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How Colleges and Universities Can Contribute to a More Equitable COVID-19 Vaccine Rollout

When a Brown student walks into the Olney-Margolies Athletic Center (OMAC), the mass COVID-19 testing site on campus, they begin a highly streamlined process — spending no longer than five minutes in the building — to clear any doubt that they might be an asymptomatic carrier of the virus. Within 24 hours, they will receive their test result. This process is not unique to Brown, of course: since colleges began welcoming students back during the pandemic in early fall 2020, many have established their own highly effective testing systems. It is likely that in a few months, vaccination sites will begin to pop up around colleges and universities next to testing sites — and the process for inoculation could be just as simple as getting tested in the OMAC. Colleges and universities can and must extend their extensive resources and capability to vaccinate large populations in a short period of time to the general public. As the pandemic rages on and disproportionately takes the lives of Black, Latino, indigenous, disabled, and low-income people, it is incumbent on institutions of higher education to curb more losses through equitable and affirmative vaccine distribution.

 Brown and other universities should take note of the controversies that have arisen out of other early university vaccination programs. According to a recent report by the New York Times, healthy, low-risk people affiliated with institutions such as Columbia, NYU, Harvard, and Vanderbilt with little to no exposure to coronavirus patients were eligible to be vaccinated in an effort toward full immunization within hospitals. Among these staff members included people in their 20s who worked on computers, cancer researchers, and technicians in non-Covid related labs. Dr. Stanley Perlman, a committee member who issued the CDC recommendations for prioritization, said that the CDC never intended the guidelines for the highest tier of priority to cover workers who do not interact with patients. Some state officials were reportedly privately furious that Columbia and NYU offered their remaining vaccinations to low-risk workers after they had vaccinated all frontline workers, considering that millions of elderly and high-risk New Yorkers were waiting desperately for their life-saving doses. One Columbia faculty member who was eligible to receive the vaccine refused it on moral grounds, calling it a “naked display of privilege.”

As of late mid-February, some universities are sitting on a surplus of vaccine doses. Northeastern University had nearly 2,000 extra doses leftover after vaccinating their frontline and emergency workers; in contrast, Dallas County is receiving 9,000 weekly doses to vaccinate the 300,000 eligible seniors who have already registered. Northeastern planned to next vaccinate elderly employees and workers with multiple conditions — people included in the next phase, according to Massachusetts guidelines — but the state asked them to stop. Colleges and hospitals report that the guidelines they have received from state departments about utilizing surplus vaccinations have been confusing. Unused vaccines, which go back into storage, are an issue for state governments because the federal government decides future allocations based on how well states make use their available doses. This requirement puts state health departments in an uncomfortable position: do they allow universities to vaccinate whomever they want in their community before deserving groups in the general public, or do they put doses in storage until the next phase begins, potentially risking their ability to receive more vaccines sooner? 

Some colleges and universities are already preparing to vaccinate certain groups of students, but questions of who can get vaccinated and when are contentious. At Georgia Tech, as of January 13th, vaccinations are only available to health and counseling services staff, Georgia Tech police, and employees over the age of 65 under Phase 1A+. However, according to sophomore Evonne Iau, there has been some backlash surrounding the upcoming Phase 1B and 1C guidelines. Phase 1B includes, “all faculty and staff, including affiliate, auxiliary, and foundation employees.” These guidelines allow graduate and undergraduate teaching assistants to be vaccinated before students with underlying health conditions that increase their risk for severe illness with Covid-19, who are currently slated for Phase 1C. However, Georgia Tech cannot alter the order — they are bound by the guidelines set by Georgia’s health department. At Tulane University, only medical staff and employees can receive the vaccine under current guidelines. However, a sophomore reports that she and roughly 50 other undergraduates were able to receive the vaccine during the first week of the second semester by asking for extra doses at the end of the day that would otherwise be going to waste at the university’s vaccination site. According to a current sophomore, Tulane has since stopped giving vaccines to undergraduate students, and recently warned students that try to sign up for an appointment through links forwarded by eligible recipients that they would be turned away. 

Rhode Island has had one of the most delayed vaccine rollouts in the country. The state just began vaccinating older adults (75+) in mid-February, making it the country’s last state to do so. Overall, it ranks among the worst states for vaccine distribution in terms of percentages of residents receiving their first dose and the percentage of vaccine doses administered. Given the slow start to the vaccine rollout and the large number of groups slated to be vaccinated before Brown students, it’s likely that students — if they don’t skip the line — may have to wait longer to receive the vaccine than friends attending colleges elsewhere. According to the Rhode Island Department of Health (RIDOH), 16-39-year-olds with no underlying health conditions — the group that the majority of Brown students fall into — can expect to receive the vaccination in early June

Brown has a mixed track record when it comes to helping the Providence community during the pandemic. In the early stages of the pandemic, medical students volunteered their time and expertise to local hospitals fighting the virus when hospitals were overwhelmed and understaffed, and the university converted its dorms to free temporary housing for frontline workers. However, Brown’s robust testing program, a well-oiled machine that has conducted upwards of 160,000 tests since it began this fall, is only accessible to enrolled students, therefore excluding many Providence community members Brown can include. Meanwhile, in November of 2020, Rhode Island was on high alert: the state led the country in new cases per capita, and the possibility that hospitals could reach full capacity was looming. If Brown had made an effort to assist with testing by inviting hard-hit non-community members to use their easy and effective system, the university could have contributed to slowing the spread and quelled fears in a time when emotions were running high. UChicago Medicine, for example, expanded their testing to partners in the South Side of Chicago, testing up to 1,000 symptomatic people each day. 

If Brown missed the mark on expanding testing to Providence community members, the university has the potential to be a powerhouse in terms of vaccine distribution with its space for mass vaccination sites, its highly skilled workforce, and volunteer base, and its access to resources. According to the university’s current vaccination plans, the university, “has offered to support Rhode Island’s vaccination distribution efforts, but at this time we do not have a direct role in providing or distributing the vaccine.” However, the university anticipates that this will change when the vaccine becomes more readily available. The state would be remiss to pass up on the university’s offer of assistance. Nevertheless, how Brown might use its vaccination power is crucial. This includes not only prioritizing hard-hit communities but being intentional about which members in the Brown community receive the vaccine, unlike peer institutions that abused lenient state guidelines and vaccinated low-risk individuals while others in perhaps greater need waited in line. Setting up vaccination sites on Brown’s campus and restricting appointments to residents of the hardest-hit zip codes to combat the co-opting of these appointments by Brown’s largely wealthy and white neighbors are potential first steps. Brown could also establish a waiting list for extra vaccinations at the end of the day that Providence community members could sign up for and be alerted when there are available doses.

Currently, obtaining a vaccine in Rhode Island is exceedingly difficult — but that will not always be the case. Dr. Ashish Jha, Dean of Brown’s School of Public Health, told MSNBC that, “we’re going to have more vaccines than people who want them,” by May. The effort to inoculate Providence and Rhode Island is a race against time in which thousands of potential lives are at stake. A recent New York Times study predicts that we will reach the herd immunity threshold by July at the country’s current pace, and an estimated 100,000 more people will die before then. When the vaccine is available to the general public, the effort will pivot from who can get the vaccine to when one can get it and how, and accessibility and ease will be vital inbeating the race against time. This is where wealthy universities, with their immense resources and influence, can step in and be proactive when it comes to reaching out to their neighboring communities to provide vaccination support, especially in predominantly Black and Latino neighborhoods, which have disproportionately higher rates of infection and deaths and are already facing neglect in the vaccination effort. With thousands of lives on the line, inoculating low-income, high-risk Providence residents would provide strong evidence for the claim Brown often makes that it cares about its neighbors in Providence. 

Image: Original Illustration by Madison Tom