With more than a half-million shots administered across the islands, Hawaii appears to be solidly on track to meet President Joe Biden’s call for all states to open up COVID-19 vaccination to all by early May.
While this progress marks encouraging gains for public health and the economy, it’s concerning that three months into the state’s vaccination campaign, only 8.8% of Native Hawaiians and other Pacific Islanders have received at least one dose — though they represent more than 40% of COVID-19 cases.
These figures and others in the state Health Department’s just-released racial breakdowns on coronavirus vaccinations serve as a red flag that more robust outreach efforts are needed to serve disproportionately impacted communities. In addition to ushering these groups toward the front of the line for immunization, more follow-up is in order to address language barriers and other issues, including vaccine hesitancy.
The new data shows that residents who identify as Asian or white are more likely to have been vaccinated, with rates of 25% and 19%, respectively. Contributing to the disparities is that initial rounds of vaccine distribution, based on federal guidance, prioritized the elderly and health care workers. In both brackets, Native Hawaiians and other Pacific Islanders are underrepresented.
Moving forward, the state and its health partners should expand the reach of community health centers and other resources. The plan to next week open a mass COVID-19 vaccination clinic at Queen’s Medical Center’s West Oahu campus is a step in the right direction — starting with residents age 65 and older as well as those with high-risk medical conditions plus hotel, restaurant and bar workers included in phase 1c.
Hilton Raethel, president and CEO of the Healthcare Association of Hawaii, has pointed out that because many workers in the latter “sub-prioritized” 1c group are Pacific Islanders, their respective vaccination rates are poised to increase. That’s a welcome upshot given that in addition to working in high-risk situations, many in this group live in large households, which also puts their families at risk of infection.
Given that roughly 500,000 people are included in phase 1c, the state’s move to sub-prioritize some high-risk employment is sensible. However, officials clearly stumbled in announcing such first-in-line priorities days after appointments had already opened over the weekend to all 1c-eligible residents.
Confusion could have been avoided had the state better directed a large swath of 1c people — in industries and occupations ranging from transportation and construction to media and public safety — into subcategories for setting up appointments.
In a state survey conducted in the weeks preceding the mid-December rollout of vaccines, only half of the nearly 3,500 respondents indicated they would get immunized. Since then, it seems, vaccine acceptance has increased — Hawaii now ranks as seventh-highest among states for per capital shots given, with the total including vaccinations by the military and U.S. Department of Veterans Affairs.
In response to vaccine hesitancy in communities hard hit by infection, the state has worked in tandem with scores of community organizations to successfully break down language barriers and step up health-related education, accessibility to COVID-19 testing and contact tracing efforts. The grassroots reach must now also focus on getting shots in arms.
As Hawaii pushes forward with the largest public health initiative in state history, officials must further prioritize the high-risk, disproportionately impacted. Fully utilized community health centers and the deployment of roving “strike teams” would enable health care personnel to be nearer vulnerable populations to administer shots, wherever necessary.