A racial gap has opened up in the nations COVID-19 vaccination drive, with Black Americans in many places lagging behind whites in receiving shots, an Associated Press analysis shows.

An early look at the 17 states and two cities that have released racial breakdowns through Jan. 25 found that Black people in all places are getting inoculated at levels below their share of the general population, in some cases significantly below.

That is true even though they constitute an oversize percentage of the nations health care workers, who were put at the front of the line for shots when the campaign began in mid-December.

For example, in North Carolina, Black people make up 22% of the population and 26% of the health care workforce but only 11% of the vaccine recipients so far. White people, a category in which the state includes both Hispanic and non-Hispanic whites, are 68% of the population and 82% of those vaccinated.

The gap is deeply troubling to some, given that the coronavirus has taken a disproportionate toll in severe sickness and death on Black people in the U.S., where the scourge has killed over 430,000 Americans. Black, Hispanic, and Native American people are dying from COVID-19 at almost three times the rate of white people, according to the Centers for Disease Control and Prevention.

Were going to see a widening and exacerbation of the racial health inequities that were here before the pandemic and worsened during the pandemic if our communities cannot access the vaccine, said Dr. Uch Blackstock, a New York emergency physician and CEO of Advancing Health Equity, an advocacy group that addresses bias and inequality.

Experts say several factors could be driving the emerging disparity, including deep distrust of the medical establishment among Black Americans because of a history of discriminatory treatment; inadequate access to the vaccine in Black neighborhoods; and a digital divide that can make it difficult to get crucial information. Vaccination sign-ups are being done to a large degree online.

Its frustrating and challenging, said Dr. Michelle Fiscus, who runs Tennessees vaccination program, which is doubling the doses sent to some hard-hit rural counties but is meeting with deep-rooted mistrust among some Black Tennesseans.

We have to be working very hard to rebuild that trust and get these folks vaccinated, Fiscus said. Theyre dying. Theyre being hospitalized.