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tv   House Coronavirus Crisis Subcommittee Holds Briefing on Vaccines  CSPAN  February 22, 2021 1:27am-3:05am EST

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the web and it can appear to be factual or true and it can also possibly be completely made up area i would urge -- the think about the sources you are getting information from and think more broadly about what misinformation means and pair that with the kind of conundrum we are faced in the middle of this pandemic. host: rana hogarth is a history professor at the university of >> this is c-span's online store at c with the 117th congress in session, we are taking preorders. it supports c-span's nonprofit operations. shop today at c-span
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>> the house subcommittee on the coronavirus crisis heard from community leaders on the affects on people of color. this is about an hour and a half. >> good afternoon. i'd like to think everyone -- thank everyone for gathering here to discuss racial equity and coronavirus vaccinations. the coronavirus pandemic has hurt all americans. but some communities have had a heavy burden. black, hispanic, and native americans have been infected with the coronavirus at higher rates than white americans. they are more than four times as likely to be hospitalized and
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twice as likely to die from the virus. men and women of these communities are front-line workers who continue to face serious death threats in the workplace. and it's not only about race. all the vulnerable communities, including lower incomes and rural communities, have faced disproportionate hardships during this crisis, as well, and especially in recent months. i am grateful that millions of americans are now receiving coronavirus vaccines. but the evidence is clear that our most vulnerable communities are at risk for being left behind. more than 57 million doses of coronavirus vaccines have been administered so far in this country.
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but only 9% of those who receive vaccines are hispanic. and only 6% are black. even though these populations we must ensure that the communities hit hardest by the virus have equitable access to the vaccine and are being vaccinated at equitable rates. in equity will not only compound the suffering in these communities, but would also delay or even derail containment of the virus across the country. which could hinder a safe return to normal life for everyone.
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the causes of disparities in vaccinations are becoming clear. middle income communities struggle to sign up for vaccine appointments. others do not own a car and may not be able to reach a vaccine site. in rural communities, residents often have to travel long distances to get access to vaccines and may not have access to pharmacists or the ultracold storage capacity needed to store vaccine doses. vaccine hesitancy is another obstacle. while a substantial number of americans currently plan to get vaccinated, others have expressed concerns. in the black community,
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discrimination and health care has resulted in mistrust that we must work to address. let there be no doubt, the coronavirus vaccines are authorized by the experts at the fda are safe. and they effectively prevent people from getting sick and dying of a horrible disease. i was vaccinated as soon as a vaccine was available to me, and i urge every american to get vaccinated as soon as the vaccine is available to them. achieving vaccinations will take planning, coronation, -- coordination, and resources. this community, and many others, warned of the challenges months ago.
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but the previous administration ignored us. the refusal to exert national leadership resulted in chaos and confusion. the wealthy are more likely to get vaccines than the poor. the biden administration has brought a fresh approach that has already shown promising results. with the shipments of vaccines to states are up 57% in the last month. and millions of doses are now being shipped directly to the pharmacies and community health centers. the new administration has also purchased an additional 200 million doses of approved vaccines, meaning that the country will finally have enough doses to vaccinate everyone.
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and the cdc has taken up vaccine hesitancy by launching an awareness campaign in black communities. as vaccines become more widely available, we will need to accelerate our efforts to educate our communities about the safety, efficacy, and importance of receiving coronavirus vaccines. i am particularly grateful to the new administration for experimenting a covid-19 health equity task force, which will help ensure an equitable response to the pandemic. the next step is for congress to pass the american rescue plan, which provides billions of
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dollars for a national vaccination campaign. it will allow us to hire more workers to split the administered vaccines over 1,000 mass vaccination sites, and use mobile vaccination units to reach underserved communities. these measures will go a long way to address and equity i -- in equity in -- inequity in vaccinations. but more must be done. i look forward to hearing additional steps that we can take to ensure all americans have access to a coronavirus vaccine, and have confidence in the vaccine safety and efficacy. now, i understand the minority staff has said they will not be
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delivering opening remarks. if that remains the case, i will now proceed to the introduction of the panelists. first, i would like to introduce dr. gale, who is a president and chief executive officer of the chicago community trust. dr. gale brings a wealth of experience. having worked at the cdc for 40 years. she was a member of the committee for equitable allocation of vaccines for all of the noble coronavirus -- novel coronavirus and who authored the framework for the equitable allocation of covid-19 vaccines, which was published last for. -- last fall.
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next, the infamous abigail echo heart, the chief research hospital at the health board and the director of the urban health institute. she will share the experience of americans of the vaccinated communities in vaccines. she will a -- was also a member of the committee for equitable allocation of the vaccines for coronavirus, and is a co-author of the group's report. next, we'll hear from mr. frankie miranda, who is the president and chief executive officer of the hispanic federation, who supports latino communities around the
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countries, and will share the experience to those communities in the axis of coronavirus vaccines. finally -- access of coronavirus vaccines. finally, my friend has been a close partner in our effort to deliver quality health care for medically underserved communities. as chief executive officer of the south carolina primary care association, she has distinguished herself at the national level and state as an advocate for community health centers, and as someone who knows the needs of the communities who were seeking to focus -- who we're seeking to focus on today. we will now hear opening
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statements from our panelists. you are now recognized. >> thank, chairman, and good afternoon. it is my honor to be with all of you today. and i want to thank chairman clyburn and his great staff and the members of the subcommittee on the importance of an equitable distribution on covid-19 vaccines. as was mentioned, i approach this from multiple lenses, as the president and ceo of the chicago community trust, where we focus on the most pressing needs of the chicago region. and it was mentioned i come to this role after almost 40 years of public health and global and local economic development, and as mentioned, was most recently the co-chair of the national academies report on the equitable allocations of the most novel coronavirus vaccine. this committee was convened by
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nah sisi to develop covid-19 vaccines. and it was insured equity was embedded throughout our recommendations. and this report was the foundation for guidelines that have been developed since the vaccine authorized for emergency use. a bit about the chicago community trust, for us, our hires organization -- highest organizational priority was closing the wealth gap. we believe by closing this economic divide, largely stemming in the history of systemic racism, the entire chicago region will thrive. not only will that have economic benefits, it's key to closing the education gap, the health and life expectancy gap that so many other inequities we face in chicago and around the nation. we know that the covid-19
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pandemic has exposed the persistent economic and health divide between black, latinx, and white communities in chicago, and people of color throughout the nation, and that controlling this health crisis is essential to our economic recovery. the disproportionate rate of infection and economic impact we're seeing are rooted in systemic inequities and decades of disinvestment and barriers to economic stability and wealth. putting equity at the core of the vaccine rollout is not only the fair thing to do, and right thing to do, it is also the smart thing to do. the best way to control the pandemic and a set up a course to an equitable recovery is to get the vaccine to where they are most needed and where the pandemic has had its greatest impact. it is sound public health policy
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to serve the populations most at risk because that is where we will have the greatest impact. this pandemic has caused great devastation everywhere. chicago is no different. we have recorded over 240 residents with confirmed cases of covid-19. of those that we have lost, 72% of the deaths were in black and latinx residents who make up 60% of our populations. we know that communities of color and lower wage earners are also at higher risk of acquiring the coronavirus vax -- infections because of the jobs they work, the homes they live in, the means of transportation they take to get to their job. as is the case across the nation, both our city and state are working tirelessly to distribute the vaccines and control the spread of the virus
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and minimize the impact of disease. in everything that they do, they are centering equity in their approach. so, as an example, in the early stages of the vaccine rollout, 50% of people receiving their first doses were white, and only 18% were black or latinx. today, only 41% are among white chicagoans, 24% black, and 26% latinx chicagoans. so, while this still does not affect -- reflect the population, it shows a targeted effort, progress is being made. more can be done, and we all have a role to play. i'm proud that the chicago community trust, national fundraisers like the rockefeller foundation, in coordination with local initiatives to protect chicago plus, and the vaccine partnership, will support community led solutions that not only respond to the immediate
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need of our communities, but also strengthen public health infrastructure and provide jobs and career pathways for residents in heavily impacted communities. this past weekend, i had the opportunity to visit a mass vaccination site. they removed barriers for essential workers, providing 200,000 doses in just two days. this morning, i attended a site in a predominantly like neighborhood. the same sort of efforts are rolling out across the city. besides providing greater access, we know that there remains hesitancy on the part of many to take this vaccine. in communities of color, especially black communities, we justifiably see hesitancy about taking the vaccine due to
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generations of discriminatory medical practices that have caused harm. we need more than brochures, flyers, and public service announcements. we need trusted local messengers to mitigate, educate, and empower hard-to-reach and skeptical populations. we also need to ensure that real life issues, like childcare and paid sick leave, are addressed so people have the ability to take the necessary time to get the vaccine and deal with the essential side effects, not have to make trade-offs between getting the vaccine and keeping their jobs. still, we know that hesitancy is only part of this story. there are real supply and distribution challenges through, in no small part, underinvestment and fragmentation in public health infrastructure. these structural barriers can be addressed with intention and with resources. that is why i'm so pleased to
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see legislation moving through congress to allocate resources toward the new administration's american rescue plan for a national vaccination program, expanding testing, direct investment in community health centers, and a robust public health jobs program. as a community foundation, it has made closing the wealth gap our highest priority, we know we cannot achieve our vision for the region if we do not equitably and intentionally ensure access to covid vaccines. it is both the public health response for a responsible first step. i thank you. sen. clyburn: thank you very much, dr. gayle. we will now hear from miss -- >> thank you for this opportunity to share with you the experiences of the indian
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country in the midst of this pandemic that are devastating our communities, nationwide. i'm -- i direct the health institute, one of 12 centers across the country who is supporting our alaska native communities in the midst of this pandemic. i'm also american indian. i'm an enrolled citizen in the poni nation of oklahoma and like many, i have experienced devastating losses, not only in my family, my tribe, and my network of friends, those working to end this in indian country are not only doing this every single day but experiencing devastating losses in our everyday lives. at the seattle indian help board in the city of seattle, seattle was the epicenter of the pandemic in february.
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we had some of the first confirmed cases of covid-19. our clinic became overrun by folks concerned about what was happening and we had doctors who were selling fabric masks. the executive leaders were washing scrubs at home, trying to get the ppe and materials needed for our staff. we put out a call because we didn't have enough ppe to our state, county, and federal partners. before we got our ppe, instead what we got was a bag -- box of body backs. it arrived when we were expecting masks, gowns, the things we needed to provide the essential care to our american indian and alaska native people and all the other races and ethnicities in our doors. instead, what we received was body backs. this exemplifies and is a metaphor for what has been happening across indian country.
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due to chronic underfunding of the system, underfunding of treaty and trust obligations, they have 3.5 times more likely to be inspected and 1.8 times more likely to die of covid-19. what does this mean? well, as the co-author of the studies, i was deeply concerned when we went to do the analyses, we were only able to look at 23 states when we looked at the infection rate. right now, our stories are being lost. policymakers could not make data-driven decisions with output data. right now, i'm a scientist who is unable to do good science. today, my organization released a report called data genocide. it's looked at as the nonreporting of state and ethnicities across four factors and degraded them on how well they were doing with this data,
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needed to understand the pandemic in our community. more than half the states in the nation graded c or lower, with 13 states receiving an f. what does that mean? there was a report that showed we are missing 38% of all the ethnicity data. when i think about our community here, we know that our folks are getting vaccinated at high rates and our urban health facilities, but not getting the same care and outside facilities. one of our programs in montana was telling us that people are being turned away at other places and being told to go to the indian center. the indian center receives very limited vaccines. they vaccinated more native veterans that has been vaccinated by their local v.a.'s and are told they are standing in line waiting to get the
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vaccines at the v.a.. we're tired of body backs. so instead -- body backs. so instead, we're looking at our sovereign rights. seattle indian health board has vaccinated 100% of our elders, but they know community in michigan has vaccinated more than 50% of their adult population that lives in their service area. and we have some reporting 50-62% vaccination rate of all village occupants. but it's done with very scarce resources. one of our clinics recently told me that with the rising cost of security, sanitation, temporary providers, they're having to take away services from other essential care and indian health programs and having to juggle every day what people are going to get. this is absolutely unfair and if we look at what is happening
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right now in the nation, the focus has been how many arms can we get vaccinations into? and my answer back to them is it's all about who's arm is it? we will not end this pandemic. we will not be able to reach equity and this we're looking at the folks with the most risk for complications,, hospitalizations, and mortality. until those people are prioritized, we will not be equity and we can do without the data. i will end with the story about a friend of a tribal leader who passed away. as i sat on a chair with my face white with cheer -- tears, did he get a chance to tell his last story? is he included in that data? are people being last. -- our people are being lost. we deserve the dignity of being counted. thank you. sen. clyburn: thank you very much, ms. echo-hawk, for your
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testimony. we will now hear from mr. miranda. frankie: thank you, mr. chairman. thank you for the opportunity to address you and the members of this committee. for three years, our work has centered on building power and capacity in latino and indian communities. and in the nonprofits that serve them. in response to the challenges presented by the corona pandemic , coronavirus pandemic, we created the most far-reaching covid-19 really fun in the nation, investing $60 million, partnering with nearly 300 nonprofits in 30 states in the territory of put rico to provide fair and hope to severely impacted families and communities. we recently launched our initiative to provide $1 million to support 15 community health
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system -- centers that serve low income latinos across the country struggling without adequate funding to administer covid-19 vaccine progress. i come to you today as a leader in a community that has been devastated by covid-19. the impact of the coronavirus on the health financial security and educational progress of latino communities has been nothing short of devastating. the impact is compounded by government inadequate preparation for vaccine dissolution. latinos are disproportionately represented among so-called essential workers. an occupation with lower wages, nonexisting benefits, and no job security. latinos are also overrepresented among the unemployed. essential can also feel like disposable. latinos account for the largest share of the nation's undocumented immigrant population, and our communities
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are home to millions who have spent the last four years in constant fear of family separation. many will not seek essential government services for fear of having it counted against them. inequities are now playing out in the ability to receive potential lifesaving vaccinations. available data shows a consistent pattern of hispanic and black people receiving smaller vaccinations as mentioned here before. for example, in texas, only 20% of vaccinations have gone to hispanic people who make up 40% of the population. 42% of the cases of covid-19 are nearly half of all deaths, 47% in that state. and as of this week, the cdc reported that race and ethnicity were not just over half of people who have received at least one dose of the vaccine.
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and as we mentioned here, among the known groups, nearly two thirds were white, 9% hispanic, 6% black, and 5% asian. latinos make up nearly one in five of the u.s. population. over 18%. and yet we represent nearly 33% of covid cases nationwide. we have been dying at rates more than twice as the white population. we need to do better not only for latinos, but for the health of this country. we know from our own work and our partners on the ground what the problems are and what needs to happen to address them. you just need to ask us. and i'm here to recommend strategies in three areas that will result in more equitable, targeted, and effective this tradition of the vaccine. first, accessibility.
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barriers to access include language, lack of transportation -- people take for granted having internet or even an email account. we need target programs that provide that's nations where hard to reach populations live and work. continuing to simply open mega sites lack creativity and a commitment to reaching hard-to-reach populations. number two, very important to me, resources in a community-based organization. we must unleash our community's greatest asset. in order to do that, we must allocate significant funding to our community-based nonprofits that have the cultural competence to educate and cover the rampant misinformation, distrust, and now fraud on latino communities. these organizations are our most trusted messengers, with decades of experience engaging,
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mobilizing our communities to action. but they remain underutilized. there's also a for case management personnel with competence to reach the population, persuade them to give vaccinated, help them sign up for the vaccine, and then follow-up to ensure they go back for a second dose. providing the vaccine is just not enough. and third, equity and prioritization. federal distribution guidelines must be created to target needed impact. there must be priority guidelines to prevent abuse and jumping the line, and other side, especially wealth shortages, remain. simply providing vaccines to people over 65 will not reach latinos who have the highest numbers of deaths among younger age groups. almost half of all covid related deaths in the 35-44 age range are latino, 48.9%, compared to
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27.3% of black people and 65 5% of whites. we cannot open the economy on the backs of the black and brown's and undocumented workers who continue to suffer disproportionally high rates of infection and economic hardships death. we need to provide equitable access to vaccines. we're not asking for equity just for the sake of equity. to continue to give low priority to immigrants and latinos is not only unfair, it is terrible policy. this country will not recover as quickly as it needs to. many are left behind in the lifesaving race to provide vaccines. thank you for asking us how, together, we can do better for
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our communities, our country, and our future. we know there is no time to waste. our lives hang in the balance. thank you very much. sen. clyburn: thank you very much, mr. miranda. we will now hear from ms. willard. ms. willard, you are recognized. >> hello, chairman, and other members of the subcommittee. i am the ceo of the south carolina health care association. i've been in the movement for over 33 years. prior to that, i was a state public health office. in south carolina, health care's provide primary care to over 430,000 patients throughout the state. there are over 220 sites which serves the state's 46 counties. all of which are either rural areas in the county.
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in addition, i have the honor of the board of directors for national associations of healthcare. nationally, we have 1,300 organizations spread out over 14,000 rural communities. and we've served over 30 million people. committees to step up to meet the needs of the communities we serve, providing this information. 115 of the 21,205 we mentioned earlier that are designated and activated as covid-19 sites. despite these efforts, there has been challenges in deploying the vaccine to rural areas and to communities of color. some of these challenges i'm going to mention from south carolina other state in our country also face.
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these are the lack of trust -- and you hear that earlier -- by some of the residents in your areas, which you have provided them mobile units to provide the testing. our health centers are well known in these communities and have been rooted in these communities, so there is that piece of trust. there is also the lack of supply. when i see the health clinics get 400 appointments in the category 1a, but no vaccine due to the lack of timing delivery and the supply of the vaccine . that was 400 people that we had to cancel appointments for. then there is also evidence to improve vaccine confidence that we mentioned also, the mistrust. and believe it or not, there are still a lot of people in rural areas and people of color that
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remember the tuskegee study. congressman, i do use you as an example. congressman clyburn did get the shot. because they need trusted places to share the right message for unit and also about stories of adverse reaction. it will take somebody to get our -- get sick, have a fever, or whatever. that's where the hesitancy comes from. this widespread culturally invitation by trusted messengers. that helps in mitigating that trust issue or that concern issue regarding how safe the vaccine is. there is also, which is not new, a lack of adequate transportation in the rural areas. and recently, the example is -- and i know mississippi, as
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well -- they called to say that they can't get through. so, is not just having transportation, but having good roads, as well, to travel on. additionally, the lack of internet access to make appointments through them. and some of our rural areas have challenges. even with internet access, we have some that are just not comfortable using the internet . my 95-year-old mom is an example. and even accessing by telephone , for many, have proven unsuccessful. either i didn't get an answer or i waited so long for appointments. and when i go to the appointment, i have to stay five hours to try to get the shot. so, for somebody to go out of their area to get the vaccination, that's not going to be a priority from them.
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when several staff must quarantine because of exposure to covid-19, this limits access. but also the funding to secure the workforce to have in some cases and also needed the ppe and other supplies. the other challenges include how they are administering the vaccine following the process in terms of the cdc guidelines. there has to be some flexibility in rural areas because of the timeliness of six hours. i will speed up because i have zero time left. other current challenges can be overcome, but i need to mention because somebody asked me a question. there is major issues, including, for us, not spanish
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application forms. we have a lot of hispanic patients. the current challenges can be overcome if we work together and not in silos and distribute equitably. and what i mean equitably, not just the minority. the people you can't reach are the hardest to reach. it sends the wrong message. we must have better coordination. that includes mobile units. we have been encouraged by the current administration enhancing mobilization health centers. we also have, and i have to say this, we were founded on social justice and health equity. today, we continue to deal with the current pandemic.
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our centers are formed by the community, are governed by the community, and hired from within the community. we are these underserved areas. we are in these underserved areas. we are trusted providers of healthcare for unit outreach services and mobile units that they have repurposed for covid-19 services. they thrived to reach the 1,600 hassles of seniors who do not have internet access nor have the ability to fill out the applications. we also work with faith-based organizations. and last, in closing, we stand ready to meet the needs of the communities at large. we appreciate the confidence in the administration has shown in
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our movement, especially with the $7.6 billion pending with those other services not vaccines. we're very optimistic about that. so, thank you again, chairman clyburn, and to the members of the subcommittee, for the opportunity to appear before you today. i look forward to your questions. sen. clyburn: thank you very much, ms woodard, for your presentation. and together, the answers will -- are going to come to you for questions. we will now have members who will each of five minutes to ask questions. and i'm going to begin, coming back to ms. woodard, with my five minutes -- and i ask you to
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not take all my five minutes -- about these issues that you left on the table. lanthran: very quickly, the system to keep up with the vaccinations from 2%, one for the providers when we have to, drop the demographics of the patients were serving. but we have to manually enter each vaccine that is done. the vaccine administration. which provides a problem when you look at the dashboard and it takes a while to manually put that in. on the others, the side that's spanish-speaking -- a lot of seniors don't have email addresses. a lot of people in rural areas don't have a addresses. let's say you have a household with two people.
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you can't use e-mail address for one both people. so, there are issues -- not even dealing with the literacy. when my staff members got frustrated with this targeted , they get frustrated filling out the form. so, those are pieces that i was talking about with them. there are several others but those two are the ones that are bigger. sen. clyburn: go ahead. i don't want to cut you short. go ahead. lanthran: the other is patients really understanding how to go and find the site. we're not really doing good with educating -- we're building this
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card as we're driving. we have to do better with communication when it comes to how the patients have access to these appointments. in one example, one person called me and the response was it would be a long time before you could get an appointment. that wasn't really the answer she wanted. even if it was six to eight weeks, that wasn't the right answer. the person did not know other sites. you are open to go to other sites. some need appointments or are not a walk-up. so there is still a lot of education. and even the bureau at cdc know there are issues. one of our largest health centers in greenville couldn't get their site designated because of technical problems. sen. clyburn: thank you very much.
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i'm going to forgo my last two minutes. next up for questions is chairman waters. and i know she's going to take more than five minutes. [laughter] five minutes, or seven minutes. sen. waters: thank you. now that you know i'm going to take more than five minutes, i will take that as understanding i will do so. [laughter] so, thank you, mr. chairman, calling this meeting today. this is very, very important and i think that our witnesses here today basically have described what the problems are. and how the communities of color are not being taken care of. and that's why we have access over 12 million people in the united states were vaccinated. and that the coronavirus vaccine became available.
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black americans make up 13% of the united states population for -- population, but according to the cdc data, they're only 5% of the people received the coronavirus vaccine in the first month. so, mr. chairman, i decided to visit one of our big sites here in my district, in inglewood, california, and i have with me one of the newspaper representatives with me in the single -- city of inglewood because i wanted to know whether or not this site, which is really a regional site, and people can come from anywhere, whether or not the seniors were being taken care of in the city of inglewood, where it is disproportionately blacks and latinos. and i discovered an awful lot and learned an awful lot. so, inglewood today, in the
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newspaper, put information out about my visit and they showed me on the side going to all of these setups and oversights that people have to go through and what they had to do. and so what i want to ask our witnesses is this. you do understand that these systems that ask our seniors to get online and make a reservation is just absolutely a misunderstanding about what seniors are able to do, willing to do. they don't know what the hell you're talking about when you say get online. some people asked me what line they're talking about. so, it is absolutely irresponsible for seniors to make reservations online and it's also cumbersome for any of the systems for those to even go online and make reservations if they know how. and many of them don't have
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computers either and nobody is assisting them. and the second thing is they don't have transportation. they don't have transportation to the site. and i learned that if they walk in, they show up, basically, they do not get taken care of. they tell them that we will send you an appointment on your e-mail. and many of them don't use their telephones that much and if they do, it's there daughters or sons or grandchildren to call them to see how they're doing. but when it comes to using these phones and getting e-mails and all of that, any of our seniors do not do that. they are handicapped. no transportation, being told to use the technology that they don't have the don't understand they can't walk on and i hear about people who took the bus because they learned about a site and they were not taken care of. and then i'm learning that there
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are others who heard that these vaccinations are available in communities were black and latinos are and they're not using them and they are coming into the area and they are getting the vaccination. so, in addition to correcting some of those problems, don't you think that we should get access to all over television and radio stations and everything, bring on the celebrities and the sports people and talk about, get your shot. i got mine. this is important to save your life. don't you think that tending to the things i'm alluding to and you're alluding to and getting the publicity done and making the public relations for our public radio and television stations to do more. it would help wasn't getting our seniors and in particular late -- particularly vaccinated. and with help to eliminate this disparity that we're all concerned about. and i address this to all of our witnesses today. and we can start with our very
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first witness, and that is dr. gayle. dr. gayle: thank you very much for your comments. it is true. in the remarks, people have addressed this issue of seniors and i think that we have to realize that we've got to make the systems that meet those needs. one of the sites that i visited , for instance, people could just walk on. they showed their zip code. and it meant that you couldn't come from outside of the neighborhood and get an appointment. so, these there are ways of handling this. there is no one magic bullet. you described several different things. we need to have a national campaign, so there is the same information to everybody and people are aware how these vaccines got created, developed,
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and so that we can eliminate some of the myths that are making it very difficult for people to get vaccines. we do need to work very closely with community based organizations and build on some of these systems that are in place. so, for instance, we're using, in chicago, the census workers in chicago for the same people are the heart accounts communities and building on the work that they've done where the vaccines for these people are part of these organizations. we're using messengers so that people see people like them. they believe this vaccine is safe and the people that take them look like them and tell them that this is ok. sen. waters: senator clyburn and
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i were part of the group -- mr. clyburn has made it known -- i have clinics that we support were not even in the system. [indiscernible] it's not enough to have one area of one state -- [indiscernible] how here in california, i'm visiting a site you can't walk on. it's not enough to be told i have reservations done online. and so i'm very pleased that in addition to all of that in places like illinois etc., that they're going to get about $14 billion into the rescue plan to
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improve covid-19 vaccine administration and distribution. [indiscernible] so, i'm very pleased to be here today. but we all need to preach a national program. the people with good sense and what the process should be and for those systems don't have black people included in the decision-making. they've got to get them so that they can tell of the black people -- [indiscernible] black people don't like to go to the drugstore to get a vaccination. they don't believe that. first of all, they're not happy that they don't see faces like theirs. when you tell them to go a different way, they say no. that's not a hospital. that's not a clinic. so, we have to straighten all of this stuff out. [indiscernible]
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dr. gayle: i would just say that i would totally agree that a national strategy is critically important and i'm happy to see the board now taking you -- taking a national approach. that is not a scattershot approach to this greater systems are being put in place. so, thank you. sen. clyburn: thank you, madam chair. and thank you dr. gayle. now, let me now recognize a gentlemen who i think is participating by telephone. the chair now recognizes mr. jordan. is he with us?
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it looks like mr. jordan is not with us. the chair now recognizes the -- recognizes ms. maloney for five minutes. ms. maloney: thank you, mr. chairman, for having this incredibly important job or hearing. i thank all of the participants. i'm very concerned that communities of color in rural communities low income communities are falling behind in vaccinations. in my home city of new york, predominantly black and latino communities have been vaccinated at lower rates than the predominantly white neighborhoods. there are reasons for these disparities. but one is that new york and other states simply need more doses of the vaccine. we do not have enough doses. mrs. echo-hawk, i would like to start with you. could moore have been done last fall to prepare for
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distribution of coronavirus vaccines? abigail: thank you so much for that question, congresswoman, and absolutely yes. we received a bunch of bags instead of the supplies needed. in your home state of new york, looking at that data put out today, they were actually second to last in the recording of race and ethnicity data. so, unfortunately, when we talk about the statistic of who is getting what in terms of the vaccination, the information is terrible. i guarantee you that it is much, much worse. and in the native population in new york, one of the largest communities decent new york city. and they're lacking. we really need to see more investment. and when i think about the previous question that was asked about elders, in our community here in seattle, washington in
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the second another place. we vaccinated 100% of our elders. how did that happen? we have entrusted home organization. we did not rely on going online. we went to them. for our homeless alaskan natives, we went to the homeless encampments, working with our homeless have taken the vaccine to them. that provider did about 15 vaccinations versus if they were in our clinic. they can do more. but it's not about doing more right now. it's about making sure that we have the resources to do those who needed the most. we are doing that with scarce resources for you to be an offer providers we could be doing moremark. so, we absolutely lack the resources. we're very excited to see this investment, particularly in health centers and community health centers, because we are the home community. this is where the investments need to go in with the people go and whether culture is understood, and where we have their best interest and their trust.
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ms. maloney: thank you. dr. gayle, let me get to you. based on the background and working in global health, why is it so critical to have enough doses to vaccinate everyone. not just to be rapid as possible. dr. gayle? dr. gayle: i missed a bit of that question. i'm sorry. ms. maloney: why is it necessary critical to have enough doses to vaccinate absolutely everyone? dr. gayle: as we know, and your question for how we think about this globally, clearly, all of -- unless all of us are fully vaccinated, then none of us is -- none of us are safe. so, i think it's critical that, here in the united states, to really focus on making sure the people who are most at risk, who have borne the greatest brunt of this get vaccinated quickly as possible because that is how we are going to drive the numbers
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down. but i also think we have a responsibility for the rest of the world and thinking about how we make sure because we're not safe unless the rest of the world is. this is really about making sure that everybody has access to this vaccine, but getting it to the people who are most at risk. it's not just the fair and just thing to do, but also will have the greatest impact during this pandemic. ms. maloney: thank you. experts warned us last year that the leadership was necessary to coordinate a massive vaccination camp. but the previous administration did not use the authority to accelerate the vaccines or create an effective distribution of plan. -- distribution plan. i'm grateful that the biden administration is making the i includes fighting an additional 200 million doses of the pfizer and moderna vaccine
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so the country will soon have enough doses to vaccinate all adults. it also includes ramping up weekly distribution to states sending doses directly to pharmacies and community health centers. we must do everything in our power to make sure that all americans have access to vaccines as soon as possible. thank you. i yelled back, missed -- i yield back, mr. chairman. ms. velazquez: thank you for this important hearing. thank you for the work you have done across the nation.
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it protects the latino community, especially at a time when latinos and other immigrants live in such fear for the last four years. in order to crush this virus, we need to make sure we have access to the vaccine, but then how do we, once you have access to the vaccine, quell the fear many latinos and immigrants live under, and the lack of trust, to be able to move people to get the vaccine? >> i appreciate the question. i have to admit the last four years have been traumatic for our communities. the toxic narrative targeting our communities, immigrants or
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latinos or those who are american citizens who have been talked to in a negative way, it has an effect on the trust and government programs. that is why it is so important, as dr. gayle has mentioned, we need to talk about who are the messengers. those are right now the community-based organizations. in new york, while they are underfunded, they continue to do more resources, including food insecurity with very little. we mentioned the census workers. we can also add the navigators of the affordable care act. they manage assistance when people are enrolling.
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they have issues like access to technology. the tool is there. the latino community based organizations are ready. they can become sites in communities. ms. velazquez: dr. gayle, how will shifting away from pharmacy based distribution help the gap in covid-19 backs and rick -- covid-19 vaccination rates in lower income and people of color communities? dr. gayle: there probably isn't a one-size-fits-all. as several of these speakers have mentioned, the health centers are where people go. it is where they feel they have trusted providers. this is how we make sure people have options with people and
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places they trust. the fact that there will now be distribution in federally qualified health centers could have a huge impact for those who depend on those providers for their health, who trust those providers. those health centers are in the neighborhood. having a balanced approach that recognizes distributions to pharmacies makes sense for some people, but not all and make sure we are meeting people where they are and where they trust and making sure it is as convenient and accessible for those who are culturally competent. ms. velazquez: thank you. i yield back.
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>> the chair now recognizes mr. foster for five minutes. >> am i audible and visible here? [laughter] alright. as a scientist, i know how important data is. there is a saying in engineering you cannot fix what you cannot measure. if you are serious about entering equitable coronavirus vaccine to all americans, we need a clear picture of who received the vaccines. the data is woefully incomplete. according to a recent cdc report, [indiscernible] 53% of all vaccine recipients. only 34 states are currently reporting any vaccine data by race and ethnicity. among those that do, the early results are alarming. the data indicates individuals
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from wealthy white communities are being vaccinated at significantly higher rates than people of color. one of the things impeding our access to usable data is the long-standing federal ban on a patient identifier. this is simply a patient number assigned to every resident of the united states. it would allow every vaccination appointment, every covid test, illness or death to be associated with any unique patient's electronic health record. this would allow for the collection of race and ethnic information for patients who opt in and prevent jumping the line by patients who do not qualify. i am proud that after the years of effort on a bipartisan basis, the house last year voted
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unanimously to remove this ban. this will simplify the collection of health care statistics. i am hopeful the senate will get this across the finish line. dr. gayle, how would accurate and complete data of coronavirus vaccines help address these disparities? dr. gayle: it's usually important to have the data. not having the data is like trying to fly a plane blind. you need to know where you are and want to go. having the data is quickly important. what you point to is what several people mentioned. we are lacking core public health systems in this country. we would not have been caught as off guard if we had the kind of information you are talking about. it is incredibly important to
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invest in this. we have a nationwide vaccination program for children that works relatively well. we don't have one for adults. there is a lot we need to strengthen as we think about how do we have the kind of public health infrastructure, including the data infrastructure to meet our goals and be more effective in targeting our resources. i will add one other caveat. part of these people being willing to give their data is a lso part of this issue of trust. people will not give their data if they don't feel they get something in return. part of this is predicated on us having the systems in place so that people feel like they are being well served when they give
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their data as part of the health interaction. it takes all of that. your point is well taken. we need to invest in the public health infrastructure to be part of that. >> i agree completely. every one of us had the experience of going into a new clinic and hospital and filling out the same forms we know is on 10 different computers somewhere. dr. gayle: it's an efficient. it -- it's inefficient. it costs us. >> as we succeeded in passing the repeal of that ban, we got a letter of appreciation from 53 medical societies that don't want to spend as much as they do on duplicitous forms. i would like to talk about vans.
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they last year the trump administration hired a private company to build software called the vaccine management system. one of the early reports confirmed by one of our witnesses is it has been very difficult to use. often malfunctioning. this seems to be a repeat of what we see from the trump administration's repeated behavior by first mismanaging the covid-19 crisis and then trying to compensate with some emergency rollout of untested software systems instead of simply building on the existing systems. i would like your insight. anything more you can say about your experience with vans aand w -- and what it doesn't do and should do to better serve your community's needs? [indiscernible] >> am i muted?
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what did you say, congressman? >> yes, we can hear you now. >> one of the things that i want to recognize is cdc and our public health department knows there is a problem and says they are going to fix it. right now it is discouraging patients. it is discouraging providers. we have burnout because the administrations are trying to individually enter each patient for vaccinations. the flipside of the results of that is we are now getting less supply, vaccine supplies. because all you have is the data. you scientists know how that is. we have to have data, but we need to have accurate data. there were 2200 doses.
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they say they only have 465 vaccinations they gave, so they did not get the next amount of doses they need. so there is a problem of uploading. there is also a problem of information being dropped. i wanted to use another system, but cdc said no. they said is overloaded. everyone recognizes you've got to change something but that change is not happening immediately. we are also not getting appointments and actually giving up. they're just saying that i am not going to do this. i tried to fill it out and gave up. >> the mayor's brother describes -- and he studied how it works in other countries -- you show up, you say here is my card. they look at your age, where you
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live, everything about you and this is your priority. here is when you qualify for a vaccination based on where you live. it sets up an appointment for you. the key of that is to get the universal patient identifier. so that people can associate themselves with the medical record. thank you very much for being -- for staying in the fight here and i yield back. >> thank you. the chair now recognizes mr. raskin for five minutes. >> thank you for calling this very important during. this is a big issue in the state of maryland. the african-americans make up 32% of the population but are 39% of coronavirus deaths.
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that is around 25% higher than indicated just by virtue of representation of the population. but conversely, african-americans receiving the coronavirus vaccine are 16% of the total. so that is half what you would expect. 50% of what you would expect from african-american representation in the population generally. we have heard many of the reasons why communities of color and immigrant communities and rural communities are not able to access vaccines at the proper rate. i appreciate dr. gayle's point about strengthening the public health vaccine infrastructure generally for the underserved population. but i'm also concerned that some people are choosing not to get vaccinated because of dangerous misinformation and propaganda about the coronavirus vaccine or vaccines in general. many immigrant families for
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example rely on social media platforms like facebook to stay in touch with their friends and relatives both here and abroad. we know that that is where a lot of dangerous information and conspiracy theories thrive. according to the washington post, recent analysis found that social media companies are far less likely to flag misleading posts or videos that are in spanish than english. the figure was 20% of dubious spanish-language posts get warnings compared to 70% of dubious english language posts. mr. miranda, i am wondering whether you see misinformation and disinformation spread in the communities you work with. what are you all doing to address it, and what are the countermeasures that are indicated in a situation like that and how can the
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administration help to get the right information about the coronavirus out to the relevant communities? mr. miranda: thank you so much congressman for the question. i will go further, it is a very accurate information that's happening in our community. i will tell you that there is now fraudulent targets on our communities, especially the spanish language senior population has been targeted on trying to get their information and also money in order to get the chance of getting a vaccine. for us once again, our solution to all of this is to continue investing and making nonprofit organizations that the working communities that have the cultural experience inside communities to employ people in the community, the aca
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navigators, census workers, all these organizations that right now are so under resourced and are providing extra services to those populations. they are the best messenger. they stand ready. there are better resources to actually be able to do micro containments in their communities. congresswoman waters mentioned about the most trusted spokespeople. all of this has to be in combination with communities. it cannot be coming from outside or from megasites or informational materials that have been done without the proper target on the very diverse spanish-language community coming from different countries. >> thank you very much. i am wondering whether you would illuminate the same question
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from your perspective about the intertwined problems of vaccine misinformation and hesitancy in the population you serve versus what are the effective educational efforts we can engage in. >> the urban indian health institute which i direct published weeks ago the first national survey on attitudes and hesitancy on the covid-19 vaccine across the nation. why a tiny nonprofit? because no one else had done it. it did not reach as far as i would like, but it gives us a snapshot. right now all of these vaccine campaigns are being conducted on the national level without our voices, without those who can reach into the latinx, the hispanic communities. they don't trust the cdc and the
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nih as a result of the things that happened in the previous administration. that eroded the public trust in these institutions. they are afraid they are getting tested on like they have done in the past. however, hesitancy and willingness to get vaccinated are not mutually exclusive. we found the native communities were more likely to get vaccinated in our study compared to the rest of the country. 75% of them were willing to get vaccinated if they received more information. we created materials using the science, using the limited data we had, including trusted messengers. representative deb haaland was the number one messenger people wanted to see get vaccinated. representation matters. that is why we are excited about her nomination to the department of interior. those things matter. so prior to our survey, after it was launched, i received inquiries from federal agencies to contractors to receive
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federal money. they wanted my data. they have been given the contracts to do these public health campaigns and they did not have the information. instead they wanted to take what little i had come and the economic investment from congress and use it for their benefit versus investing in our communities. those resources have to flow to us. >> thank you. i yield back. >> the chair now recognizes for five minutes the next person. >> thank you, mr. chair. can you hear me? dr. gayle, i'd like to ask you a question. as a representative of the chicago area, i'm so pleased that you are joining us and we
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are honored you are here. thank you for your work over the decades in the early stages of the aids crisis and eliciting a presidential apology to the tuskegee airmen and i understand your own father was an airman. so thank you to your family for your incredible public service. let me direct a question to you as a physician about a phenomenon we are noticing, which is hesitancy among healthcare workers to taking the vaccine. in one hospital, in the suburbs, 40% of healthcare workers were hesitant to take the vaccine. and i would be curious about any observations you have about whether you have noted similar patterns or greater patterns among even physicians of color.
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>> thank you very much and thank you for representing our state well. it was my husband's father that was a tuskegee airman. [laughter] anyway, yes, we are seeing that trend across the country that health care workers themselves have hesitancy. we cannot pretend one profession takes you away from who you are, your sense of trust, your lack of trust. but i think the positive is that as time has gone on, we are seeing that hesitancy among health care workers subside. as more of them see their own colleagues getting the vaccine and as more information came out -- as everyone remembers, before
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these vaccines were authorized to use, we were talking about warp speed and names the at suggested that maybe we were taking shortcuts. the healthcare workers of all people being close to the science were skeptical as well. a health care worker who is a person of color also brings with them the histories of discrimination, lack of trust and all of these other issues, but i think as the information is coming out, as people are seeing more people, the main reason people are hesitant is because they want to wait and see. what are the effects, what does it do to people who look like
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me? if health care workers don't want to do it, it is hard to convince others. >> let me ask you a question as well about this. i imagine that if we put jim clyburn on a psa in south carolina, everyone would start getting vaccinated. that is just my guess. but at the same time i've got to believe some people are hesitant about airing those psa's right now when there is such a shortage of vaccines. they may fear folks may say, yeah, i am coming to get vaccinated because congressman clyburn told me to get vaccinated. and they show up at your hospital and you say sorry, we don't have vaccines for you. how you balance this outreach on the one hand to reduce the vaccine hesitancy and on the
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other hand, this terrible shortage of vaccines that you're having to deal with. it's can you talk a little bit about that? i think you are muted. >> yes, congressman clyburn has influenced a lot of people, but that was one of our major problems with hesitancy. how are our patients going to take the shots if the workforce would not take it? pfizer was kind enough to give us one of their scientists and our clinical staff was on a call and it made the process more comfortable. he explained we put in extra
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hours and our doctors started feeling better and started relaying that to the staff. since the shortage, one of the things we are missing is a lack of appropriate communication. we need to start upfront with we know we don't have enough supply. that is why we are prioritizing. we do expect to have enough for everybody. we don't want to grab just the low hanging fruit. when you are very upfront statewide and know who the messenger is, and finding people who are respected in the community -- it is not always the doctors, sometimes it is the faith leaders, to explain around
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hesitancy and supply. we have got to communicate in people's language and make them feel comfortable and ask questions. we don't have a hotline for people to ask questions. that is one thing i think we need. like an alms bondsman -- ombudsman. we have a national strategy for communities. we can have a national plan, but those strategies have to be culturally appropriate for the community. all rural communities are not the same. you have to deal with the culture in that community and who they listen to, which is not the same in each community. >> thank you. i yield back. >> thank you very much.
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let me thank all of our guests here today, the consultants who have shared their experiences with us. as mentioned earlier, the title of the memo is blessed experiences. i said, in writing that book, that we are what our experiences allow us to be. as we just heard from everybody here, the communities we serve dictate what approaches we have to make if we are going to make the connection with those
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communities. if we are going to make this challenge successful, and we must be successful. i want to thank the presenters here today and all of the members for their great questions that i'm sure will be beneficial as we go forward. if the vaccinations are not administered to those at greatest risk of becoming infected, we will not be able to get this virus under control. our ability to safely reopen our businesses and schools will be threatened. the virus's continued spread among those who have not been vaccinated also increases the risk of new vaccine resistant
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variants emerging. that puts everyone at risk, including those of us who have had the vaccinations. as martin luther king junior wrote, which i quoted in the subcommittee before, injustice anywhere is a threat to justice everywhere. we are caught in an inescapable network of brutality, tied in a single garment of destiny. whatever affects ones directly affects all indirectly. the issue of vaccination equity affects us all. access to vaccines is a critical step and we must use all available tools to make sure vaccines are distributed not just effectively and
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efficiently, but also equitably. i am thankful to the biden administration for making equitable vaccine access a top priority. as i said earlier, when we met with the president several weeks ago, i raised the issue of the effective distribution and called upon him to utilize the federally qualified community health centers as a way to connect with these communities because these community health centers are trusted entities in the communities they serve. we met, i believe, on friday morning. on tuesday, the president announced a program to utilize the federally qualified community health centers in order to get that done.
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i am thankful for those of you connected. i worked with you for a long time. i want to continue to see the subcommittee, the information they are gathering out there. you are the national president of your association and i want you to gather information from your members as to what their experiences are. please get them to this subcommittee so that we can share with this administration exactly what your experiences are so we can be more efficient and effective as we work to achieve equity. congress must pass the american rescue act. t [; -- that plan provides the
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resources we need to get the vaccines to the communities of color, low income communities, rural communities that have been hardest hit by the pandemic. we must improve collection of data by race. get this information by ethnicity, location, to all the communities which are being underserved. i encourage all of my colleagues to work in a bipartisan way in order to enact this critical legislation. this legislation is a must. we can argue about the size all we want to, but we cannot or we should not argue about size based upon emotions.
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what we need to do is focus on what the need is. if we address people's needs, that ought to dictate the size of this expenditure. because if we fail to address the needs simply because we don't feel good about the number, what will be the cost in the final analysis? that is the question we need to be asking ourselves. it is essential we provide federal leadership to that that -- to do that. states must also play their role as well. the state should fast-track the process of getting an appointment to receive the vaccine. we just heard testimony about failure to get appointments. i have been experiencing my
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office is getting calls from people who seem not to get appointments. we need to take these experiences into consideration when we talk about what we need to do to get people appointments. i want to thank all of us who have been working with us. to those of you working with this administration, i want to thank you. let's make sure we do what is necessary with our colleagues across the aisle to get this rescue plan done, and hopefully within the next several weeks so we can get this pandemic behind us. thank you so much for being here today. if no one has any other
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questions or comments, i am going to declare this briefing adjourned. >> thank you, congressman, for your leadership. >> thank you. >> mr. chairman, i believe you inspired the quote of the day, which is coronavirus anywhere is a threat to health everywhere. [laughter]
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in kalamazoo michigan. he announced a


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