Presence Is Not Inclusion: Race and Ethnic Disparities in Florida’s Vaccine Distribution
Kesha Moore

Kesha Moore

TMI Senior Researcher

Presence is not Inclusion

April 19, 2021

Florida has very large racial and ethnic disparities in its administration of COVID-19 vaccines, despite having a significant number of majority-minority counties and a large number of Black and Latinx residents overall. The lack of a state-wide vaccine equity plan allows these disparities to occur and reflects a lack of commitment by the state to an equitable distribution plan.

The Latinx population has experienced a disproportionate share of COVID-19 cases in Florida. Figure 1 below shows that the Latinx COVID-19 case rate (37%) is ten percentage points higher than their share of the population (27%). In comparison, the Black population’s COVID-19 case rate (14%) is one percentage point below their portion of the population (15%), while the White population’s COVID-19 case rate (40%) is fourteen percentage points below their population percentage (54%). The death rate from COVID-19 is slightly higher for Black and White Floridians and marginally lower for Florida’s Latinx residents. Figure 1 shows that the COVID-19 death rate is two percentage points higher for both Black and White residents than their proportion of the population. COVID-19 death rates for Latinx residents of Florida (25%) are two percentage points lower than their percentage of the population (27%).

Despite modest racial group differences in COVID-19 death rates and more substantial differences in COVID-19 cases relative to the group percentage of population, there are significant racial and ethnic disparities in COVID-19 vaccination rates in Florida. White people are vastly overrepresented in COVID-19 vaccinations, while Black and Latinx people are substantially underrepresented. Numerous critics have identified Governor Ron DeSantis’ vaccine roll-out as a form of vaccine favoritism contributing to racial and ethnic disparities in Florida’s vaccine distribution. Examples of such vaccine favoritism include the state’s partnership for vaccine distribution with Publix (a company that contributed to the Governor’s campaign) and state-run pop-up vaccine clinics in wealthy gated communities, yacht clubs, and golf courses.

Even though they are only 54% of the state’s population, White residents of Florida have received 68% of all the COVID-19 vaccinations thus far. This vaccination rate for White Floridians is 1.7 times higher than their portion of COVID-19 cases (40%) and 1.2 times higher than their proportion of deaths from COVID-19 (56%). In contrast, the vaccination rate of Latinx residents (14%) is less than half their COVID-19 case rate (37%) and slightly more than half of their COVID-19 death rate (25%). The vaccination rate of Black Floridians (7%) is half their COVID-19 case rate (14%) and slightly less than half their COVID-19 death rate (17%).

Figure 2 below documents that this pattern of underrepresentation of Black and Latinx residents among those receiving the COVID-19 vaccines is consistent for almost all Florida counties, with the Black vaccination rate being lower than the Black population in every county in Florida. The majority of Florida counties (32/67) have Black vaccination rates five to nine percentage points below the ratio of the Black population.

Latinx Floridians face a similar pattern of consistent underrepresentation in COVID-19 vaccinations across all counties in Florida. There are no counties where the Latinx vaccination rate is equal to their proportion of the population and only one county where the vaccination rate is higher than their population. Most Florida counties (28/67) have Latinx vaccination rates that are one to four percentage points below the Latinx population percentage. Hardee County and Osceola County have Latinx vaccination rates as large as 27% and 25%, respectively, below the proportion of the county’s Latinx population.

Figure 3 displays the Florida counties with the most significant underrepresentation of Black and Latinx residents in COVID-19 vaccinations. One-third of the counties with the most significant racial and ethnic disparities in COVID-19 vaccine distribution (3/9) are counties with majority Latinx populations (Miami-Dade, Hendry, and Osceola). In Miami-Dade County, Latinx people are 69% of the population, but only 49% have received the COVID-19 vaccines. In Hendry County, Latinx people are 54% of the population, but only 31% of the vaccinated. In Osceola County, Latinx people are 54% of the population, and only 29% of the residents vaccinated.

Broward, Leon, and Orange counties all have a sizeable Black population, but a relatively small percentage of their Black residents are vaccinated. Black people comprise 28% of Broward County’s population, but only 12% of its vaccinated residents. Black people are 31% of Leon County, but only 14% of those vaccinated. In Orange County, Black people make up 20% of the county’s population and only 8% of those vaccinated.

While some people are quick to attribute the low vaccination rates among Black people to vaccine hesitancy, national survey data reveal that Black and Latinx people want the COVID-19 vaccines. According to a survey by the Pew Research Center, 61% of Black Americans state that they want to take COVID-19 vaccines, and the gap between racial and ethnic groups wanting to take the COVID-19 vaccine has been steadily shrinking. Several structural barriers help explain the underrepresentation of Black and Latinx residents among the vaccinated better than vaccine hesitancy.

In Florida, Gov. DeSantis announced the vaccine roll-out strategy at a pop-up vaccine clinic in a wealthy gated community in Palm Beach County. As of April 1, 2021, Florida maintained nine vaccine clinics at country clubs in the following counties: Marion, Osceola, Hillsborough, Manatee, Charlotte, Martin, Palm Beach, Collier, and Monroe. Geographic proximity to vaccination sites can be a substantial barrier to Black and Latinx residents. An analysis of some states’ vaccine roll-out found that vaccine hubs were missing from Black and Latinx communities. We also see a relationship between wealth and vaccination rates.  Florida, like the rest of the U.S., has a well-documented pattern of racial disparities in income. In February 2021, an analysis of the relationship between wealth and vaccination rates in Florida revealed that “residents age 65 and older in the top third of counties ranked by median income were vaccinated at a rate more than 4 percentage points higher than seniors in the rest of the state.”

Technology also can provide a structural barrier to Black and Latinx communities in their ability to access COVID-19 vaccines. Existing racial divides in internet access make it harder for Black and Latinx residents to schedule vaccination appointments using online registration systems. The Mayor of Miami-Dade County, Daniella Levine Cava, often uses her Twitter feed to alert residents of pop-up vaccine availability. This communication strategy is less accessible to vulnerable populations, such as Black, Latinx, and low-income communities that are less likely to have internet access, than for White populations.

Finally, employment remains a significant barrier for many Black and Latinx workers in accessing the vaccine. Black and Latinx Americans are disproportionately essential workers and less able to request time off to get a vaccine than are White workers. Some governments have opened 24/7 vaccination hubs and walk-in vaccination clinics in Black and Latinx communities to make it easier for working people to get vaccinations. In Miami-Dade, the administration has dispensed some mobile vaccination operations to public housing developments to vaccinate elderly residents. Going directly to public housing is a valuable strategy to promote vaccine equity because many low-income Black, Latinx people do not have internet access to complete online registration or cars to take advantage of drive-through vaccination clinics. Increasing mobile vaccination operations in low-income, Black, and Latinx communities and expanding vaccination hours would promote vaccine equity in Florida.

As of April 12, 2021, Florida has lifted its stay-at-home order, lifted mandatory quarantine for travelers, opened non-essential businesses, removed limits on large gatherings, and opened restaurants. Black and Latinx workers are overrepresented in low-wage, frontline occupations and more likely than their White counterparts to have underlying health conditions. Both of these conditions make Black and Latinx workers even more susceptible to contracting the coronavirus through close contact with the public and spreading it to their families and communities. Thus, Florida’s reopening, without an equity-based vaccination strategy, will likely exacerbate the harmful impact of COVID-19 on Black and Latinx communities relative to that already existing in the state.

#FairShot: Tracking COVID-19 Vaccine Equity