51
The plan was approved 3-1, with
one abstention. Jenkins advised the
Republican- led state’s department of
health, which sets rules for vaccine hubs,
of the plan; one day later, the state told
Dallas County that its vaccine doses
would be cut and its status as a vaccine
hub revoked if the plan went forward.
Even as they urged “equitable” distri-
bution of doses, state officials said the
hardest-hit areas could not be prioritized
above others. Later that day, the county
rescinded the plan.
When the Biden Administration took
office, it shifted away from the Trump
Administration’s vague assurances that
after medical workers and people in
long-term-care facilities had been vac-
cinated, other Americans soon would be
able walk in and request a jab at their
neighborhood pharmacy or health care
provider. Instead, Biden wanted mass-
vaccination hubs controlled by states,
counties and cities, and equity would
be a priority. He named Marcella Nunez-
Smith, a public-health researcher, dean
and associate professor at Yale Univer-
sity, chair of a White House task force to
to just over 20%. And the proportion of
white registrants shrunk from about
63% to about 54%. The numbers don’t
put registrations close to a mirror of the
population or those at greatest risk, but
they are moving in that direction, slowly.
Black and Latino Americans continue
to express greater amounts of hesitancy
around the vaccine, and the rollout has
offered them little reassurance.
Dallas, a county that tried to address
vaccine equity overtly, is a place that
people are watching. PCCI’s COVID vul-
nerability index and the clinical impli-
cations for it will be published in April
in the New England Journal of Medicine’s
Catalyst in Innovations Delivery, focused
on health care delivery. And the federal
government has stepped in with a plan
to offer the type of targeting local offi-
cials tried, prioritizing people in 17 hard-
hit ZIP codes.
“This pandemic has been a trans-
formative moment for us,” says Bowie,
the Johns Hopkins behavioral scientist.
“And it’s what we will do with it, as we
move forward and move through—this
is really going to tell a lot about who we
are as a country.”
As the cold air forces an indoor re-
treat, Mixon and I sit down, masked
and separated by several feet, in T.R.
Hoover’s computer lab. Theodore Roo-
sevelt Hoover, Mixon’s great-grandfather
and the center’s namesake, brought the
family to Ideal in the early 20th century.
He and his seven brothers left their mark
on the landscape by building houses.
Mixon tries to build better, and now
longer, lives in what some locals still
call “the Ideal.”
Down the hall, staff and volunteers
are discussing plans to create a database
drawn from voter-precinct lists and from
names of people who have had contact
with T.R. Hoover. Volunteers will call ev-
eryone listed to see if they need help reg-
istering for a vaccine.
Mixon pokes her head into the meet-
ing and then tells me the group has voted
to buy two pay-as-you-go phones to put
the registration effort into action.
But she looks a little forlorn. After a
moment, she explains that two weeks
ago, her neighborhood fishmonger lost
his father to COVID-19. She’s just heard
the virus has killed her fishman, too.
— With reporting by Julia Zorthian •focus on health disparities. But in Dal-
las County, people responsible for mass
vaccinations were scrambling, and it
quickly became obvious, Koch says, that
the “standard of success is getting shots
in arms.”
Shots in arms keep the vaccine supply
coming, Koch says. Vaccination dispari-
ties do not shut it off.
And disparities were virtually guar-
anteed, not just because of things like
Internet access. The system was tilted
in favor of wealthier white people by
prioritizing the 75-and-older crowd ini-
tially for vaccines. That eliminated many
in South Dallas, where living to 75 is rel-
atively rare. In Ideal, life expectancy sits
at an area low of 67.6 years. Of the 11 tar-
geted ZIP codes, three have average life
expectancies below 75; none reaches the
county average of 78.3 years. An analy-
sis produced by PCCI found that in the
weeks when vaccine registrations were
limited to those 75 and older, 71% of
the people registered in that age range
were white. About 8% were Black and
11% were Latino.By the time I visited Mixon at T.R.
Hoover, the county and city had ac-
knowledged that the registration system
had given North Dallas a huge advantage
and that things had to change. Officials
added more in-person sign-up loca-
tions. They announced plans for a door-
to-door registration drive and for a call
center so more people could register by
phone. The share of Black people signed
up to get the vaccine rose by a sliver from
almost 11% on Jan. 24 to almost 12% by
Feb. 7. During that period, Latino regis-
tration increased from 19.5% of the totali said to myself,
where did all
these white
people come from?!’
—JOHN WILEY PRICE