Should Governments Consider Roma a Priority in Their COVID-19 Vaccination Roll-out Plans?

"Without more effort in collecting reliable data and supporting Roma communities to hold public authorities accountable, governments will be able to easily continue to abstain from mitigating the unequal burden of COVID19 and other diseases on Roma."

Scientific evidence demonstrates that the novel coronavirus SARS-CoV-2 exerts a disproportionate burden on racialised and ethnic minorities living under detrimental social, economic, political, and environmental conditions in Europe and the United States. From the start of the COVID-19 outbreak in Europe in March 2020, Roma civil society organisations (CSOs) warned that Roma communities, the largest ethnic minority group in Europe, were going to be severely affected. Yet, there are hardly any data on the number of infections, hospitalisations, intensive care unit admissions, and mortality among Roma. With a few exceptions, they are also not mentioned in national vaccination roll-out plans, and only a few advocates make a case for their priority for vaccination. This article urges that governments should be publicly held to account for not introducing a more diverse vaccination strategy that includes deprived and vulnerable Roma.

Noting that "health inequalities are deep structural problems", the article lays out some of the reasons - e.g., socio-economic and ideological/religious (racism, elitism, and anti-vaccination) factors - that have compounded the effects of the pandemic on Roma. For example, for large numbers of Roma who live in substandard and over-crowded housing in segregated neighbourhoods, following public health recommendations in times of pandemic outbreak is a challenge. As the authors argue, factors such as those outlined in the article also impact health and social workers' practices when it comes to treatment of Roma, as well as the hesitation over the Roma vaccination priority - determining the COVID-19 impact.

In detailing the impact of the first COVID-19 wave on Roma communities, the authors note: "While the most effective public health strategies are based on mutual trust between the government, public health authorities and citizens, these collective repressive measures and directive top-down communications against Roma had a largely opposite effect and created an atmosphere of mistrust. This gap in trust towards their governments provided fertile soil for anti-vaccination conspiracies among Roma. While language and cultural barriers make their access to official information even more limited, Roma tend to rely on social media for advice on COVID19 prevention and mitigation. This advice is often, and sometimes intentionally, erroneous."

In light of the argument presented, the authors call for an urgent effort to collect Roma-specific data in hospitals and in their communities. "The fact that when it comes to Roma the governments do not commit to a simple review of existing medical data, is itself a form of serious neglect of their legal obligations under the public health emergency." The authors call for CSOs "to ensure that Roma inclusion policies are a substantive part of any COVID19 recovery strategies at national and European level."

In June 2020, Sastipen, the Roma Centre for Health Policies in Romania, in collaboration with the National Roma Agency, made an address to the Prime Minister requesting the activation of a national emergency programme addressing the needs of vulnerable communities at higher risk of COVID-19, such as Roma. "The Government responded with formalistic assurances that every citizen of Romania will be treated equally." This example demonstrates how mobilising governments to take the Roma situation seriously requires public scrutiny. That said, ultimately addressing the health gaps among ethnic groups calls for a "concentrated effort going beyond political declarations."