Florida’s strained vaccination process hasn’t been so bad on oceanfront Fisher Island, where half of the residents have gotten their shots.
Not so in Opa-locka, where about 40% of the population lives in poverty and only 2% of the population have received vaccinations for COVID-19.
New state data on vaccinations by ZIP codes map out a familiar pattern for the coronavirus pandemic. Just as low-income neighborhoods tended to get hit harder by COVID-19 spread, wealthier neighborhoods are getting their shots at a faster rate.
Fisher Island’s ZIP code of 33109 easily leads the county in vaccination rates, with 51% of the enclave’s 400 inhabitants vaccinated, according to a Miami Herald analysis pairing vaccine data from the state’s SHOTS registry with population numbers from the U.S. Census.
Only a few neighborhoods have vaccination rates above 10%, and each of them are among the county’s top 20 wealthiest ZIP codes. Those include 33158, home of the posh Deering Bay neighborhood, with a vaccination rate of 14%, and the luxe condos of Aventura’s 33180 ZIP code, where the rate is 13%.
Age does play a factor for Fisher Island’s vaccine share in a state where doses are largely reserved for people 65 and over. Census data show the 33109 ZIP code has the highest share of people in that age range in Miami-Dade. But age doesn’t appear to be driving the trend.
North Miami’s 33167 ZIP code ranks 11th in terms of households with people 65 and over, and has the county’s 76th worst vaccination rate: 1.5%. Deering Bay’s 33158 ZIP doesn’t fall in the top 20 list for households with people 65 and over, but has the fourth highest vaccination rate in Miami-Dade.
“We are continuing to have every single effort that we’re moving forward with operate along lines of inequity,” said Zinzi Bailey, a research professor at the University of Miami who studies health inequities.
Bailey recalled how Fisher Island, with its University of Miami Health System outpost, was able to secure COVID-19 tests for every one of its residents in mid-April through the institution. Meanwhile, lower-income areas with more essential worker had no access to testing until months later.
“We have learned nothing through this crisis,” Bailey said.
Miami-Dade released the data Friday as the administration of Mayor Daniella Levine Cava announced new efforts to expand vaccination efforts beyond a system that largely favors the affluent: Online reservations for vaccinations can surface at a moment’s notice, favoring people not burdened by shift work or people with family who have free time to help. People with cars can select vaccination options across Miami-Dade.
Some of the county’s poorest ZIP codes have the lowest vaccination rates. Of the three ZIP codes in Opa-locka, 33054 sits at the bottom with vaccination rates. The area has a Census population of 31,797 people and state Health Department figures list 431 vaccinations there — a rate of 1.4%. The ZIP code also ranks fourth from last in terms of median income in Miami-Dade, with the average person receiving just $27,000 a year. By contrast, the median income at Fisher Island is about $200,000.
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The added detail of vaccination by ZIP code came on the heels of the state releasing demographic information by county — showing that just 6% of the 138,000 people who received a COVID vaccine in Miami-Dade are Black in a county with a 17% Black population.
Inequities have been worsened in part, Bailey said, by state policies that skipped over essential workers, who often are low-income and disproportionately people of color, in favor of senior citizens. County and state officials then set up vaccination campaigns for seniors that favored those who are able to access digital sign-up sheets and follow social media closely for alerts of new appointments available.
“The lawlessness around all of this and everything being left up to chance is where we systematically put inequity into the system,” Bailey said. “We’ve incorporated it within.”
That falls well short of what public health experts say will need to be a concerted effort to overcome deeply rooted mistrust in the COVID vaccines in majority-Black neighborhoods.
The ZIP codes being left behind in that lawlessness are those hardest hit by COVID, said Alexandre White, a Johns Hopkins University assistant professor of sociology and the history of medicine. Though there are logistical challenges that make it harder to get the vaccines to areas with less healthcare access, White said that is just more reason to develop coherent plans to address them.
The situation playing out in Florida, White said, spoke to a “lack of coordinated planning.”
“If you focus on speed, those who are most easily accessible will be the ones who receive the most care, and those who have been most historically isolated from healthcare access … will be the ones most likely to suffer without vaccine coverage,” he said.
Levine Cava said the county was planning to open a reservations phone line once Florida supplies its vaccination sites with more doses. The state already offers phone lines for the two Miami-Dade sites its emergency division oversees: Hard Rock Stadium and Marlins Park. (The number: 1-888-499-0840.)
At the county-owned Jackson Health system, CEO Carlos Migoya said the hospital network plans to open up telephones for reservations. “We know online booking isn’t the best solution for everyone in our county,” he said.
The county also has been arranging mobile vaccination efforts in public housing complexes. Separately, Florida state officials, partnering with the Jackson Health system, are reserving some vaccination appointments for churches, temples and mosques to reach people who either can’t access vaccines or aren’t enthusiastic about getting them.
“We will go deeper into underserved communities,” Levine Cava said.
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Eileen Higgins, a county commissioner representing Little Havana and parts of Miami Beach, said the ZIP code analysis shows the same kind of prosperity gaps seen on testing availability. “Some of the ZIP codes where we see shots in arms have very high incomes,” she said during a Friday meeting of commissioners with Migoya and Levine Cava. “We need to make sure… we’re not just looking at race, but we’re also looking at income.”
Like Bailey, the UM professor, Melissa Ward-Peterson, a social epidemiologist at Florida International University, cited deeply rooted mistrust in majority-Black neighborhoods in Miami-Dade County as a barrier that demands more planning than state and county officials have mustered thus far.
“It seems like a very disorganized effort, unfortunately, which I don’t think is necessarily the fault of Miami-Dade County,” said Ward, who studied disparities in healthcare and has worked on HIV. “There’s a lot of spillover effects happening from the federal level down to the state level and to the county level, but this is what happens when you don’t take health equity into account during the planning process.”
Ward-Peterson said that planning should have started six or nine months ago, when officials first knew vaccines were in the pipeline.
“I think the can keeps getting kicked down the road, and we can’t keep kicking it down the road because the disparities are only going to keep growing as the vaccines become more available,” she said. “It’s going to catch up to us eventually.”
The signs of vaccine hesitancy in those communities officials want to reach are not hard to find.
Shirley Kemp of New Beginning Missionary Baptist Church receives her vaccination shot on Friday, January 22, 2021. Jackson Health System has partnered with nearly 55 churches, synagogues and mosques in Miami-Dade County with the goal of reaching people who are age 65 and older in underserved communities.
Shirley Kemp, 71, said it took a lot of thought before she reached the decision to get vaccinated at the North Dade Health Center in Opa-locka — becoming part of a tiny percentage of Black people in her community who got the shot. Kemp was invited by her church, New Beginnings Missionary Baptist Church, which partnered with Jackson Health System to schedule appointments for members and their families.
“I have a lot of things going on with myself and I was scared for that,” said Kemp, who lives in Opa-locka. “But I had to realize that things happen for a reason. We are here to get this shot.”
Miami Herald reporter Samantha J. Gross contributed to this story.