SACHA PFEIFFER, HOST:
Only 23 states track the race or ethnicity of people getting the coronavirus vaccine, but the data that is out there shows that white residents are getting the shot at twice the rate of Black residents. In Tennessee, one strategy to close that gap is to send more vaccine doses to community health clinics. WPLN's Blake Farmer visited one in Nashville.
BLAKE FARMER, BYLINE: Mary Barnett has to wait 15 minutes after getting the COVID vaccine in case she has an allergic reaction.
MARY BARNETT: Oh, is my time up, baby?
UNIDENTIFIED PERSON: Yes, ma'am, it is.
BARNETT: OK.
FARMER: The 74-year-old, who uses a wheelchair, isn't in any particular rush. But her nephew is waiting outside, and he needs to get to work.
BARNETT: Oh, I'm ready. Come on.
FARMER: Transportation is a key holdup for many seniors at risk of being left behind in the rush for vaccines. At this nonprofit clinic, Neighborhood Health, some patients have to cancel last minute because a ride falls through. The federally funded clinic is familiar with life's realities. They'll even offer to pick people up if they need it. Unlike many local health departments, Neighborhood Health is not fending off crowds. They're seeking people out. Barnett lives in public housing, which gathered names of people interested in getting the vaccine. Aside from logistical challenges, she says many of her neighbors are in no rush to get their dose anyway.
BARNETT: I, you know, tell them about taking it. They say, oh, no, I'm not going to take it. And I say, what's the reasoning?
FARMER: Usually, Barnett says, there's not much of a reason. Her motivation is a sister with kidney disease who died of COVID last July.
BARNETT: You either die with it or die without it. So if the shot helps, take the shot.
FARMER: People of color have made up an outsize share of the cases and deaths from COVID nationwide. And not surprisingly, the same factors driving those trends are also complicating the vaccine rollout. Rose Marie Becerra received a vaccine invite to this clinic through a local immigrant advocacy group. She's a U.S. citizen originally from Colombia, but she says those without documents are nervous.
ROSE MARIE BECERRA: Go over there. I give my name and the people maybe follow me, I don't know.
FARMER: And undocumented immigrants are among those at highest risk of COVID complications. In Tennessee, many hospitals had only been vaccinating their existing patients, so state leaders took action. They shifted doses from hospitals to clinics and rural pharmacies in the hopes of getting more shots to people of color. And now the Biden administration has announced plans for the federal government to send doses directly to community health centers starting next week. Federally funded clinics - at least one in every state - will divvy up a million doses to start with. Dr. Marcella Nunez-Smith leads the administration's health equity task force.
MARCELLA NUNEZ-SMITH: Equity is our north star here. This effort that focuses on direct allocation to the community health centers really is about connecting with those hard-to-reach populations across the country.
FARMER: Those populations also include people who are homeless and migrant workers. Even with hundreds of community clinics around the country, Neighborhood Health CEO Brian Haile says it might not be enough to balance out a health system that tends to favor white patients with means.
BRIAN HAILE: We know what's required in terms of the labor-intensive effort to focus on the populations and to vaccinate the populations at highest risk. What we have to do as a community is say we're all going to make this happen.
FARMER: Haile says everyone giving vaccines, from hospitals to health departments, will have to focus more on equity, too.
For NPR News, I'm Blake Farmer in Nashville.
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