At this stage of the pandemic, Dr. Sandra J. Valenciano counts each shot in an arm as a small victory.
Vaccine hesitancy, misinformation, racial disparities in access to health care and distrust in institutions remain some of the biggest hurdles to vaccinating Black Georgia residents against COVID-19. Public health officials and advocacy groups have worked hard over the past year to make inroads with marginalized communities and those efforts have started to show promising signs.
The gap between Black Georgians who have taken the shot and the rest of the state has narrowed.
“COVID-19 is essentially here to stay,” said Valenciano, district director of the DeKalb County Board of Health. “If you are fully vaccinated, and you are eligible for the booster, get your booster. If you’re not vaccinated getting your vaccine protects you and it helps protect your community.”
But progress is slow going, and too few Georgians are vaccinated, public health experts say.
The state remains one of the least vaccinated in the country. That’s why Valenciano and others continue to push community outreach, campaigns to combat misinformation and mobile clinics across Georgia as a way to close racial and ethnic gaps.
The rate of Black Georgians who have been vaccinated with at least one shot (52.3%) has essentially caught up to the rate of whites (53%).
The rates for both races are about 10 points below the overall state average. Hispanics (55%), Native Americans (69.7%) and Asian Americans (94.9%) are all higher, state Department of Public Health data from Wednesday show.
Two years into the pandemic and even with the uptick in vaccinations among Blacks, the coronavirus continues to have a disproportionate effect on them.
Credit: Steve Schaefer
Credit: Steve Schaefer
Nationally, African Americans are between two and three times more likely to be hospitalized for COVID-19 than a non-Hispanic white person of the same age, federal data show.
African Americans disproportionately face higher barriers to reach health care, more often lacking health insurance or a primary care doctor. And they are more likely to work in higher risk front-line jobs and have co-morbidities that COVID-19 exploits.
“COVID just magnifies the pre-existing situation we’ve had all along with health disparities and inequities,” said Dr. Lilly Immergluck, a professor and director of the Pediatric Clinical & Translational Research Unit at Morehouse School of Medicine. “Pick what you want – testing and access to testing, prevention measures, it goes on and on and on.”
Though severe disease in children is rare, Black children also are more likely to be hospitalized and to develop a rare complication following infection known as multisystem inflammatory syndrome in children or MIS-C. Studies have shown children of color are also more likely to have lost a parent or caregiver to COVID-19 than white children.
When COVID-19 first struck Georgia, the disease hit communities of color particularly hard. By the end of June 2020, several months into the pandemic, Blacks, who represent about a third of Georgia residents, accounted for about half of hospitalizations and deaths.
The demographics of COVID-19 death and hospitalizations have shifted more towards white Georgians since the initial waves. African Americans now account for about 44% of COVID-19 hospitalizations and about a third of coronavirus deaths since the start of the pandemic.
“COVID just magnifies the pre-existing situation we've had all along with health disparities and inequities."
Covington pediatrician Dr. Samira L. Brown said knowing COVID-19 risk factors in the homes of her patients has become one of the core parts of her practice. Given the disproportionate impact of COVID-19 on Black families, a large part of the discussion is about vaccinating children and their families.
Brown said many of her patients don’t know about new COVID-19 treatments beyond vaccines and still struggle to access testing. Nationally, access to antiviral pills and monoclonal antibody therapies is also unequal, a recent Centers for Disease Control and Prevention report showed.
“Trust and access are huge issues especially for the black community,” she said.
Friends Killed by Virus
Few areas suffered more than Hancock County, one of Georgia’s historic Black Belt counties that was once filled with cotton plantations. The county is northeast of Milledgeville with roughly 8,700 residents, 71% of whom are Black.
Hancock has the country’s third highest death rate from COVID-19, according to U.S. data. It also ranks near the bottom in rankings of health outcomes statewide.
It is one of Georgia’s poorest counties and its health care system reflects that. The county’s small hospital in Sparta closed two decades ago and Hancock is served by two full-time doctors and a third who practices part-time in the county. Hancock has only two ambulances.
Credit: Handout
Credit: Handout
All of it has taken its toll on Adrick Ingram, owner of a funeral home and the county coroner. He has seen death from COVID-19 closer than anyone. And it’s worn him down.
“Seeing people that I know, literally I know, that have passed from COVID when I walk through the door,” he said.
The virus has killed friends, and people who supported Ingram’s campaign when he was first elected in 2016. Ingram succeeded his father, who was the first Black coroner in Georgia and served in Hancock for 41 years.
Ingram said after the stress from the pandemic, he no longer plans to seek a third term in 2024.
He is one of the community leaders who tries to encourage people to get the shot.
“I think a lot of the deaths could have been prevented,” he said.
Skepticism Persists
The vaccine rollout in Georgia has slowed considerably since peaking last March.
Those eligible individuals who were eager for the shot have largely gotten it. Children under 5 are not yet eligible for vaccine.
The statewide vaccination effort relies on a constellation of pharmacies, health departments, federal health centers, private medical practices and non-profits.
In DeKalb, state data show 47% of African Americans have received at least one dose, That’s about 15 percentage points below the overall average for the county and for all Georgians, and five points lower than the rate among Blacks statewide.
But the county has shown improvement.
The DeKalb Board of Health operates a vaccine site at the Doraville MARTA station and four health centers across the county. The county health department pivoted to offering vaccines at civic events and mobile clinics in partnership with community groups.
Much of the focus has been on South DeKalb, home to the highest percentages of the county’s African American population, as well as some of the county’s highest rates of obesity, diabetes, heart disease and other co-morbidities. South DeKalb is also home to some of the county’s lowest rates of vaccination.
“Sometimes that first conversation doesn’t lead to a vaccination,” said Valenciano, the DeKalb Board of Health leader. “Sometimes we’re there the next week and the person comes back, and they get their shot.”
The New Georgia Project, a nonpartisan voter registration group founded nearly a decade ago by Democratic gubernatorial candidate Stacey Abrams, has added vaccinations to its outreach efforts. NGP, which often partners with faith groups, offers health screenings, COVID-19 testing and shots through partner organizations at many of its events.
These events often start the conversations about vaccination, said Brandt Lewis, director of NGP’s vaccination program, and NGP follows up with mailers and texts to help people schedule shots.
The reasons some haven’t gotten vaccinated are nuanced, he said. Some say they can’t take time off work or fear side effects might sideline them from their job or make it difficult to care for children after they get their shots.
Some African Americans remain skeptical, invoking a federal government-backed “Tuskegee Study of Untreated Syphilis in the Negro Male” decades ago in which scientists withheld treatment from Black men who had syphilis to see how the disease would progress.
But Lewis said NGP stresses the facts about the “Tuskegee Experiment,” as it is better known, that care was denied, and the COVID-19 vaccines are safe and effective.
On Martin Luther King Jr. Day last month, six attendees at a day of service event rolled up their sleeves and got their boosters, Lewis said.
“In my line of business, that’s a good day,” he said.
EDITOR’S NOTE: Photo captions in an earlier version of this story misidentified Our Lady of Lourdes Catholic Church. The story has been updated with the corrected information.
