Georgia Washington, 79, can’t drive. Whenever she needs to go somewhere, she asks her daughter or her friends to pick her up.

She has lived in the northern part of Baton Rouge, a predominantly Black area of Louisiana’s capital, since 1973. There aren’t many resources there, including medical facilities. So when Washington fell ill with COVID-19 last March, she had to get a ride 20 minutes south to get medical attention.

Washington doesn’t want to fall sick again, so she was eager to get vaccinated, which is in line with federal health recommendations. But she faced the same challenge she did last year: finding a local provider, this time for a vaccine. She tried for weeks, checking at pharmacies in the area. And she was put on a waiting list.

“I’ve got lots of patience,” Washington said. “I just want to get it over with.”

Communities of color have been disproportionately harmed by the COVID-19 pandemic. Now they’re at risk of being left behind in the vaccine rollout.

Using data from several states that have published their own maps and lists of where vaccination sites are located, NPR identified disparities in the locations of vaccination sites in major cities across the Southern U.S. — with most sites placed in whiter neighborhoods.

NPR found this disparity by looking at Census Bureau statistics of non-Hispanic white residents and mapping where the vaccine sites were. NPR identified counties where vaccine sites tended to be in census tracts — roughly equivalent to neighborhoods — that had a higher percentage of white residents, compared with the census-tract average in that county. Reporters attempted to confirm the findings with health officials in nine counties across six states where the differences were most dramatic: Travis and Bastrop counties, Texas; East Baton Rouge Parish, La.; Hinds County, Miss.; Mobile County, Ala.; Chatham County, Ga.; DeKalb County, Ga.; Fulton County, Ga.; and Richland County, South Carolina.

The reasons are both unique to each place and common across the region: The health care locations that are logical places to distribute a vaccine tend to be located in the more affluent and whiter parts of town where medical infrastructure already exists. That presents a challenge for public health officials who are relying on what’s already in place to mount a quick vaccination campaign.

It’s a problem that exists not just in the South but across the country. A team of researchers at the West Health Policy Center and the University of Pittsburgh found nearly two dozen urban counties where Black residents would need to travel farther than white residents to a potential vaccination site — unless health officials act to narrow the disparities.

“We’re hopeful there will be new facilities that are stood up,” says Dr. Utibe Essien, an assistant professor of medicine at the University of Pittsburgh who studies health disparities and worked on the research team. “But what we saw play out with COVID testing was there were new facilities that came up, but they relied on existing infrastructure.”

“This is structural and foundational to the racial disparities in our country.”

Troubles getting vaccinated in Black neighborhoods

In the part of Baton Rouge where Georgia Washington lives, there is just one Walgreens where COVID-19 vaccines can be found.

Ever since an interstate was built through Baton Rouge in the 1960s, the population in the northern part of the city has struggled with housing, food insecurity, poverty and crime. These inequities have always fueled disparities in health care in Baton Rouge. The vaccine rollout is just the latest example.

“When you go to north Baton Rouge, there are very few [health care] choices. And then how many of those are participating in the vaccine program?” said Tasha Clark-Amar, CEO of the East Baton Rouge Council on Aging.

Clark-Amar runs about two dozen senior centers around the city, and her organization stepped up to fill the pharmacy gap by obtaining and providing vaccines. Clark-Amar’s group organized a pop-up clinic in mid-January, giving out around 1,000 doses that it secured from the grocery chain Albertsons. But another time, a community health clinic planned to give Clark-Amar around 150 doses for seniors — except the clinic couldn’t deliver on that promise and she had to cancel the pop-up event at the last minute.

“I was livid. I was so angry and frustrated,” she said. “Thirty-five of the people we had registered are between the ages of 80 and 99. Now you tell me, how am I supposed to pick?”

Clark-Amar has been able to schedule other pop-up events. In fact, that’s how Washington was finally able to get a vaccine. She went to one of the council’s pop-up events at a local community center in late January.

Clark-Amar says this patchwork of resources is part of life in many underresourced Black communities.

In the next state over, people are facing similar challenges. In Hinds County, Miss., where the state capital of Jackson sits, there’s only one major drive-through site, which is where the state is sending the vast majority of doses. The state added the site in late January, weeks after it had already put two drive-throughs in the wealthier, whiter suburbs just outside the city.

“It took us a little bit of time to get it logistically set up to make sure we had a Hinds County site,” Mississippi’s state epidemiologist, Dr. Paul Byers, acknowledged at a recent news conference. “But we were always planning to do that. And we are glad that we have that now.”

There’s still a problem for the residents of Hinds County, nearly three-quarters of whom are Black: The vaccination site is north of downtown Jackson in a neighborhood that is 89% white and already has more medical facilities. It’s close to a 30-minute drive from the more rural parts of the county, where many Black residents live.

In Alabama, the state has consistently ranked near the bottom in vaccine distribution since the rollout began.

But in terms of where the vaccine is available, NPR’s analysis found a disparity in one of the state’s largest counties. In Mobile County, 18 vaccination sites are listed on the Alabama Department of Public Health webpage. Fourteen are located in the whiter half of neighborhoods in the county.