May 21, 2021

Multnomah County today submitted a required plan to the Oregon Health Authority on how local public health, in partnership with the State and health systems, will support communities who have not had equitable access to the COVID-19 vaccine. The plan will build on culturally specific education and partnership opportunities to narrow deep disparities that put some communities of color at greater risk of contracting the virus.

The equity plan is the second element of a two-part framework that allows counties to ease restrictions on public life. Gov. Kate Brown last week announced a dramatic shift in the State’s reopening plan, away from a strategy based on the level of disease spread and instead relying on a statewide target of vaccinating 70 percent of people 16 and older.

Counties also have the option to move to “Lower Risk” once 65 percent of residents 16 and older receive at least one dose of the COVID-19 vaccine, and once a county’s Local Public Health Authority submits a plan to the State on how it will address low vaccination rates among some communities of color.

Multnomah County, which remains in “High Risk” under the Governor’s “Risk and Protection” framework, reached that 65 percent target last week. After submitting its equity plan today, Multnomah County will be eligible for easing restrictions next Friday, May 28.

But in a letter sent along with the plan, Multnomah County Chair Deborah Kafoury requested Gov. Brown speed up that timeline and allow the County to ease restrictions and further reopen before May 28 — as soon as the state has reviewed and approved the equity plan, ideally by Wednesday, May 26. That would allow restaurants and bars, entertainment venues and gyms to expand capacity possibly several days sooner than they’d otherwise have to wait. 

“More than 65 percent of county residents have received at least one dose. And that’s something to applaud. But that number masks deep disparities that leave some communities at greater risk than others,” Chair Kafoury said Friday. “We look forward to reopening, allowing businesses to get back on their feet and people to reconnect. But we have to remember that lower risk doesn’t mean low risk for everyone, and that’s why we took the time we needed to get our equity plan on vaccinations right.”

Statewide data published by OHA shows the percentage of people who have received at least one dose of a COVID-19 vaccine is significantly higher for white people than for many communities of color. Where the state’s first-dose rate for people who identify as white is 45 percent, the rate for Black, Latinx, and American Indian and Alaska Native residents hovers just above 30 percent.

OHA data provided to local health officials show those same disparities play out locally.

And those disparities remain despite months of intense work by local public health and safety net clinics that have been able, with the relatively small number of vaccines they’ve been able to directly allocate, to predominantly serve immigrant and refugee residents and other people of color.

The County’s plan demonstrates its ongoing commitment to centering equity in its COVID-19 response. It calls for continuing the grassroots community-led education and outreach spelled out in the 2020 COVID-19 BIPOC Plan. That plan lays out the County’s commitments and goals to ensure racial equity would be centered throughout the County’s response.

In this next phase of its emergency response, Public Health will:

  • Shift its response from the acute needs of an emerging pandemic to the long-term health and social conditions that increase COVID-19 risks and impacts. 

  • Support more focused, culturally specific and community-driven vaccine education.

  • Widen the focus of community partnerships to address underlying social determinants and health inequities, and support community members who are experiencing too much daily stress and trauma to focus on decisions about vaccination.

“We applaud the State for requiring local governments to consider equity in this next phase of vaccinations. We have worked hard to center equity in our overall COVID-19 response, but we’re a small player in the vaccine world,” said Public Health Director Jessica Guernsey. “We will continue to work with the State and health systems to play an active part in achieving equity. We need to work together to respond to BIPOC communities as they continue to tell us what they need in our approach to COVID-19 vaccination efforts and in all other aspects of health"

The plan also calls on local health systems and the State to step up as a partner in equity. Health systems have received the vast majority of vaccines to allocate locally, with just a small share given to the County and its health system. The plan would build that partnership through: 

  • Gathering, analyzing and sharing data on the race and ethnicity of people who receive the vaccine to better identify barriers and strengths within specific cultural communities.  

  • Commitments to ongoing and substantial financial support for large and small culturally specific nonprofits.

  • Providing communities of color a role in the State’s and health systems’ disease response and vaccine rollout.

  • Acknowledging the time it may take for some people, even when they have the support of trusted leaders, to make a decision about getting the COVID-19 vaccine.

“Confidence in these vaccines is built on trust, which will take continued investment in community partnerships and deep outreach,” said Health Officer Dr. Jennifer Vines. “It’s going to mean getting people the right information at the right time in the right way. And county residents should expect that level of commitment from their health care providers and governmental public health.”