With the success of COVID-19 vaccine trials and their imminent introduction to the public, a discussion originating in the United States had arisen regarding whether members of non-White ethnic groups should get preferential treatment in the immunization program.
The issue has also divided opinions in parts of Europe. While to date there seem to be no major institutional or public challengers to these unprecedented plans, the legal path to allowing such discrimination may not be without hurdles.
As the criteria for the vaccine’s gradual distribution are being defined, according to experts, the first beneficiaries should be the most vulnerable groups in society. Most committees have recommended the prioritization of front-line health care workers and elderly occupants of care-homes. However, voices calling for the vaccines to be distributed among Black and other ethnic groups are gaining prominence both in the US as in Europe. Yui Mok/Pool Photo via AP A NHS pharmacy technician at the Royal Free Hospital, simulates the preparation of the Pfizer vaccine to support staff training ahead of the rollout, in London, Friday Dec. 4, 2020. The argument is based on research that shows that COVID-19 related infections and death rates are much higher among non-White ethnic groups, and are particularly high among Blacks. This could seemingly justify a preferential treatment of one ethnic group over the other until one delves into the reasons and causes for such differences.
According to US and Japanese studies , there are no underlying genetic causes among ethnic groups that would cause one to be more susceptible to infection than another. The seven genes responsible for the viral entry of COVID-19 are equally present and function the same way in all ethnicities. The causes for the disparity have been mostly traced back to other underlying health problems, such as diabetes or obesity, or social factors, such as crammed housing and access to health care. There are currently no studies publicly available comparing adherence to health recommendations such as social distancing, personal hygiene or mask-wearing comparing different communities.
However, views justifying preferential health care for certain ethnic groups on the basis of historical racism and social inequality are rising in prominence. Dayna Bowen Matthew from George Washington University states that “it’s racial inequality — inequality in housing, inequality in employment, inequality in access to health care — that produced the underlying diseases… That’s wrong. And it’s that inequality that requires us to prioritize by race and ethnicity.”
In the US, there is no current legal precedent for a preferential allocation of resources other than the affirmative action known from education. However, in order to bypass possible legal challenges against such a decision, there are reportedly plans to use what is called the Social Vulnerability Index (SVI) that would effectively guide the immunization resources to areas overwhelmingly inhabited by ethnic groups.
In the United Kingdom, the Joint Committee on Vaccination and Immunisation stated that immunization should begin with care-home residents and workers, a group that had been hit disproportionately by the virus. The mayor of London, Sadiq Khan, however, had asked the committee to also include ethnicity as a factor. Gareth Fuller/Pool via AP A pharmacy technician from Croydon Health Services prepares to store the first delivery of Pfizer’s COVID-19 vaccine, at Croydon University Hospital in Croydon, England, Saturday Dec. 5, 2020. “I have asked for additional things to be factored in, and that includes concerns I have got around Black, Asian, ethnic minority Londoners who disproportionately suffered during the deaths,” said Khan.
Plans to give preferential treatment to Black and Asian populations, however, seems to have encountered a resistance from the intended beneficiaries both in the UK and the US. According to studies , the largest proportion of those who will choose not to get the vaccine in the UK is among Londoners, and East-Londoners in particular, an area that has one of the highest proportion of Asian and Black inhabitants in the country. In the US, American Public Health Association head Georges Benjamin had stated that “the other challenge you have with saying, ‘We want African Americans to step up first,’ is that we don’t want people to feel that they’re being guinea pigs… We don’t want to give people the perception that they’re being experimented upon.”
If plans for a positive discrimination in health care and crisis management go ahead, this could set a worldwide precedent for racial discrimination not only against majority White social groups across the developed world. The introduction of the principle of historic grievances in the allocation of vital life-saving resources could have unforeseeable consequences for regions where ethnic tensions are rife.
