Democrats spar over COVID-19 vaccine strategy

Publicly, House Democrats are largely united behind a simple message surrounding COVID-19 vaccines: Get one as soon as you can and take whichever one is offered.   

Yet behind the scenes, Democratic leaders and rank-and-file members are at odds over their strategy, a disagreement rooted in growing concerns that the new, slightly less effective one-shot Johnson & Johnson vaccine might be sent disproportionately to vulnerable minority communities. 

“I do not think that there should be any effort that focuses on distributing one specific type of vaccine to one specific community,” said Rep. Karen Bass (D-Calif.), a former health care worker and community organizer in Los Angeles who led the Congressional Black Caucus last cycle.

“All three vaccines are great. All three vaccines should be sent to all communities,” she told The Hill. “One vaccine should not be put aside for inner cities.” 

Speaker Nancy Pelosi (D-Calif.) has sided with those Black Caucus leaders, arguing on a recent conference call that underserved communities, including Black and brown populations, should get to pick which vaccine they receive, according to sources on the call.  

But on the same call, Rep. Kim Schrier (D-Wash.), a pediatrician, issued a stern warning to her colleagues that demanding choice would not only buck the advice of public health experts and muddle the Democrats’ vaccine message, it would also heighten the the doubts of many Americans already skeptical about taking vaccines — doubts that threaten the arrival of herd immunity and a return to social normalcy. 

The Democrats’ message, Schrier said, should be clear and simple: All vaccines are good. And the best thing American can do to protect themselves and their loved ones is to get a shot. Any shot.

Minutes later, Pelosi came back on the line and defended her position that people should have a choice, the sources said.

“It was a tenser exchange than we usually have in these meetings,” said one House Democrat on the call.

Asked about the exchange, Pelosi spokesman Henry Connelly said the Speaker was simply reflecting concerns in her diverse caucus about whether minority communities were being treated equitably in the aggressive push to vaccinate all Americans.

“The Speaker was giving voice to concerns being raised by Members about the clear equity issues at stake for communities of color with the distribution of the J&J vaccine and the historically-rooted fear of being treated differently than other populations, while still recognizing its success in preventing deaths and hospitalizations,” Connelly said in a statement. 

“The Speaker will continue to work to ensure that decisions about the deployment of each of the vaccines protect historically disadvantaged communities and are based in the science.”

The disagreement among Democrats comes during a pivotal moment in the fight against the coronavirus pandemic as states like Texas and Mississippi end their mask mandates and lift restrictions on businesses, and health experts worry about a surge in cases driven by COVID-19 variants.

It also comes amid a raging national debate over systemic racial inequity, relating to policing and economics but also glaring health disparities. Black people are nearly three times more likely to be hospitalized with COVID-19 than white people and nearly two times more likely to die from the disease; Hispanics are more than three times more likely to be hospitalized with COVID-19 than whites and 2.3 times more likely to die. 

The racial disparities are also reflected in vaccination efforts. White people have been vaccinated for COVID-19 at two times the rate of Black people, according to a New York Times analysis. The figures are worse for Hispanics. 

That disparity has been attributed, in part, to the fact that the earlier Moderna and Pfizer vaccines each require two shots and colder refrigeration, complicating storage and distribution. That’s created additional barriers for getting the vaccine to poorer, historically underserved populations and rural communities.

Because the new Johnson & Johnson vaccine requires only one shot and regular refrigeration levels, some officials like New Jersey Gov. Phil Murphy (D) have ordered that shipments of that vaccine be prioritized for harder-to-reach Black and brown communities. 

The Johnson & Johnson vaccine, like the Pfizer and Moderna versions, is about 100 percent effective in preventing coronavirus-related hospitalizations and deaths. But while Pfizer and Moderna vaccines have an overall efficacy of about 95 percent in preventing moderate to severe disease, that number for the Johnson & Johnson version is just 66 percent — though experts point out the J&J vaccine was being tested after more contagious variants had begun spreading in the U.S., unlike the Pfizer and Moderna versions. 

That’s led to some in those minority communities voicing concerns in recent days that they are being given a less-effective vaccine than more affluent, white communities. On Friday, Detroit Mayor Mike Duggan, whose constituents are nearly 80 percent Black, rejected 6,200 doses of the Johnson & Johnson vaccine, saying he would do “everything I can to make sure that residents of the city of Detroit get the best.”

Two days later, after creating a political headache for the White House, Duggan was forced to reverse course, writing an op-ed urging Detroit residents to “take the first vaccine that is available to you.”  

Those same tensions have emerged among Democrats on Capitol Hill, where Black Caucus leaders like Bass are wary that vaccine distribution will advantage wealthier communities at the expense of minorities. Rep. André Carson (D-Ind.), another CBC member, noted that those suspicions have historic roots, pointing to the infamous Tuskegee syphilis study — a deadly federal research project that targeted poor Black people in rural Alabama in 1930s — as evidence of the “painful history” of biomedical mistreatment of African Americans in the United States. 

Over All-Star Weekend, NBA legend LeBron James, an influential voice in the Black community, said his decision about whether to get vaccinated will be a “private thing.”

“I want to be clear, I want to encourage anyone who is eligible to get a vaccine,” Carson said. “But I see this especially [in] the African American community who may have some very real concerns about the efficacy of vaccinations and just concerns in general and suspicions.”

“I share those suspicions.” 

Despite such reservations, the broad consensus in the caucus appears to favor efforts to maximize vaccinations in the shortest possible time, regardless which shot is available in a given community. That’s the message coming from public health experts like Anthony Fauci, President Biden’s top coronavirus adviser, and Democrats have emphasized the importance of embracing the scientific advice. 

“I’m more of the school: whatever you can take, take,” said Rep. Robin Kelly (D-Ill.), another Black Caucus member. “We’re trying to get as many people vaccinated as possible.” 

“I agree with Fauci,” echoed Majority Leader Steny Hoyer (D-Md.). “Take the first vaccine you can get.” 

On Wednesday, Kelly is set to join Rep. Joyce Beatty (D-Ohio), head of the Black Caucus, in an online forum with medical experts designed to educate minority communities on best vaccine practices. 

“We’re trying to make it plain, and I know the message will be: take the shot,” Kelly said.

Rep. Anthony Brown (D-Md.) said officials should monitor the distribution of vaccines to identify “patterns” that might indicate prejudices in the dispensation. But he’s also encouraging all of his constituents to get whatever vaccine is available first, and he highlighted the advantages of the one-dose Johnson & Johnson shot, particularly in hard-to-reach populations like the homeless. 

“Right now there’s a balance between speed and equity,” he said. “Given the limited availability I would discourage people from trying to pick and choose.”

Schrier, a Washington state pediatrician who won her first political office in the 2018 wave election, made clear in an interview that her comments on last week’s call were not directed at Pelosi specifically but a response to “general murmurings” about Johnson & Johnson and that some vaccines were better than others.

“So it was a comment to our entire caucus that we need to be really careful about how we talk about vaccines, and realize that you can’t just look at the top-line number … To have a one-and-done shot that’s 70 percent effective and then to have essentially 100 percent efficacy against death? Yeah, that’s a total winner, and to portray it as anything other than a winner would be a mistake,” Schrier told The Hill.

“It’s very easy to accidentally say something and then to inadvertently send a message about a vaccine that might play into people’s preconceived notions, anti-vaxxer notions,” Schrier added. “I kind of feel like as the doc, it’s my job to just … make sure we’re looking at the whole picture.” 

Schrier discussed the inequity concerns with colleagues and said she’s advocating for all three vaccines to be “proportionally” sent to all hospitals, community health centers and other distribution sites.   

Pelosi told colleagues she has asked for guidance from Rochelle Walensky, head of the Centers for Disease Control and Prevention, about how lawmakers should be talking about the various vaccines back in their districts and communities. 

Fauci and other top Biden health officials will testify on March 17 before House lawmakers on the nation’s vaccination effort, and questions about equity and access to vaccines are sure to arise. 

Juliegrace Brufke contributed.