This week, New York City announced a new proof of vaccination requirement for residents, visitors and workers in indoor spaces — including restaurants, gyms and entertainment venues — which is opening the door for similar vaccine strategies nationwide as the Delta variant of COVID-19 drives up cases worldwide.
The Big Apple's new rule, set to go into effect this month but not enforced until September, is the first of its kind in the country. However, it raises questions about who could be negatively impacted by the announcement based on low vaccination numbers.
New York City data shows the city's vaccine uptake is lowest among certain demographics, particularly Black residents that account for the lowest, with only 31% reported as fully vaccinated. Latinos fare a bit better at 42%, while White residents are 46% fully vaccinated. By comparison, more than 67% of Native Americans and 71% of Asians or Pacific Islanders are fully vaccinated.
Dr. Oni Blackstock, executive director of Health Justice, said a one-size-fits-all approach isn't appropriate while the country is still trying to battle inequities to vaccine access and hesitancy.
"It's a challenging situation. While vaccine passports have the potential to decrease the spread of the virus and may be an incentive for some to get vaccinated, their implementation also has the potential to worsen existing inequities," Blackstock told Yahoo Finance.
In some ways, the passports could penalize those who are hesitant or have concerns, especially as seen in Black and Latinx communities.
"One could even say that it feels like people who have been traumatized by racism and systemic oppression are now being penalized because they haven't gotten the vaccine. Also, having to provide documentation ('papers') may be a deterrent for many marginalized groups who have been surveilled and are understandably concerned about being surveilled by showing their 'papers'," Blackstock said.
Instead, she added, President Joe Biden's announcement for incentives such as paid time off should be leveraged as much as possible.
Dr. Howard Forman, a professor of public health at Yale University, told Yahoo Finance that any leaders considering following suit with a vaccine mandate or similar measures should weigh the impact on minorities.
"What must weigh heavily on leaders’ minds is the disproportionate impact of many mandates on the lowest wage, most vulnerable workers," Forman said.
"In many cases, this group harshly intersects with people of color, disproportionately Black Americans who remain relatively less likely to be vaccinated in most (but not all) locales compared with White and Asian Americans," he added.
However, the story isn't unique to New York City. Broadly speaking, African-Americans account for the lowest uptake in a majority of states, according to a recent analysis by Bloomberg — even though they've been hardest hit by the pandemic.
And CDC data shows a similarly worrying trend nationally: Just 25% of Black Americans are fully vaccinated nationwide, well below virtually every other ethnicity. A number of observers have pointed out that NYC's policy could result in minorities being inadvertently shut out of public life, based on their resistance to inoculation.
President Joe Biden recently announced incentivizing vaccines with $100 at the state and local level — something that's seen quick uptake in New York City since implementation— as well as mandates for federal employees. The president also said employers will be reimbursed for giving employees time off to get vaccines — one of the common reasons cited by unvaccinated individuals.
Meanwhile, some of those employees who remain unvaccinated work in health care, according to Forman.
"Many of the lowest wage healthcare workers are currently unvaccinated. There is a great imperative to see these patient-facing individuals be vaccinated and not contribute to the transmission chain and potentially the infection or death of nursing home or hospitalized patients. But they are also low wage: often patient care aides, transport staff, food services, etc," he said.
Giving an 'additional nudge' to get the vaccine
New York's strategy is the first of its kind in the U.S., but French President Emanuel Macron announced similar measures in July. The move proved effective as it caused a rush for vaccines— to the point of crashing the appointment system.
New York City Mayor Bill de Blasio acknowledged the controversy in his announcement on Tuesday, saying that his administration was "hearing from so many folks in the business community is they understand it's time, but they need government to lead. That's going to help them do what they need to do," he said.
"Not everyone is going to agree with us, I understand that. But for so many people, this is going to be the life-saving act," de Blasio added.
In Los Angeles County, where soaring COVID-19 cases fueled by the Delta variant have prompted a reimplementation of indoor masking, data revealed similarly low vaccination numbers among Blacks. Less than half of that segment has received at least 1 dose; meanwhile Asians lead with more than 77% receiving one or more doses, followed by 67% of Whites and 55% of Latinos/Hispanics.
Dr. Leana Wen, a public health professor at George Washington University, told Yahoo Finance that the efforts by the Biden administration are important in the push to increase vaccinations in the country.
"There are many unvaccinated people who are not 'anti-vaxxers', but who need an additional nudge to get vaccinated. Vaccine requirements provide that additional incentive," she explained.
"Communities of color have been hit disproportionately hard from COVID-19. It's critical to focus efforts to increase vaccination rates in these groups, including with paid time off, vaccinations at workplaces and schools, and efforts to make getting vaccinated the easy and convenient choice," Wen added.
The struggle to reach herd immunity is becoming an increasingly uphill climb, as hesitancy and outright hostility to the shot makes swaths of the population vulnerable to infection, unswayed by rising cases nationwide.
One survey found that at least 15% of respondents were unlikely to ever get a vaccine, down from about 20% in earlier months. Meanwhile, the latest Kaiser Family Foundation (KFF) survey found 31% of respondents saying they plan to remain unvaccinated.
Among those that say they will "definitely not" get vaccinated, 75% say getting vaccinated poses a bigger risk to their health than getting infected with coronavirus.
The KFF survey has been conducted monthly throughout the pandemic and, despite a reduction in those willing to get vaccinated, some trends have remained the same. For example, race or ethnicity and political leaning are still key identifiers for the majority of the hesitant, or those who refuse to ever be vaccinated.
At least 40% of those who would wait and see about getting a vaccine are minorities, while those who definitely will not are overwhelmingly White, per KFF.
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