Very few African Americans have used Los Angeles County's free H1N1 vaccine clinics, public health officials told county leaders Tuesday, raising concerns about outreach to a community that, as a group, has a high risk for serious flu complications.
Dr. Jonathan E. Fielding, the county's public health director, expressed disappointment in the turnout by blacks but said he did not think the problem was a lack of clinic sites.
"Some surveys suggest it's lack of willingness to come forward," Fielding said, "and some of that is historic."
African Americans received 2.57% of the initial 60,773 vaccinations countywide, although they make up about 9% of the county population, according to public health figures released Tuesday by Supervisor Mark Ridley-Thomas.
Within the South Los Angeles service area, where African Americans make up 32.4% of the population, they received 10.89% of the vaccines, county health records show.
The data comes less than a week after a Times/USC poll found that blacks in California were far less likely than other groups to say they planned to get the vaccine.
Although public officials chose locations throughout the county in hope of reaching diverse populations, the clinics were open to anyone. County statistics show that more Asians than African Americans were vaccinated at clinics held at South L.A. County locations. Asians make up less than 2% of the population in that area, according to county statistics.
Overall, Asians account for 13% of the county's population but made up more than 27% of those vaccinated at the first county clinics. The Los Angeles Times/USC College of Letters, Arts and Sciences poll of California voters found that Asians, by far, were the most likely to say they planned to get vaccinated. Whites and Latinos also were vaccinated at public clinics at rates lower than their overall county populations, but not by nearly as wide a margin as blacks.
"There is no way it is conceivable to me that with proper outreach the numbers would have looked like they did," Ridley-Thomas, whose district includes South Los Angeles, said of the turnout in the black community.
He said public health officials should have anticipated low turnout among African Americans -- who studies show are more likely to lack access to healthcare and less likely to get the seasonal flu vaccine. Blacks and Latinos are among those most at risk from H1N1 flu, primarily because they suffer disproportionately from asthma, diabetes and other health problems, and are four times more likely than whites to be hospitalized with H1N1 flu,
Loretta Jones, chief executive of South L.A.-based Healthy African American Families, said many patients she serves do not know where to get the vaccine and also question its safety. Some blame the distrust on the Tuskegee Syphilis Study, which lasted from 1932 to 1972, in which federal researchers withheld treatment from black men.
But many of those most at risk of H1N1 are too young to remember that study. More likely, blacks are less aware of the dangers of the flu and of the vaccine's benefits, Jones said.
"It's more than the legacy of Tuskegee -- it's a whole lifetime of poor access to healthcare," Jones said.
Few African Americans stood in line at a county flu clinic at USC last week. Several black students walked by without stopping.
"I keep hearing the cases of people getting sick from the shot," said Bridgette Jackson, 22, a senior from Riverside. "I'd just rather get the flu."
Fielding agreed Tuesday to retool a radio and television ad campaign that initially was canceled because the supply of vaccine was so low. He said public health officials would work with neighborhood churches, schools and trusted public figures in the African American community, as well as review clinic sites to make sure the vaccine is distributed equitably countywide.
About 5.5 million people belong to H1N1 flu priority groups countywide. As of this week, the county's public and private healthcare providers have received 810,000 H1N1 flu vaccines total. Eighteen county H1N1 flu clinics are planned through Sunday.
As of this week, public health officials expanded their list of priority groups eligible to receive the vaccine to include the obese, who recent studies show are at risk of complications from H1N1 flu. Other priority groups include pregnant women, people who live with or care for babies younger than 6 months old, healthcare and emergency services personnel, those ages 6 months to 24 and those ages 25 to 64 with chronic health problems or a compromised immune system.