These states had big plans for addressing Covid disparities. They’re still struggling to vaccinate underserved communities.

Addressing these disparities while ramping up vaccine supply will be a crucial early test for President Joe Biden’s administration. He signed an executive order on his second day in office aimed at tackling racial equity, and has named advisers to specifically focus on disparities in health. But solving the problem will require more than good intentions.

“This pandemic has really exposed the failures of our health care system,” said Rep. Raul Ruiz, (D-Cal.) a physician who represents a district with many Latino farmworkers with limited health care. “We cannot rely on this health care system to address equity … We are only going to continue to fail. And we see that now with the vaccine distribution.”

The federal government doesn’t explicitly mandate vaccines be distributed or administered equitably “so you’ve got states like Michigan that are well-meaning and thoughtful but didn’t have a comprehensive plan,” Debra Furr-Holden, a public health expert at Michigan State University who serves on the state’s coronavirus racial disparities task force, said in an interview.

“In the absence of a mandate, our natural drift is to inequity,” she added.

An early stumbling block has been a lack of data. In theory, the CDC required states to report race and ethnicity data from the start. But the rule was not strictly enforced, and some states did not initially require providers to collect the information, leaving major gaps in efforts to identify unmet needs.

As of mid-January, only 17 states had publicly released race and ethnicity data on who is getting vaccinated — often with caveats that the data are incomplete. Other states are collecting the information, but have declined to release it citing similar quality issues. The CDC says 47 percent of vaccination data is missing information on race and ethnicity — a flaw public health experts say needs to be corrected as the pandemic enters a new, dangerous phase.

“We can’t keep kicking the can. We can’t keep saying we don’t have the data, the data isn’t great,” said Cara James, former CMS director of the Office of Minority Health who now leads the organization Grantmakers In Health.

Marcella Nunez-Smith, chair of Biden’s Covid-19 equity task force, said at a Monday White House briefing that holes in the record “don’t just hurt our statistics, they hurt the community that are at the highest risk and have been the hardest hit.”

Data in those states that have collected it reveal stark racial disparities, with white residents typically getting vaccinated at more than twice the rate of Black residents. In Pennsylvania, which has one of the largest disparities, the ratio is more than three to one.

“We have had such weak federal leadership up to this point. At this stage of the pandemic, it is appalling that there are not standardized reporting systems,” said Jeffrey Levi, professor of health management and policy at George Washington University.