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In California, Health Workers Will Get COVID-19 Vaccine 1st. Who's Next?


In California, officials have already decided that health care workers will be the first to get a COVID vaccine. But then who should come next? Well, the state says it wants to consider, quote, "historical and contemporary injustices" as a factor. That could mean giving priority to groups like Native Americans. From member station KQED, April Dembosky reports.

APRIL DEMBOSKY, BYLINE: As recently as the 1970s, Indigenous women were subjected to forced sterilization by the U.S. government. Virginia Hedrick is a member of the Yurok tribe, and she suspects her grandmother was one of them. It was after giving birth to her father.

VIRGINIA HEDRICK: The doctor told her then that she would never have children again, that my dad, quote, "ruined her." There are many stories like that that you sort of turn your head and think, were you sterilized, like, in that hospital? Is that what happened?

DEMBOSKY: Long before that, dating back to the first pilgrims, she says Indigenous people have been dying of illnesses brought by white settlers.

HEDRICK: American Indian people died then due to infectious disease.

DEMBOSKY: Now, during the 2020 coronavirus pandemic, American Indians are four times more likely to be hospitalized than whites and more than twice as likely to die. Hedrick says for all these reasons, past and present, they should be moved toward the front of the line for a vaccine.

HEDRICK: When we think about, like, the historical injustice of this nation, of California, isn't now the time to say that, for the first time, we prioritized Indigenous people?

DEMBOSKY: Hedrick is the head of the California Consortium for Urban Indian Health. Her group is one of 70 that the state is consulting on an equitable vaccine distribution plan. At their first meeting, Hedrick urged the committee to take historical injustice into account. And at the second, the state surgeon general, Nadine Burke Harris, said they would. Here's what she told the group.


NADINE BURKE HARRIS: And so that's what we did in bringing forward another definition of equity that includes a reflection of the historical and contemporary injustices.

DEMBOSKY: The plan is still in the earliest stages, and it's not clear how it might be implemented. Lawrence Gostin is a law professor at Georgetown University in Washington, D.C. He says California could open itself to legal challenges if it uses race or historical injustice as a factor in prioritizing who gets the vaccine.

LAWRENCE GOSTIN: That is affirmative action. That's choosing one group over another.

DEMBOSKY: Gostin says the Supreme Court has looked down on plans like this in education and would very likely be hostile to a similar plan in public health. Instead of using race, he says, the state should focus on other factors that capture race - poverty, education or housing.

GOSTIN: Being fair, being equitable - I think that's a noble societal goal. We just have to do it smart and keep the courts out of it.

DEMBOSKY: Even if the state manages to avoid lawsuits, Virginia Hedrick is concerned tribal communities may not want to be at the front of the line for a vaccine.

HEDRICK: I'm working with a community of people who are saying that, isn't this a funny time for the federal government or state governments to say, oh, we need racial equity? All of a sudden now we want to make sure brown people get this vaccine first.

DEMBOSKY: She says any plan to prioritize American Indians will have to come with serious investment in building trust. But she says her community needs this for their own generational healing.

HEDRICK: So that when my granddaughter's looking back at the 2020 pandemic, she'll say, this is where we started to turn the tide.

DEMBOSKY: She says this could be a form of reparations, a chance for the government to mend its relationship with Indigenous Americans.

For NPR News, I'm April Dembosky in Oakland. Transcript provided by NPR, Copyright NPR.

April Dembosky is the health reporter for The California Report and KQED News. She covers health policy and public health, and has reported extensively on the economics of health care, the roll-out of the Affordable Care Act in California, mental health and end-of-life issues. Her work is regularly rebroadcast on NPR and has been recognized with awards from the Society for Professional Journalists (for sports reporting), and the Association of Health Care Journalists (for a story about pediatric hospice). Her hour-long radio documentary about home funeralswon the Best New Artist award from the Third Coast International Audio Festival in 2009. April occasionally moonlights on the arts beat, covering music and dance. Her story about the first symphony orchestra at Burning Man won the award for Best Use of Sound from the Public Radio News Directors Inc. Before joining KQED in 2013, April covered technology and Silicon Valley for The Financial Times, and freelanced for Marketplace and The New York Times. She is a graduate of the University of California at Berkeley Graduate School of Journalism and Smith College.