Most at risk, first in line: Public health experts say racialized Canadians should be prioritized for vaccines

Two public health experts in Toronto say governments must prioritize vaccinating Black Canadians and other people of colour against COVID-19 because the data shows they are most at risk of contracting the virus.

Akwatu Khenti and Ananya Tina Banerjee told CBC Radio's The House that failing to vaccinate those communities will not only put them at greater risk of getting COVID-19, but also increases the chance that the virus will spread more widely.

"The reason that Black people have a higher rate of positivity, or higher hospitalization rates, is actually because of social inequities, systemic racism and neighborhood vulnerabilities," said Khenti, who teaches at the University of Toronto's Dalla Lana School of Public Health and chairs the city's Black Scientists Task Force on Vaccine Equity.

"If we use some type of vulnerability index we would arrive at the same conclusion, the most vulnerable should be first in line. Right now, the most vulnerable are racialized health professionals, racialized communities."

Banerjee founded the South Asian Health Research Hub, and like Khenti, is on the faculty at the Dalla Lana School of Public Health. She said the data shows racialized communities are not only hardest hit by the virus, but many people in those communities work in manufacturing, distribution, the service industry and travel to their jobs using public transportation.

"And so given this information, it has to be prioritized that ... the hardest hit neighbourhoods have to get vaccinated first or community transmission is just going to escalate," she told The House.

CBC News: The House10:31Building an equitable vaccine rollout

Akwatu Khenti, chair of Toronto’s Black Scientists’ Task Force on Vaccine Equity, and Ananya Tina Banerjee, founder of the South Asian Health Research Hub, share what’s needed to create an inoculation campaign that provides equal access to shots.

Advisory committee looking at next priority groups

CBC News put those concerns to Canada's chief public health officer, Dr. Theresa Tam, on Friday.

Tam noted that the goal of prioritizing specific groups or locations, such as congregate settings, is to reduce serious illness. But, she added, different provinces would use their own evidence to inform their rollout plans.

She said the National Advisory Committee on Immunization (NACI) is examining the next set of priority populations for vaccines as deliveries begin to ramp up in the weeks ahead.

"For example, if you are in Toronto or if you're in Ontario, they've already got data in relationship to where those higher risk populations are and that they be considered as part of the rollout for the prioritization of vaccines."

Ontario's Ministry of Health told CBC News that the province is already collecting some demographic information, including age and sex, from people receiving vaccinations on a voluntary basis; it is also exploring how additional data might be used "to support the efficient, equitable and effective vaccine rollout for communities that are at-risk and disproportionately impacted by COVID-19."

The statement goes on to say that the ministry recognizes Black and racialized communities have been disproportionately affected by COVID-19 and is working with local health authorities to establish guidelines for delivering the shots.

"The ministry works with its health system partners to ensure the guidance and information provided is clearly understood by all partners regarding the prioritization of populations for COVID-19 vaccines."

Racialized populations at risk elsewhere

The federal government already identified the need to prioritize Indigenous communities for vaccination. But this country isn't alone in grappling with how to protect the most vulnerable sectors of the population from COVID-19 amid shortages of vaccine doses.

In the United States, Black and Hispanic Americans are bearing the brunt of infections, hospitalizations and death linked to the coronavirus. Experts there, and in Canada, are warning that the lack of race-based data on vaccinations runs the risk of leaving those same communities behind.

Khenti said part of the effort needed now is to overcome the reluctance of some people in racialized communities to get the vaccine by working with community partners and other local agencies.

"You have to work through trusted partners because the issue isn't just one of information, it's one of trust. And to date, many institutions haven't made the effort to earn that trust," he said. "Systemic racism has been ignored. It hasn't been given the priority that it deserves, especially with respect to anti-Black racism, which is the issue facing my task force."

Community outreach critical

That kind of community outreach is being credited with reducing coronavirus infections in South Asian communities in BC's lower mainland. 

The province, like most others, doesn't systematically track race-based COVID-19 data. But Banerjee told The House it's possible to replicate anywhere.

"I mean, think about it. We need to bring the vaccine to the people and meet them where they're at right now ... We need to be thinking about that. We can't just rely on these large health care systems, malls and chain pharmacies to have these vaccination programs," she said.

" And so we need to be, I think, at these access points of trust, as we call it. Just this past weekend in the U.K., there were hundreds of people actually vaccinated at a pop up clinic set up by the East London mosque to encourage Muslims to be inoculated and given their widespread concerns about the vaccination. And I think that is an incredible model that is community driven, that can be rolled out to temples, churches, gurdwaras, mosques in Ontario, especially if you want to target those racialized communities."

But both Khenti and Banerjee warned that time is short. New, more contagious variants of the virus are beginning to spread, increasing the need to act now to give priority to Black Canadians and others who are already at higher risk of contracting COVID-19.

• Listen to CBC Radio's The House: Businesses reopen, variants close in