Vaccine inequality threatens global Covid-19 recovery. Here's why

New York (CNN Business)Grocery store workers in the United States have been stocking shelves, handling customers and keeping stores tidy in challenging and sometimes dangerous pandemic conditions for almost a year.

But a vaccine that once offered these essential workers hope for their safety remains elusive for most. Although coronavirus risks are high and new variants of the virus are spreading, most of the more than 2.4 million low-wage grocery workers in this country have not yet been made eligible for the vaccine. Guidance on vaccine eligibility continues to evolve, leaving these frontline workers unsure of when they’ll be able to receive the vaccine. Some workers say they feel let down that they have not been given vaccine priority and are bracing themselves for months more of possible exposure to Covid-19 at their jobs without the best protection against the virus.
This is the reality facing Eric Nelson, who can’t work from home, despite the virus raging around him and a heart condition that may put him at greater risk of experiencing severe symptoms if he catches the virus.

The 49-year-old Kroger worker in Cincinnati needs the $16 an hour he makes at the store selecting customers’ online grocery orders for pickup and delivery to pay rent and support his two children. He’s searched for jobs at call centers that would allow him to work remotely during the pandemic, but has come up empty handed.

Nelson comes in close contact with thousands of people a week at the supermarket. Despite Kroger’s policy requiring customers to wear masks, he said some shoppers walk around without a mask or wear them below their noses or mouths, reducing their efficacy. Nelson often works weekends, which are the busiest times on the job when customers are off work and buying food for the week.

“There’s so many people in the store,” said the 11-year Kroger veteran and United Food and Commercial Workers union member. “You just don’t know who has what or who has come across what. You just don’t know.”
Sometimes his store requires him to work mandatory overtime when extra orders need to be filled, increasing his exposure to customers. Other times co-workers show up sick, he said, because they can’t afford to miss work. (A Kroger spokesperson said in an email that the company offers paid sick leave to workers. The company said it also offers pay for up to two weeks for workers diagnosed with Covid-19; workers placed under mandatory quarantine by a medical provider; and workers practicing self-isolation for Covid-19 symptoms.)
“I’m really, really concerned,” he said. “If I catch the virus, it’s going to put me down for a little while, if not kill me.”
The arrival of the vaccine offered “light at the end of the tunnel” for Nelson, but he isn’t eligible to receive it in Ohio. Each state sets its own vaccine distribution phases, and after vaccinating health care workers and staff and residents in long-term care facilities like nursing homes, Ohio has moved to prioritize vaccinating people over the age of 65; people with severe congenital, developmental or early-onset cognitive medical conditions; and teachers. The state has not announced a timetable for when grocery workers, transit workers, first responders, workers at essential retailers or other frontline workers will be vaccinated.

Nelson is frustrated he and his Kroger co-workers have been left out of initial vaccine priority groups. He worries that the virus would spread like wildfire at the store if he or a co-worker were to get it, possibly jeopardizing the community’s access to food.
“You got to think about the grocery [workers] as well,” Nelson said. “You don’t want them to be sick while they’re stocking shelves. That would spread fast.”
The Kroger spokesperson said that the company has invested more than $1.5 billion in safety measures in stores and additional pay for workers during the pandemic.
“Kroger continues to advocate to federal, state and elected officials to prioritize frontline grocery workers to receive the vaccine,” the spokesperson added.

High exposure jobs

The United Food and Commercial Workers union, which represents more than 1.3 million workers in the grocery and food industries, says at least 137 grocery workers have died from Covid-19 and more than 30,100 have been infected or exposed to the virus.
Grocery workers are in “high exposure, high contact jobs and if they’re infected they may become super-spreaders,” said Justin Yang, assistant professor of medicine at Boston University’s School of Medicine.
Yang worked on a study, published in October in the journal Occupational and Environmental Medicine, that found that 20% of 104 grocery workers tested for Covid-19 at an undisclosed grocery store in Boston in May had active Covid-19 cases, although most didn’t show symptoms. This was a significantly higher rate of infection than what was seen in the surrounding communities, the researchers found. Workers who dealt with customers in the store were five times as likely to test positive for Covid-19 as colleagues in other positions.
But despite the risks, in 37 states, grocery workers are not eligible to get vaccinated, according to the union.
In December, the Centers for Disease Control and Prevention issued initial guidance recommending the vaccine should be offered in the second phase of the rollout — after health care workers and residents and staff in long-term care facilities — to people over 75 and frontline essential workers outside of health care. But the federal government in January shifted its rollout recommendations, encouraging states to move older people and people with high-risk medical conditions up the vaccine priority list.
States followed suit, said Jennifer Tolbert, a health policy expert at the Kaiser Family Foundation. “Many states have shifted away from a focus on frontline essential workers and more toward targeting older adults,” she said. “By prioritizing older adults over frontline essential workers, it does end up bumping people who are at greater risk of exposure at their jobs further down the line.”
There is limited supply of the vaccine and “unfortunately we can’t vaccinate everyone,” she said. States have been forced to make “trade-offs” about whom to prioritize, she said, and have focused on vaccinating older adults and those with certain underlying medical conditions, who are at increased risk of experiencing a severe illness from the virus or death if they contract it.

“These decisions in no way change the fact that grocery workers and other frontline workers are at greater risk of exposure to Covid-19,” she said. As more vaccine becomes available, she predicts states will expand eligibility to include grocery workers.
Still, many grocery workers will likely have to work for months more without access to a vaccine that is inside their stores. Grocery and pharmacy chains such as Kroger (KR), Walmart (WMT), CVS (CVS) and Walgreens (WBA) are administering the vaccine at some of their stores to eligible customers. And some chains, such as Trader Joe’s, Kroger, and Target, have announced that they will offer to give workers paid time off to get vaccinated. But most of their workers can’t yet take advantage of these policies.
Both unions and the trade group representing grocery stores say workers should be moved up the vaccine line now.
Grocery workers “should be prioritized for the [Covid] vaccine” as the CDC first recommended, Leslie Sarsin, CEO of FMI, the Food Industry Association, said in an email. “To do otherwise ignores the critical role these individuals play in keeping the country fed.”

‘Fearful every day’

Sarah Demerrit, 58, who works overnight shifts at a Safeway in Lake Oswego, Oregon, cleaning down the store, said that even though she is not interacting with customers, she worries that one of her co-workers may infect her.
“I don’t feel safe at all,” she said. Her co-workers are “becoming very complacent” and not always maintaining social distancing when they are in the store, she said. “People [are] just used to it.” (Christine Wilcox, a spokesperson for Albertsons, which owns Safeway, says safety is its top priority and it has “very clear social distancing reminders” in place at stores, in addition to PPE, cleaning protocols, Covid-19 testing and other measures to protect workers and customers.)
Demerrit would be “first in line” to get the vaccine, but Oregon has not made grocery workers eligible.
Kelli, an online order filler and cashier in her mid-30s at Sprouts Farmers Market in Texas who spoke on the condition her last name be withheld from this article because she was not authorized to speak to the media, said it was “heartbreaking” that grocery workers like her were not eligible to receive the vaccine in the state. Texas has prioritized vaccinating people over the age of 65 and people over 16 with health conditions after health care workers. A spokesperson for Sprouts said in an email that the company is “working to coordinate access to the vaccine for our workforce as supply increases and grocery workers become eligible” in different states.

She said was laid off from a restaurant in the spring and is the primary breadwinner for three children and her husband, a freelancer who has had trouble finding work in the pandemic. She makes $13.80 an hour, she said, and she has no choice but to keep working in the store. She has a 13-year-old with asthma and worries that she will contract the virus at work and pass it onto her son.
“I am fearful every day I go into work,” she said. “I go into my job ready. But sometimes it makes it really hard with the customers.”
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