Underprivileged Communities: Barriers to Immunization and Possible Solutions

Written By: Vijay Jayamani

According to the CDC COVID-19 Data Tracker, there are currently 4,649,102 total COVID-19 cases in the United States with 154,471 total deaths, which is equivalent to 1,418 cases per 100,000 people. As the number of cases continues to increase, combatting the virus and its implications have created major health challenges, including the development of an effective vaccine. Once an effective vaccine is produced and distributed across the country, the transmission of the virus will significantly decline as people will start developing immunity to the disease. However, the idea of distributing and having access to the vaccine has left a large question for the underserved and marginalized communities.

As stated by the Office of Disease Prevention and Health Promotion, the COVID-19 outbreak has caused a major impact on various social determinants of health including economic stability and health care. These social determinants have significantly been affected in underserved areas where access to health-care resources are severely limited due to their marginalized community context.

For instance, in the economic stability domain, the pandemic has caused a tremendous increase in financial hardships especially for the underrepresented communities, which as a result, have confined their access to monetary relief programs. With this shortage of funding and attention, these communities are less likely to afford any sort of vaccines or health-care resources (testing, medical equipment) and as a result, develop a higher risk of infection.

As mentioned by UNICEF, vaccination services are kept unavailable to the poor because of “insufficient resources for distributing vaccines and maintaining the all-important vaccine cold chain, along with too few health workers.” This issue has made these communities more vulnerable and difficult to cope with during these challenging times and are placed with a significant disadvantage from keeping themselves healthy compared to middle and high-income communities.

This raises another serious question: what are some other serious burdens keeping underserved communities from vaccination services and quality health-care? Apart from the lack of funding and affordability, factors including residential status, mobility impairments, and language boundaries (ineffective communication capacity), all serve as a significant impediment for underserved populations from accessing vaccination services. According to the New York State Department of Health, these barriers to immunization have the potential to influence further medical implications including “distinctive treatment” as well as social challenges like “exclusion and quarantine” without access to quality vaccine services.

However, when compared to many middle and high-income communities, access to vaccine services is not an issue due to greater financial investment in health-care and medical resources. This illustrates the idea of the “immunization gap” (vaccine access and coverage only likely in higher-income areas) which “can have disastrous consequences for individuals and communities” who are disproportionately affected, according to the National Center for Biotechnology Information.

For instance, some previous examples of the “immunization gap” include the Influenza outbreak where, according to CDC, the hospitalizations in underprivileged communities were twice that of high-income communities. Additionally, according to the Jama Network, bacterial pneumonia cases from low-income populations were greater than that of wealthy populations. This was no different when reported Tuberculosis (TB) transmissions were more common in underserved communities according to a study of TB health status disparities from ScienceDirect. These patterns illustrate that more awareness of these underserved populations from community organizations is necessary and that they should have equal access to vaccination services to prioritize the well being of these populations.

When realizing this issue in health disparities, it is essential to consider possible solutions that allow these vulnerable populations from accessing vaccination services, especially during this pandemic. One possible solution to this problem includes an increase in access to vaccine testing at a minimal cost.

For instance, According to the Yale School of Medicine, Yale has instigated research for the development of a vaccine where they direct their efforts towards underserved communities having “equal access to both the vaccine development process and the ultimate distribution of vaccines.” Yale considered the socioeconomic status of communities in their research and specified their trials in “diverse populations” in order to “have trial results that are generalizable to the populations most impacted by this outbreak.” This emphasizes the idea that more medical organizations and communities should consider the disproportionate impact of the underserved communities to ensure that they also have access to vaccination services.

Another possible solution includes the expansion of pharmacy-based immunization programs. For example, according to the National Center for Biotechnology Information, by increasing the capacity of vaccination services in pharmacies, disparities in the use of vaccination services from underserved communities will decrease. Providing pharmacy technicians the role of a vaccine provider will increase the education about vaccines to patients and will improve vaccination rates from medically underserved areas.

This “promotion of pharmacy-based immunization services are in line with efforts by the Centers for Disease Control and Prevention (CDC) and National Vaccine Advisory Committee” according to the National Center for Biotechnology Information. Additionally, this increase in vaccination rates will aid these underserved communities and provide immunity to combat various diseases including the current pandemic.

Essentially, prioritizing greater access to vaccination services for the underprivileged communities, where they have difficulty coping with major economic and social challenges including limited health-care resources and deprived living conditions, serves to reduce the risk of disease transmission, including COVID-19. Increasing vaccination access and strengthening the access to health-care services for the underserved communities will ensure to eliminate health disparities like the “immunization gap.” Additionally, it is essential to provide more consideration to these marginalized communities and continue to spread awareness of health disparity issues to health-care policymakers in order to help alleviate major health challenges faced by many vulnerable populations.

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