Minnesota’s Vaccine Rollout Strategy: A Socialist Perspective

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From the Twin Cities DSA Health Justice Working Group

The Health Justice Working Group interviewed TCDSA member Pat for a socialist perspective on Minnesota’s vaccine rollout strategy. Pat is a PhD student studying occupational and environmental epidemiology at the University of Minnesota, as well as a graduate research assistant. Pat also works in local public health, mostly on “the data side” of the COVID-19 response. We asked Pat about Minnesota’s current vaccine strategy and how we as socialists might work to pressure for a more just rollout.

In a nutshell, what is the current strategy for the COVID-19 vaccine rollout in Minnesota?

Currently, the two broad groups being targeted for vaccination are healthcare workers (HCWs) and residents of long term care facilities (LTCFs). LTCFs include skilled nursing facilities, assisted living facilities, intermediate care facilities for individuals with developmental disabilities, residential care facilities, and state veterans’ homes. 

So far, according to the available data, everyone who works at or lives in a skilled nursing facility has had the opportunity to get their first vaccine dose. Most HCWs at hospitals and clinics–especially those affiliated with large health care systems–have also had the opportunity to be vaccinated. HCWs and residents at assisted living facilities and other LTCFs are now starting to receive their first doses, and any HCW whose employer doesn’t have a plan for their vaccination or is having trouble finding answers about getting vaccinated can fill out this vaccine connection form.

What are these “Phases” we keep hearing about? How can we know which phase we are in?

The purpose of the phases is to prioritize who should be vaccinated since there are currently limited doses. The Minnesota Department of Health COVID-19 Vaccine Allocation Advisory Group (“MDH VAA” for short) decides who to prioritize, but they base their decisions on recommendations from the CDC’s Advisory Committee on Immunization Practices. It’s worth noting that these recommendations from the CDC are just that, recommendations, so states, for better or worse, can be flexible in how they implement vaccine distribution. When creating the phases, the MDH VAA considered a number of factors, including a desire to maintain essential workforces, concern for those at greatest risk of serious illness or death, and how efficiently the vaccine can be distributed. In Minnesota, we are at the tail end of Phase 1a, which includes HCWs and long term care residents. 

We’re in a transition between phases 1a and 1b right now because most people (with notable exceptions) in Phase 1a have received at least one vaccine or have had the opportunity to be vaccinated. So places with extra vaccines are getting creative and are vaccinating people who are 75+, for example, which blurs the lines of which phase we are actually in. Also, as many will know, the state is running a pilot vaccination program for education and child care workers and for people aged 65+ to figure out how to best distribute the vaccine to this large workforce and age group. So Phase 1b is off to a soft launch, though we don’t know yet exactly who will be in Phase 1b. Currently, it looks like the recommendations for this phase will be formalized soon, though we don’t yet know an exact date. Eventually, that information will be posted here with sub-prioritizations within Phase 1b.

If all this is confusing, you’re not alone. The phase notation is confusing due to the “sub-phases” (for example, Phase 1a and Phase 1b)  and sub-prioritizations within phases (like HCWs and LTCF residents). If you hear of someone getting a vaccine who isn’t explicitly spelled out in the current phase, then it’s probably because a specific health care system or county public health department interpreted the recommendations in a certain way or took liberties because they needed to get flexible with vaccination due to nearly-expired vaccine. Of course, there have also been egregious exceptions to this.

From a socialist perspective, who are some of the people who might be overlooked in the current vaccine strategy? 

There are several groups:

  • People who are incarcerated, unhoused, undocumented, uninsured, or living in poverty. 
  • People who are “vaccine hesitant,” especially those who are hesitant to take the vaccine due to a history of poor interactions with white supremacist, anti-LGBTQ, misogynistic, classist, and elitist health care providers and health care systems. 

Minnesota’s own Vaccine Allocation Advisory Group has attempted to formulate an equitable and efficient strategy, including allocating more vaccines to socially vulnerable areas, to people in prison, and to BIPOC older adults, but their role is merely advisory. The governor is ultimately not accountable to anyone, and he has made the  publicly available data on who is being vaccinated next-to-useless. There’s no race or ethnicity data available, and county-level data doesn’t cut it, especially in counties as large and socioeconomically diverse as Hennepin and Ramsey counties.

What are some things we might do as socialists to impact the vaccine strategy to make sure the most vulnerable members of society are protected? 

One thing we at the TCDSA Health Justice Working Group are working on is getting better publicly-available data. Once we know who is actually getting vaccinated, we will be able to push for accountability. We are also working on a mutual aid project to help some of these previously mentioned overlooked groups who want to get vaccinated. 

I think we should also be thinking about ways to successfully communicate with people who are vaccine hesitant because that’s a significant group of people, many of whom are vulnerable to severe disease and death. People don’t just take the vaccine because experts tell them to, and that makes sense, given people’s experiences with experts, so we need other strategies.

What other concerns do you have, as a socialist, about the current vaccine strategy?

I’m concerned that many people who are forced to work in person will be overlooked in this next phase. There’s a balance between vaccinating the most medically vulnerable, who skew older, and those who have to work in person. There’s a lot of crossover between those groups, and older workers should really be prioritized over retirees and older adults who can safely stay at home. 

I’m also concerned about teachers being forced back to work immediately after being vaccinated. It takes two weeks for both vaccines to get an immune response, and it takes two doses for a really solid immune response. So it would be 5 or 6 weeks from the first vaccination before people see that 95% probability of being immune. 

On an international scale, I worry about poorer countries in the Global South not getting vaccines until 2022, 2023, or even 2024 because of intellectual property law. The underlying research for these vaccines was publicly funded and is now being monetized by Big Pharma. There should be no patents on them, and anywhere with the capability to produce vaccines should be allowed to do so without having to pay royalties. And it’s in everyone’s best interest. Because of possible mutations and the possibility of immunity waning over time, as long as anyone has COVID-19, none of us are truly safe. A globalized society guarantees this, and this situation is a reminder of the importance of internationalism in socialism.

How do you think the transition from the Trump administration to the Biden administration will impact statewide rollout in Minnesota? 

I think the major change is going to be the communication between the federal and state governments. The Biden admin is promising 3 weeks advance notice of vaccine allocation per state, which is no small thing since it allows state governments the ability to plan out their vaccine strategy. Whether that strategy is sound is ultimately up to the governor, though. 

There’s also talk of FEMA funding for National Guard deployment in vaccination, which could help with mass vaccination clinics, but I’m wary of using the National Guard for the purposes of public health, especially in the wake of the George Floyd uprising. If people don’t trust the vaccinators, then they won’t get vaccinated. 

Biden recently responded to journalists suggesting his goal of 100 million vaccines isn’t high enough by saying, “When I announced it, you all said that’s not possible. Come on, give me a break, man. It’s a good start.” As socialists, how might we respond to this?

At that rate, if everyone in the country were to be vaccinated, we wouldn’t have the whole country vaccinated until some time in the Fall of 2022. 100 million vaccines means 50 million people vaccinated by the end of April, and that isn’t an improvement over the Trump Administration. I know Biden has now revised that to 1.5 million vaccines per day, but that rate would only bump up full vaccination to March 2022. 

It’s no surprise that Biden’s number is so low. By their nature, most Democrats can’t help themselves but to come to the negotiating table with a compromise already built in. As socialists, we should be pushing for something more aspirational, even if it seems unrealistic. Getting everyone vaccinated is going to take a lot of work and creativity, and nothing guarantees failure more than a lukewarm and “reasonable” plan. What’s unreasonable is vaccination taking over a year. 

We can’t rely on the technocracy to solve these problems, and, to be honest, I don’t have all the solutions. The solutions must be democratic and solved by the people who are most affected by this pandemic; by people who are close to those who are vaccine hesitant; by workers who have no ability to stay home and survive. So let’s figure out ways to make that happen.

Thanks so much for sharing your insights, Pat! If you’re interested in getting involved with the Health Justice Working Group projects Pat mentioned, be sure to join the #healthjustice channel on TCDSA’s Slack, and come to our next meeting on Sunday, February 28th, at 11:00am

Ash C.

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