A gloved hand holding a bottle of the Covid-19 vaccine.
Multnomah County health officials will submit the required vaccine equity plan next week. Paul Biris

Multnomah County will not be moving to “Lower Risk” COVID-19 restrictions level on May 21 as previously anticipated because county health officials declined to submit a required vaccine equity plan to the Oregon Health Authority (OHA) by the Friday deadline. According to a statement posted on Multnomah County’s website Thursday, county health officials will instead submit an equity plan to OHA on May 21, with the goal of moving to “Lower Risk” on May 28, in time for Memorial Day weekend.

In a press conference Tuesday, Governor Kate Brown announced that in order for counties to move to “Lower Risk” status—most food and entertainment, including indoor dining and gyms, venues can operate at 50 percent capacity—they must reach a 65 percent vaccination rate for residents age 16 and older, and submit a vaccine equity plan to OHA. Multnomah County has vaccinated 63 percent of residents 16 and older as of Monday and is projected to meet the 65 percent vaccination rate requirement on Friday—the deadline to be considered to be moved to “Lower Risk” on May 21.

Multnomah County received the guidelines of what needs to be included in the vaccine equity plan Wednesday morning, three days before the deadline.

County health officials did not submit an equity plan this week because they wanted to give the equity plan the “same attention to inclusion that the County has given to its overall COVID-19 response,” according to the statement.

“The health of our whole community hinges on the health of each of our communities, and that’s why the equity component of the state’s newest framework must be developed intentionally,” said Multnomah County Chair Deborah Kafoury in the statement. “And that is going to take more than three days.”

The equity plan guidelines require county health officials to answer 14 questions about their plans to close race and ethnicity gaps in county vaccination rates, including identifying what existing barriers are creating vaccine equity gaps, what communications plan is in place to dispel vaccine misinformation and increase confidence, and how the county plans to create low-barrier vaccination clinics that take language and transportation accessibility into account. The guidelines suggest a transition from mass vaccination sites to community-based, culturally-responsive vaccination sites as a solution and states that OHA expects the local public health authority and its partners “have been and will continue to actively collaborate with community-based organizations, employers and others to proactively reach all eligible populations who have not yet been vaccinated.”

In addition to submitting answers to the 14 questions, the county’s public health administrator, public health officer, and Kafoury, the Multnomah County chair, must sign a statement agreeing that the county and its community partners “will continue to ensure that vaccine sites are culturally-responsive, linguistically appropriate and accessible to people with physical, intellectual and developmental disabilities and other unique vaccine access needs.”

According to Multnomah County’s Public Health Director Jessica Guernsey, the county has already been regularly checking in with community stakeholders like faith and cultural center leaders to take stock of how the vaccine rollout is going and what barriers need to be addressed. The county has partnered with community members to host virtual information sessions where people can ask questions about the vaccine and hear responses from community leaders they may trust more than healthcare providers. Guernsey says continuing and expanding on those community-based conversations will be key to developing trust in the vaccine and health providers.

“This country, unfortunately, has a really horrific history of betraying communities of color and public health in particular, we have plenty of egregious examples that are well and alive in people's memories of public health hurting people,” Guernsey told the Mercury Friday morning. “It's not unfounded for folks to not necessarily trust the message or the messenger, so we're doing our due diligence to make sure there's a strong runway for people to get the information to base their decision on.”

Guernsey said that trust in public health is the primary barrier the county is working on addressing, but public health officials will also be looking to address logistical barriers like ease of traveling to a vaccine site and language accessibility. Now that youth ages 12 and older are eligible for the vaccine and vaccine supplies are being distributed to smaller clinics and primary care doctors, Guernsey is hopeful that people will be able to bring their whole family into their trusted doctor to get the shot.

The county health department has been working with community groups since December to close disparities in vaccine access. So far, county-run vaccination clinics have vaccinated 20,000 people, nearly 80 percent of whom identify as people of color.

Going forward, the Governor’s office will evaluate the new county criteria on a weekly basis. The equity plan must be submitted for approval the week before the county wants to move to the lower risk level. Multnomah County will remain in “Higher Risk”—venue capacity capped at 25 percent or 50 people, whichever is smaller—until at least May 27. If the equity plan the county submits on May 21 is approved by OHA, then the county can be moved to “Lower Risk” on May 28.

Support The Portland Mercury

The “Lower Risk” status allows most food and entertainment establishments, including indoor dining and gyms, to operate at 50 percent capacity.

Brown has stressed the importance of an equitable vaccine rollout since vaccines started to become available, but that has not been the reality. While more vulnerable populations like older Oregonians and healthcare workers were prioritized for the first wave of vaccines, communities of color—who have been disproportionately hit by COVID cases—have been receiving vaccinations at a slower rate than white Oregonians.

Hispanic people make up 13 percent of Oregon’s population, but represent 24 percent of the state’s COVID cases. Additionally, Oregon’s Hispanic, Indigenous, and Black communities are getting vaccinated at a slower rate; 33 percent of Hispanic, Indigenous, and Black Oregonians 16 and older have received at least one dose of the vaccine in comparison to 52 percent of their white counterparts.