County officials discussed how to increase vaccinations among people who are most affected by COVID-19 cases. The map shows area such as Gaithersburg, Montgomery Village, Wheaton, Rockville, and Damascus with a high number of COVID-19 cases per 1,000 residents in the last three months.

As Montgomery County continues to vaccinate its older population against COVID-19, officials have turned their attention to others lagging behind — minorities whose communities are affected the most.

A new county vaccination equity plan will set aside a portion of vaccines for minority communities disproportionately affected by the coronavirus.

The county-run clinics are currently vaccinating eligible residents and workers in Phase 1A and only those who are age 75 and older in Phase 1B. Phase 1A, considered the highest priority for vaccinations, includes health care workers, nursing home residents and staff members, first responders, and other specific essential workers.

The phases are further divided into certain groups that prioritize vaccinations for people more at risk of contracting the virus or having severe side effects.

Of the roughly 230,000 people who have preregistered with the county, 69% are white. Another 14% are Asian and Pacific Islander, 8% Hispanic, and 6% Black or African American.

The wide registration gap between white residents and workers and those in other groups has county officials concerned about populations that are lagging behind in getting vaccinated.


Eligible residents and workers are first required to preregister. Preregistration allows the county to gather information on individuals and place them into the vaccination system.

Once enough vaccines are available, eligible individuals get an appointment link to sign up to receive a dose at a clinic.

Although individuals in most of Phase 1B and Phase 1C are not eligible to receive a dose from the county government yet, preregistration is open for those groups.


Of the people who have preregistered and are age 75 and older, the majority — about 73% — are white. But that older white population only accounts for 64% of the older residents in that age group in the county. That means many of the other 36% of county residents at least 75 years old are not getting vaccinated.

Dr. Raymond Crowel, director of the county’s Department of Health and Human Services, said older white residents appear to be registering in the county’s system multiple times. He said this could be because they want to make sure they are preregistered in the system, or have family members who sign them up, as well.

In comparison, here are the percentages of minorities age 75 and older among those who preregistered. (In parentheses is the percentage that group represents out of the total age-75-and-older population):
● Asian and Pacific Islander: 14% (14%)
● Black or African American: 6% (12%)
● Hispanic: 6% (8%)


But the percentage of COVID-19 cases attributed to each of those races in the age group is:
● Hispanic: 40%
● White: 25%
● Black or African American: 19%
● Asian and Pacific Islander: 5%

“We are underregistering dramatically in communities that have been most impacted,” Crowel said.

Under the new plan, the county health department will set aside 25% of the vaccine doses it receives to continue vaccinating residents and workers in Phase 1A, independent living facilities, child care providers and other groups prioritized by the state.


The remaining 75% will be used to continue vaccinating residents age 75 and older.

But of the vaccinations set aside for the older population, the county will prioritize “high-impact ZIP codes” to receive vaccinations.

Those “high-impact ZIP codes” will be identified by considering case rates for the past 90 days, death rates for residents not living in nursing homes, and high combinations of case and death rates for communities of color, Crowel said.


For people within those priority ZIP codes, the county doses will be allocated based on case rates and death rates by race and ethnicity.

“Our framework is designed to ensure that vaccines are made available to those who have been most severely impacted and also to make sure we are attacking the virus where the virus is attacking us,” Crowel said.

County officials noted that the plan only applies to doses that the county health department receives and that other parts of the county will still be receiving doses and might administer them with a different approach.


The list of priority ZIP codes is still being finalized and will be available to the public early next week.

ZIP codes on the list will change over time depending on where the virus is spreading, Crowel said.

A second part of the equity plan is focused on increasing access to vaccination sites and preregistration for people who do not have access to technology.


The plan will also address vaccine “hesitancy” referring to people who are skeptical about getting vaccinated. The county will have a communications campaign to will share information on the vaccination process.

The county is also continuing to host town hall meetings with several communities.

Briana Adhikusuma can be reached at