By Sophia Barberini
ACLU NorCal is challenging the California Department of Public Health to review their current methods of distributing the COVID-19 vaccine, arguing that they should transition to a method that will ensure that those in underserved communities “will not be left behind.”
California has created an algorithm based on ZIP codes in order to distribute vaccines, and despite California aiming to center equity in this distribution, evidence suggests that the “algorithm may fall short, leaving millions of the neediest Californians without additional supply.”
The use of a ZIP code based algorithm instead of a census tract “means that more than 2 million Californians – living in neighborhoods with the worst health outcomes, many of them communities of color – may not be given needed additional vaccine supply.”
As highlighted by ACLU NorCAL in an article by Jacob Snow, the pandemic has disproportionately affected communities of color, “with Latinx people representing close to the majority of COVID-19 deaths.”
Acknowledging the greater impact of COVID-19 on communities of color, California chose to employ “the ‘Healthy Places Index’ – a metric that assigns scores to communities across California 
according to health outcomes – in order to identify areas of the state where additional supply of the vaccine is necessary.”
Utilizing this index, California would give additional vaccines to areas that have “scored in the bottom 25%” of the Healthy Places Index.
Instead of using this census tract method, which is “specifically designed for making place-based socioeconomic comparisons,” to determine the allocation of vaccines, California announced it would use an algorithm generated by Blue Shield that distributes vaccines based on ZIP code.
The transition to the ZIP code based distribution “could transform which communities get additional vaccine supply, potentially undermining equity and access for many vulnerable communities.”
Because ZIP codes “represent much larger geographical areas, containing both low-income and wealthy communities,” a “low income, underserved neighborhood with a very low Healthy Places Index score can end up erased from the state’s priority list.”
Further, over 2 million people live in “census tracts in the least healthy 25% of the Healthy Places Index that fall outside of these prioritized ZIP codes, which apparently won’t receive additional supply under the state’s equity framework.”
If the state continues with the ZIP code algorithm, the communities that “will not receive additional vaccine supply are disproportionately communities of color.”
Further, “Statewide, Latinx people make up approximately 38% of the population, but Latinx people make up 53% of the population in the census tracts that may be omitted from the state’s equity focus. The same is true of Black populations, making up 6% statewide but 8% of the census tracts potentially left behind.”
The state has chosen to use the ZIP code algorithm instead of the census tracts because vaccine delivery based on ZIP codes is both simpler and easier to track.
These algorithms, however, are inherently biased, and “can cloak human decision in a guise of objectivity.” Moreover, “technology can alleviate harm, but it can also exacerbate existing inequality.”
The ACLU is calling on California to confront the innate issues within the ZIP code algorithm, and explain how they are going to address the 2 million people that live in the bottom 25% of the Healthy Places Index, “many of whom are in dire need of life-saving medical care.”
Sophia Barberini, from San Mateo, CA, is a fourth-year student at UC Berkeley. She is double majoring in Political Science and Legal Studies and hopes to pursue a career in law.
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