Missouri’s COVID-19 vaccine strategy shortchanges KC’s most vulnerable, officials say
Missouri’s COVID-19 vaccine distribution strategy, which favors hospitals over local health departments, is contributing to a lack of equity that hurts underprivileged communities, according to officials in Kansas City.
More than half of the state’s vaccine supply is being sent to hospitals, while 8% is going to local health departments that many say are better placed to reach the most vulnerable, including in communities of color.
Kansas City Health Department Director Rex Archer said local health departments are best suited to serve many of those residents.
“We’ve built a trust; many already know our employees and services,” he said in a statement to The Star. “When it comes to preventing disease and injury, we are our community’s experts.”
The Kansas City Health Department received 800 doses from Feb. 15 to 21, according to the Missouri Department of Health and Senior Services.
By contrast, across the state line, Kansas is sending thousands of doses to local health departments in Johnson and Wyandotte counties. In the Johnson County Department of Health and Environment’s weekly allocation, it received 8,190 doses and the Unified Government Public Health Department received 3,900.
The volume allows Wyandotte County to operate two mass vaccination sites.
The lack of vaccine resources at the Kansas City health department contributes to racial inequities that public health experts and officials have been worried about since the vaccines started rolling out.
Recent data from the health department showed the largest numbers of Kansas City residents who have gotten the vaccine live in overwhelmingly white areas. The ZIP code with the most vaccinated residents — 64114 — is 82% white, while the city as a whole is about 57% white.
Mayor Quinton Lucas said Missouri’s structure was fundamentally flawed. People without a primary care physician or insurance may not seek services at a hospital or health system except in emergencies.
“These are the sorts of things that are incredibly stark and they will lead to this perpetual inequality because the health department actually knows how to reach a population that finds themselves in these ZIP codes with lower life expectancies,” Lucas said during a phone interview this week. “I am not sure our hospital groups are as strong in reaching out to those groups.
“It angers me actually.”
In Kansas City, where more than 36,500 cases have been reported, Black and Hispanic residents are more likely to die from COVID-19.
Public health advocates and officials said equity would be easier to achieve if local public health departments got more of the supply. But the state dictates where doses are distributed: 53% go to hospitals, 23% to mass vaccination events, 8% to health departments, 8% to federally qualified health centers and 8% to community providers.
Jeron Ravin, the CEO of Swope Health, a federally qualified health center, said relying on hospitals can present barriers.
“Not all patients can navigate large hospital systems, whether it be online registration, whether it be transportation,” he said. “I do believe the state will have to think very carefully over the next several weeks about whether or not that system is working.”
The Missouri Department of Health and Senior Services defended the state’s approach, saying hospitals are not only vaccinating their own patients but have also partnered with community organizations to reach more people. Spokeswoman Lisa Cox said the state health department is also reviewing incoming data to identify vulnerable populations that haven’t gotten the vaccine and will shift their plans accordingly.
But Bert Malone, a board member of the Missouri Public Health Association, said public health agencies have managed vaccination clinics for decades.
“They’ve been doing it, they know how to do it. They know where the minority populations are, that they can get in. They know the pastors of those churches, the homeless advocates,” Malone said. “The hospitals — and I’m not blasting the hospitals — but they’re looking to serve their clients, their patients.”
Steve Stites, the chief medical officer at the University of Kansas Health System, acknowledged the limited role hospitals may play in outreach. The health system, he said, has worked from a patient list, often contacting patients eligible for the vaccine electronically.
“We quickly found out that there were a lot of people we were missing and so we’ve started doing mail and phone calls,” he said.
“That’s our ability to do it while relying on health departments to do other types of reach out into communities.”
Missourians who are in an eligible phase for the vaccine can sign up for Truman Medical Centers’ waiting list. Spokeswoman Leslie Carto said it is a first come, first serve model.
