Maryland’s Health Officers: Improve Vaccine Distribution Equity

On March 22, the Equity Committee of the Maryland Association of County Health Officers (MACHO) sent a letter to Maryland Acting Deputy Secretary for Public Health Services Jinlene Chan, M.D. urging the Maryland Department of Health to take action to improve vaccine distribution equity. The letter also asked the state health department to lay the foundation for longer-term work to address the systemic influences on equity. The actions were identified as follows:

  • Provide a detailed strategy to focus vaccination distribution to low-income neighborhoods and communities that may lack the technology infrastructure for online registration platforms;
  • Prioritize equity, as much as speed, in vaccine dose distribution;
  • Publish disaggregated vaccination data by vaccine provider and county;
  • Consider alternative options for distribution/allocation based on highly impacted ZIP codes within each jurisdiction;
  • Consider alternative models of prioritization, such as age-based distribution, or having lower age requirements for racial and ethnic minorities, given the disproportionate impact of COVID-19 and disparities by life expectancy; and
  • Optimize local allocations of vaccine as regional vaccine sites necessitate access to private transportation and jobs that allow for extended time off.

“MACHO established an Equity Committee, in response to last year’s unrest, to examine persistent disparities that impact the health and well-being of Maryland residents,” said Edwin F. Singer, L.E.H.S., president of MACHO and Carroll County health officer. “As an organization of health officers from each county, we feel that local health departments have local relationships and know our communities best and are therefore best able to reach our most underserved and at-risk communities. The state and local health departments must work together to get shots in arms today and improve Maryland’s health for the future.”

Travis Gayles, M.D., Montgomery County health officer and MACHO Health Equity Committee co-chair, said “Equity is important not just in terms of the number of doses provided but also in having a fair strategy to remove the barriers and obstacles that continue to prevent certain communities from getting access to health care, vaccinations and other support services that could help them achieve improved health outcomes.”

MACHO Health Equity Committee Co-Chair and Anne Arundel County Health Officer Nilesh Kalyanaraman, M.D., said, “Maryland has a long-standing history of health and social inequities that have put many racial and ethnic minorities and low-income communities at high risk of severe COVID-related illness and deaths. The decreased access to medical care, health information, internet service, technology, transportation and workplace leave has an impact on their ability to get an appointment and get to a vaccine clinic. Data is also important as jurisdictions plan, implement and assess effective ways to vaccinate those who are most overlooked and disenfranchised.”

MACHO is the professional association of the Chief Executives of the state’s 24 local public health departments. Its mission is to promote, protect and improve the health and well-being of all Maryland residents through an effective statewide system of local public health departments. For more information, visit

Michael Sanderson

Executive Director Maryland Association of Counties