Chocolate City, Vanilla Vaccine: Racial Disparities in Washington, DC COVID-19 Vaccine Administration

by Kesha S. Moore, Ph.D., Senior Researcher, Thurgood Marshall Institute

Washington, DC has often been referred to as Chocolate City because of its historic high percentage of Black residents comprising a majority of the population. While the percent of Black DC residents has dropped in recent years to 45% and the White population has risen to 36%, the nation’s capital is experiencing a gross magnification of the racial disparities in COVID-19 deaths and vaccinations compared to the rest of the country.

Although Black people comprise 45% of DC’s population, they make up 75% of all COVID-19 deaths in the city (Figure 1) — a stunning 30 percentage point gap. In comparison to all US states and territories, DC has the largest gap between the Black population and their percentage of all COVID-19 deaths. Michigan has the next largest gap at 10%, followed by New York and Louisiana, both with 7 percentage point gaps.

Even though three-quarters of the DC residents who have lost their lives to the COVID-19 pandemic are Black — Black people have received a little over a quarter of the vaccines distributed in DC thus far. In contrast, White DC residents have received vaccinations three times their rate of deaths from COVID-19.

DC residents experience a variety of barriers to access to the vaccine, including the heavy reliance on internet access to register for the vaccine, insufficient call center capacity resulting in limited access by phone, and a website that lacked the overall capacity to handle the incoming requests. The Mayor of Washington, DC, Muriel Bowser, announced several recent measures to reduce the racial disparities in vaccine distribution and ensure that the populations most vulnerable to death from COVID-19 have access to the life-saving vaccine. Several interventions focus on Wards 7 and 8. According to Figure 2, Wards 7 and 8 have the lowest vaccination rate among seniors, and Ward 3 has the highest. Figure 3 also shows that these communities also represent neighborhoods with the highest proportions of Black residents, and Ward 3 has the lowest percentage of Black residents in the city.

The new measures include establishing a registration day when only DC residents (specifically, those over 65 or those with a qualifying medical condition) who live in priority zip codes can register for vaccination, allowing residents to pre-register for the vaccine and receive alerts when vaccination appointments are available, and expanding vaccination sites. Two innovative city interventions that look promising are the Faith in the Vaccine Clinics and Senior Vaccine Buddies. The Faith in the Vaccine Clinics are hosted at local churches where residents can receive information about the COVID-19 vaccine, ask questions, and be vaccinated on-site. Senior Vaccine Buddies are uniformed individuals who canvass wards with high rates of COVID-19 deaths to discuss vaccinations with residents and help those interested register to be vaccinated. Prioritizing communities most burdened by COVID-19 and engaging residents in two-way conversations mediated through trusted partners are examples of the kind of information interventions recommended by the Johns Hopkins Center for Health Security to promote equity in vaccine distribution. Such interactions are likely to increase Black residents’ access to vaccinations and confidence in the vaccine. We will continue to closely monitor the racial disparities in Washington, DC, and states across the country.

Additional Resources:

Philly Surgeon Delivers COVID Tests, Vaccines and Compassionate Care to the Black Community

Declare Racism a Public Health Emergency

Structural Racism is a Public Health Crisis