In this March 2021 file photo, Phil Tartalone, an EMT with Premier Medical Group, administers the Moderna COVID-19 vaccine to a patient at a mobile vaccination clinic in South Tucson. Health officials cite a variety of reasons why the racial and ethnic makeup of vaccinated people is unlikely to align with the makeup of Arizona's general population. 

 Josh Galemore, Arizona Daily Star, File

White people have been vaccinated against COVID-19 at a higher rate than other racial or ethnic groups in Arizona, even though they have had the lowest overall rate of COVID-19 cases per capita during the pandemic.

The Arizona Department of Health Services didn’t expect the racial and ethnic makeup of vaccinated people to align with the makeup of the general population “due to the phased approach of vaccine distribution,” according to a disclaimer on the department’s online chart of COVID-19 vaccine administration.

Health experts point out that the older population, which is populated by more whites, was given vaccine priority because age is such a big risk factor for severe COVID-19 illness. So it’s not surprising that the overall makeup of vaccinated people skews whiter.

On Friday, however, the Arizona’s top health official, Dr. Cara Christ, walked back the health department’s disclaimer that vaccine distribution in the state isn’t expected to align with the racial and ethnic makeup of the state’s general population.

“That probably should come down off of our website. I’ll talk to the team,” she said. “Now that we are vaccinating the general population and we’ve had multiple weeks where everybody has been eligible, that disclaimer probably should come off of our website.”

On March 24, Arizona opened vaccine eligibility to everyone 16 and older.

While this opened up vaccines to more people of color, the state’s cumulative vaccine distribution has remained misaligned with the makeup of the state’s general population.

“I don’t know that I have an anticipated timeline, if ever, that it will exactly match the demographics of this state,” Christ said.

The data do have some caveats, she said. For example, not all federal and Indian Health Service facilities are reporting vaccine data to the state health department.

Christ said the percent of vaccinated people who are Native American may never fully match the percentage of Native Americans in the general population.

The Native American population is disproportionately represented among COVID-19 cases, hospitalizations and deaths in Arizona, according to the COVID-19 Tracking Project, which flagged these data for likely representing a racial disparity.

Native Americans are also under-represented in the vaccinated population, according to the state’s data. But the percentage of Native Americans who have been vaccinated is higher than the percentage of Backs and Latinos who have been vaccinated in Arizona.

Christ gave other explanations for the misalignment too.

“We know that we’ve got vaccine hesitant populations. So while we’re working with the leaders of those communities to really increase messaging and increase the communication and the encouraging of getting the vaccine, I don’t know that they ever will meet the state demographics for those,” Christ said, adding that the state will continue to help increase access to vaccines in underserved areas.

In Arizona, nearly 37% of whites, 25% of Native Americans, 22% of Blacks and 17% of Latinos have been vaccinated with at least one dose of vaccine, according to population estimates from the 2019 five-year American Community Survey and the state’s vaccine data.

Health experts also look for racial disparities by comparing the makeup of vaccinated people with the makeup of the general population.

Latinos or Hispanics represented about 13% of all vaccinated people in Arizona, but they make up 31% of the general population.

Blacks represented 2% of vaccinated people, but they are about 4% of the general population.

Native Americans represented about 2% of vaccinated people in the state, but they also make up about 4% of the general population.

And whites represented 48% of vaccinated people, but they are about 55% of the general population.

The state didn’t have race and ethnicity data on 398,231 vaccinated people, or 13.6% of those vaccinated, as of Friday.

The way the health department categorizes other groups by race and ethnicity doesn’t align with how the U.S. Census Bureau categorizes the general population by race and ethnicity.

The misalignment is not caused by race alone, said Dr. Joe Gerald, an associate professor with the University of Arizona’s College of Public Health. “It’s not race, per se, but rather the conditions and structural inequities that these groups face. Some of it may be, they may be more likely to live in an area where there’s a healthcare provider shortage. That kind of thing. So, it may be unrealistic to expect them to ever catch up fully.”

Gerald pointed out that this trend is also evident in colorectal cancer screenings too, which is a prevention measure, much like a vaccine is. It’s something that people who are sick can get to stay healthy.

Every year since 2000, white people 50 to 75 years old got this screening at a higher rate than any other racial or ethnic group.

The same type of barriers that would prevent a person of color from getting this type of cancer screening would also prevent that person from getting a COVID-19 vaccine, he said, adding that it’s not a perfect comparison, but a reasonable one.

“There’s this correlation between race and income, education, occupation and living conditions, such that Hispanics, for example, may always face more barriers to vaccination than whites. And they may never catch up and may never be vaccinated at the same proportion as they are in the population,” Gerald said.

It was logical to prioritize older people for the COVID-19 vaccine due to the strong correlation between age and severity of disease, Gerald said.

Health experts widely agree that this strategy led to disproportionately vaccinating white people at a higher rate because the older population is whiter.

“One might say, ‘well that’s not racism, that’s fair,’” Gerald said.

While public policy didn’t overtly exclude people of color from getting vaccinated, structural racism did put them at a disadvantage, he said.

“Where the structural racism comes into play with a strategy that’s fully age based is that minorities, on average, don’t have an equal opportunity to live to the same age,” he said, adding at the types of barriers that people of color face have an impact on life expectancy.

“And so they’re going to be disproportionately shut out,” he said. “So yes, the prioritization schema did disadvantage minority groups.”

Herd immunity occurs when a high percentage of the community is immune to a disease (through vaccination and/or prior illness), making the spread of this disease from person to person unlikely.

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Contact reporter Alex Devoid at adevoid@tucson.com or 573-4417. On Twitter: @DevoidAlex

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