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Privilege, Access and Navigating the Ohio Vaccination System

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Ashley E. Nickels, with Amanda Clark & Hannah Lebovits
June 26, 2021

In this 2021 series, we take a closer look at the concept of deservedness as it pertains to local governance and beneficiaries of public programs. We will focus on the COVID-19 vaccine rollout and take the opportunity to examine local impacts in Texas, Ohio and Florida (the current geographic locations of your three authors). This quarter, we look at Ohio.

I live in Ohio—home of Dr. Amy Acton, the public health official who resigned in 2020 after months of harassment, and Vax-A-Million! To say that Ohio’s response (both from public officials and the general public) has been chaotic and confusing would be an understatement. Throughout the pandemic, information has been communicated through multiple outlets at all levels of government, adding to the overall sense of confusion. Guidance at the federal level may or may not be followed at the state and local level. In addition, depending on one’s main news source, information may be framed in different ways or clouded by other viewpoints.

While many agree that the science behind vaccine safety is sound, some, like Dr. Tara Smith, professor of epidemiology at Kent State University (Ohio), argue that lifting safety protocols is premature. Dr. Smith points out, “Many still want to be vaccinated and can’t be or haven’t been yet for many reasons. They’re now at risk.” Dr. Maria Del Rios, associate professor of clinical emergency medicine and Director of Social Emergency Medicine at The University of Illinois College of medicine, suggests that, “If the United States’ overall vaccination rates were as low as they currently are for Latinx and Black people, the CDC would NOT have changed their guidelines.” Access to healthcare, including access to credible, scientifically accurate information about the vaccine, is not equal.

According to the Ohio Department of Health, while Black people represent 14% of the population, they account for 11% of cases and 18.6% of hospitalizations. In Ohio, not only have people of color been disproportionately impacted by COVID-19, but issues of equitable access to the vaccine have also been raised. Wealthier Ohio counties show higher rates of vaccination, echoing trends in healthcare that are well understood; people with better jobs, more flexibility in time off and more vaccination site choices near them are more likely to be able to be vaccinated. These variables, which keep willing people from being vaccinated, are often conflated with actual vaccine hesitancy, clouding the issue. The Ohio Department of Health reports that while 40.97% of Caucasian people have been vaccinated, only 25% of Black people have been vaccinated.

Ashley’s Ohio Experience

On December 14, 2020, Governor DeWine announced the first COVID-19 vaccination in Ohio, and that a shipment of just 975 doses had been delivered to The Ohio State University (Columbus) and UC Health (Cincinnati). In January, I celebrated—masked & distanced—around an outdoor fire pit, as friends who worked in healthcare received their first shots. I joked that it might be fall before I received my turn. As a white woman, with a PhD, job security and no health complications, I was willing to wait, but the rollout was slow and the process confusing.

Then, in March, the one-year anniversary of the start of the pandemic in Ohio, Governor DeWine announced that he would expand eligibility. And expansion came quickly. On March 9, DeWine lowered the age of eligibility to 50+, suggesting that the decision was a, “Move toward equity,” though many continued to voice concerns that Ohio’s eligibility guidelines were confusing, and many remained frustrated. By the end of March, I was eligible for the vaccine.

Getting an appointment presented a new challenge. The state launched https://gettheshot.coronavirus.ohio.gov/ to track vaccine locations and for appointment scheduling. However, not all vaccine locations used the site in the same way. So, the day I became eligible, I found myself monitoring multiple websites: Walgreens, CVS, Giant Eagle and Gettheshot. Too many people trying to access at the same time? Refresh and start again. Friends encouraged me to get tips and tricks from online “help” groups. I spent hours trying to get an appointment. I am privileged to have the time to do so.

I am now fully vaccinated, as is my partner. My kids are scheduled for the second shot. I am fortunate that I have the time and resources to sift through the mis-information, access to public health professionals who could talk me through my concerns and a job that offered flexibility.

Navigating the COVID-19 vaccine landscape differs for every individual, but the privilege of time, money and job flexibility undoubtedly changes the impact it has on one’s life. Access to vaccines and trusted medical information, amidst constant changes in guidance, have created inequities in vaccine distribution and acceptance. The latest change in the guidance surrounding mask wearing for the vaccinated leads to other questions regarding inequity. If vaccination rates in the Caucasian population were as low as populations of color, would the same guidance be given? Although officials have stated that the guidance is data-driven, the move seemed very sudden for most. And, as states, cities and businesses move to follow the CDC guidelines, we are once again faced with low-wage earning service personnel being the most exposed to those that may not be vaccinated.


Authors:

Ashley E. Nickels, Ph.D., is associate professor at Kent State University and co-PI of the Growing Democracy Project. Her work focuses on urban politics, local governance, and community using a social equity lens. @AENickelsPhD

Amanda D. Clark, Ph.D., is an adjunct professor of public administration at Kent State University. Her work focuses on social movements, governance, and the U.S. policy process. @adclark_phd

Hannah Lebovits, Ph.D., is an assistant professor at University of Texas-Arlington. She studies the relationship between governance, spatial structures and social equity. @HannahLebovits

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The American Society for Public Administration is the largest and most prominent professional association for public administration. It is dedicated to advancing the art, science, teaching and practice of public and non-profit administration.

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