latino.
Whites accounted for 66.4% of the more than 370,000 first doses administered so far. About 4.3% of those vaccinated through the state’s program identified as American Indian and 2.0% as Asian. Many Oklahomans with Native heritage also have the option to be vaccinated through tribe-administered programs.
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The inequity is underscored by federal data acknowledging that racial and ethnic minority groups get infected and ultimately die from COVID-19 at rates far exceeding their share of the population.
In August, the CDC released data showing that Blacks, Latinos, and American Indians are experiencing hospitalizations at rates 4.5 to 5.5 times higher than non-Hispanic whites.
In Oklahoma, Blacks account for 6% of all coronavirus deaths, Latinos 5.4%, Asians 1.3%. American Indians have accounted for 9% of Oklahoma’s COVID-19 deaths — the highest among minority groups in the state.
“Our system is not yet prepared to center on and reveal the truth of structural racism and how it plays out,” said Kelly Gonzales, a member of the Cherokee Nation of Oklahoma and a health disparity expert on the committee about whether race played in a role in minorities failing to gain access to vaccinations.
Phil Maytubby, the chief operating officer with the Oklahoma City-County Health Department, said gaps in vaccination are a concern, especially related to minorities.
He noted that data gaps are also problematic, compromising officials’ ability to accurately track who gets shots.
Nearly one-third of people who have been vaccinated through the first two phases of the process did not identify themselves by race, Maytubby said.
Although vaccination distribution data is skewed toward whites, the imbalance could be explained by several factors, including limited vaccine supplies, difficulty using the vaccine registration portal, hesitancy to get vaccinated, and the demographics of the state’s early priority groups. Health care workers, first responders and those 65 or older are the only Oklahomans to get the shots so far.
Deputy Health Commissioner Keith Reed explained that the state wanted to make sure vaccines are distributed equitably across Oklahoma as additional doses arrive in the supply chain over time.
“That’s something we do watch closely and we want to make sure that we have a program that includes good health equity, and that we are equitably distributing a vaccine based off of race and demographic factors in the state,” Reed said.
Last week, a vaccine pod opened at an African American church in Oklahoma City to increase efforts to get minority residents access to the COVID-19 vaccine.
“When we saw that the African American population was at 2½% receiving the vaccine, I put our team in motion to actually set a pod where we could change that outcome,” Gov. Kevin Stitt told The Oklahoman.
Mindy Spohn, OSDH vaccine facilitator, is part of a planning team that has been working to identify inequities within the current structure and then address findings with stakeholders and grassroots centers across the state.
“One of the quickest things that we decided to do was to provide vaccines through our federally qualified health centers,” Spohn said. “Their primary mission is to serve those that are not as connected in the community or have transportation issues or really have some social barriers that are keeping them from accessing health or from getting to a larger (vaccine) pod somewhere in our communities.”
The Biden administration reemphasized the importance of including “social vulnerability” in state vaccination plans — with race, ethnicity and the rural-urban divide at the forefront — and asked states to identify “pharmacy deserts” where access can be difficult.
Once more vaccine becomes available, Spohn says, the hope is that health care providers, urgent care centers, clinics and pharmacies will be able to administer the shots to those in underserved communities.
The Oklahoma Caring Foundation is working to reach vulnerable communities in Tulsa County through a partnership to offer vaccines at churches and community centers in predominantly minority neighborhoods starting next week. Tulsa Health Department Executive Director Bruce Dart said they will go to “eligible residents in low-access areas in Tulsa County, especially in places where English may not be their native language.”
Krystal Reyes, chief resilience officer for the city of Tulsa, helps lead the Latinx COVID-19 Outreach Committee in a partnership with the Tulsa Health Department.
Formed last summer in response to the disproportionate rates of COVID infections among Latino residents, the group has been steadfast in working with business leaders and faith-based organizations to inform Spanish-speaking individuals about transmission prevention and testing along with other important details about the virus.
A major challenge for primarily Spanish-speaking people in gaining access to the vaccine is the state’s portal for registration and appointments is currently only in English.
“We can get the word out and get information out in Spanish, but if someone is not a primary English speaker and is not proficient in English, they might have some difficulty with the site,” Reyes said.
Officials have said the state is committed to providing bilingual options but have not been able to answer questions on the timeline.
The Rev. Jamaal Dyer spent 15 days just before fall severely sickened with COVID-19. Dyer, pastor at Friendship Baptist Church on Tulsa’s north side, said the experience made him gain a new perspective on life.
While he is not completely satisfied with vaccine accessibility for African Americans at this point, Dyer hopes elected officials will “do all they can to ensure that it’s equally distributed.”
He is scheduled to moderate a public forum Feb. 10, “COVID Vaccine and the Black Community Town Hall,” featuring African American physicians and health care professionals.
“I know a lot of people are are a little leery of it,” Dyer said. “I wanted to put together some Black doctors who have taken the vaccine. If Black people see reputable Black physicians who treat them and their children encouraging them to take it, they will be less apprehensive to take it.”
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Who is eligible currently?
As of March 29, all Oklahomans 16 and older will be vaccine-eligible.
What determines how many appointments are available?
The state is reliant on COVID-19 vaccines supplied by the federal government; officials reportedly are notified of shipments one week at a time. The limited supplies make it logistically impossible to schedule vaccinations weeks in advance. Oklahoma officials hope for a policy change that resupplies be based on states' “burn rate,” of how many shipped doses are distributed promptly.
States and tribal leaders are receiving federal shipments of vaccines based on population, OSDH leaders have said. Oklahomans with a CDIB card would go to a tribal health care center for vaccines.
I signed up at vaccinate.oklahoma.gov but never got an email confirmation of any kind — what should I do?
Confirmation emails are sent out in batches; users should receive one within 24-48 business hours of registering. “Emails are sent out over a span of time in the order in which registrations occurred,” the state said. “As a result, some emails may be delayed.” If you've waited at least 48 hours without having gotten a response, it could mean a data-entry error was made by the user during registration.
State and county health officials also have said most of these issues are resolved when the user checks their junk mail folder for messages flagged as spam.
I’ve been told I can make an appointment, but I went to the portal and there were none available within 100 miles — what do I do now?
First, if the portal has a link that says "No appointments available," click anyway. Possible glitches in the system might result in that message showing up even when appointments might be open outside the user's immediate area.
If you're still coming up empty, bookmark and keep checking the “Click here” link emailed to you, says deputy OSDH commissioner Keith Reed. The link does not expire and is the only method to check for appointment availability. No further emails will be sent.
When will new appointments be added to the online portal as the state is updated on the supply of vaccines expected to ship from the federal government?
A new round of scheduling should be available on the portal every Thursday. Starting 5 p.m. Wednesday through Thursday morning, new appointments are uploaded for distribution pods, said Mindy Spohn, OSDH vaccine facilitator.
Tulsa Health Department did not add appointments Feb. 10-11 for the coming week due to inclement weather.
Someone I know is unable to go online to access the vaccination portal — how can they make sure to get an appointment?
The state recommends that those unable to access the online portal ask a family member or friend with internet capabilities to assist them with the registration process.
Some churches have stepped up to help people without internet access register on the portal, as well as those who need a foreign-language interpreter. State officials have said a Spanish translation is forthcoming for the online vaccine portal.
How are 211 and LIFE Senior Services trying to help?
Call center staff at 211 can help Oklahomans connect to resources they may need to physically access the vaccine distribution sites, but they cannot schedule appointments. OSDH helped add to 211 staff, who can collect patients' contact info to pass on to local health departments for phone scheduling.
LIFE Senior Services is helping callers get scheduled by signing them up on the portal and receiving emails for the patient. Pictured: LIFE Senior Services activities director Amberly Villegas and Geneva Boling.
Who else is trying to help people book appointments?
Josh Wright, software developer from Norman, developed a text-alert system for Oklahomans as a companion site for the state's COVID-19 vaccine portal.
The vaccine-alerts.com site has 41,000 users, who have received 1.25 million text alerts, as of Feb. 5.
Can I show up at a vaccination site without an appointment to wait for someone to miss their scheduled time?
No, Tulsa Health Department and other sites say those without appointments are not welcome at known vaccination sites. THD says if someone does miss their appointment, those shots may be offered to first-responders in the area who have not been able to get vaccinated yet.
What happens if I am unable to make my scheduled appointment? Can it be changed?
Asking that residents strive to keep their bookings as time slots are in high demand, the state has said that those who miss their scheduled time will need to make a new appointment. Cancellations or scheduling changes can be made through the portal. “There’s been some difficulty with that,” Spohn said. “Sometimes you have to wait 24 hours to be able to get back in and redirect your appointment because it locks up. … That’s among fixes we’re working on on our end.”
At what point do I schedule my second dose or "booster shot"?
The answer seems to change depending on which site a patient received their first dose.
Second-dose appointments may be scheduled at the time of the first shot. It is not required to schedule booster doses through the portal. “Follow the instructions given when you got your first shot,” OSDH Deputy Commissioner Keith Reed said.
Second-dose appointments may also be made via the state portal, and users will be asked whether they need the Pfizer or Moderna shot. Some clinics have had scheduling issues for second doses, Spohn said, so officials are working to ensure those sites aren’t filling up with only first-dose appointments.
Tulsa Health Department says: “You are able to walk in for your second dose without an appt, provided you come at the same time as your first dose. Must bring your vaccination card with you.” Director Bruce Dart said those who got a Pfizer vaccine through Tulsa Health Department should try to come back to the same site 21 days after the prime dose; those who got Moderna should walk back into the same site 28 days after.
In Wagoner County, second-dose appointments cannot be made until one week before the patient is due for the booster shot.
I can't get an appointment for my booster dose when I am supposed to — is it OK to take it any later?
Those concerned about getting appointments exactly 21 or 28 days after their first dose don’t need to worry; if you’re a little late, it doesn’t cause you to have to restart the shots. You may just take a few more days to reach 95% immunity.
The state says it may take longer for second-dose appointments to show up in the system as those cannot be entered into the system weeks in advance. Because the timing of booster doses means a three- or four-week delay, those scheduling their booster dose via the online portal are told not expect to set the schedule right after the prime dose.
Can I choose whether I receive a Moderna or Pfizer shot?
Some clinics have both Pfizer and Moderna available, but basically it’s whatever is available at the time of the appointment at the site.
Will I be able to drive-through to get my vaccination or will I have to go inside a facility?
Mindy Spohn said the state is trying at each location to help patients with accessibility issues to be able to drive-through. “The problem with drive-throughs … it does limit our throughput because you have a 15-minute observation period.” She said some sites may have found ways to offer drive-through with observation, "but their ability to reach large numbers is limited because of that."
If I have already had COVID-19, do I still need to consider getting the vaccine?
The short answer is yes. Dr. Jennifer Clark, who leads Project ECHO’s COVID-19 data sessions, said the human body’s natural immunity isn’t fully reliable and can be erratic. She said the response a person’s body will have from the vaccine will be more reliable and robust relative to the body’s natural immune response. Monks recommends waiting 90 days after recovering, especially if those who received monoclonal antibodies or convalescent plasma.
Do I still need to practice the three W’s after getting my vaccination?
Yes, it is vital for Oklahomans to continue to wear masks, wash their hands and watch their distance even after being vaccinated. The vaccine effectively protects recipients, but recipients may still be able to spread the virus to others. The CDC has not yet determined if or when it will stop recommending that people wear masks and avoid close contact with others to help prevent community spread.
Can you be a carrier of the virus after receiving a vaccination?
"We have to assume the answer is yes, you can. In other infectious diseases, this happens pretty commonly, though in others it does not. It won’t be known for another few months as we’ve gotten lots of people vaccinated and then tested with viral swabs," Oklahoma Medical Research Foundation President Dr. Stephen Prescott said.
Why do I have to wait 15 minutes before being able to leave after my vaccination, and what side effects are common?
Any adverse reaction that could endanger the patient's health should be evident within 15 minutes, so those receiving the vaccine must agree to observation during that time. Dr. George Monks, president of the Oklahoma State Medical Association, said possible side effects include mild pain or swelling at the injection site, true of any medicine injected into skin. Other possible side effects include mild fever, chills, tiredness and headache. Monks said side effects are almost always mild and are more common in younger people or when receiving the boost dose. Monks said one can think of the symptoms as a sign that the vaccine is working.
How many vaccine doses have gone to waste in Oklahoma?
State officials say there is no problem with expiring vaccines; doses arriving each week are already scheduled to be distributed the following week. “We don’t have any vaccine that’s sitting on the shelf,” says deputy OSDH commissioner Keith Reed. On Feb. 9, he said only 247 cumulative doses had been wasted due to broken or leading needles and vials.
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