Anasthasia Shilov, Illustrations Editor
Having effective COVID-19 vaccines will do little to end the pandemic if shots are not equitably distributed to reach the communities who need them the most, many experts have stressed.
In the United States, communities of color have been disproportionately affected by the pandemic, with Black people twice as likely and Latinx Americans 2.4 times more likely to have died of COVID-19 compared to white people. A DataHaven report last updated on March 10 also showed that there have been higher rates of positive cases and fatalities in Black and Latinx communities in Connecticut than in white and Asian ones. According to the Kaiser Family Foundation, as of March 1, only 6 percent of those vaccinated in Connecticut were Black, and only 5 percent were Latinx.
“All COVID did was reveal what was already there,” Catherine John –– a member of Unidad Latina en Acción and Black and Brown United in Action — told the News.
In New Haven –– where entrenched health disparities have continued to manifest throughout the pandemic –– concerns surrounding equity in vaccine distribution have been raised by public health experts and people of color. The Yale New Haven Health system, local community leaders and city and state health departments have made wide ranging efforts to address those concerns. The hospital system and city’s approach includes town halls, pop-up vaccine clinics in underserved areas of the city and a hotline for residents to ask questions about the vaccine.
But despite these efforts, difficulties persist as individuals struggle to navigate accessibility and communication barriers, in addition to their own reservations about the shots.
The importance of messaging
The President of the Greater New Haven National Association for the Advancement of Colored People, or the Greater New Haven NAACP, Dori Dumas said that her organization was “committed to addressing health inequities” by spreading information to communities of color.
“Certainly we are advocating that our communities need to be a priority, and our communities need to have as many people having access to getting the vaccine, [and] having information about the vaccine,” Dumas said in an interview with the News. “Especially in the Black and brown communities when we are the ones dying at the highest rates and being affected the most.”
Dumas emphasized the importance of spreading awareness of the vaccine to communities of color, and mentioned a Zoom event the NAACP hosted in collaboration with YNHH titled “COVID-19 Vaccine: The Facts vs. Fiction” this January.
Together with local organizations, YNHHS has been hosting virtual community town halls, where scientific experts, hospital officials and community leaders are gathering to dispel myths about the vaccine and answer questions from the public. The town halls, which are conducted live on Zoom and later uploaded to the YNHHS website, often feature some of the Yale Center for Clinical Investigation’s cultural ambassadors –– who have been participating in Yale’s COVID-19 vaccine outreach to communities –– and are typically carried out in English and simultaneously close-captioned in Spanish.
According to Kyle Ballou, YNHHS Vice President for community and government relations, the idea to initiate these town halls stemmed from the observation that many YNHHS employees –– especially those of color –– have been hesitant to get vaccinated.
Lost in miscommunication
But despite these efforts to educate the public, some community members are slipping through the cracks. John told the News that vaccine distribution, COVID-19 education and outreach to “Black and brown residents of New Haven,” overall, has been “terrible.”
In Newhallville, a predominantly Black neighborhood where John resides, she said that people walking on the street often are not wearing masks. With the politicization of mask-wearing since the beginning of the pandemic, it can be difficult to discern whether that observation is linked to a lack of information. But it is possible that messaging campaigns are not reaching enough people.
John did not know of Yale-led campaigns to educate the public on mask-wearing and vaccinations, for example.
“Where’s Yale Hospital and University’s education campaign on [mask-wearing] and vaccination?” John said. “People are going to lose their jobs because they’re not vaccinated … We need to tell people why they need to get vaccinated.”
YNHHS has launched a website titled “Get Your COVID-19 Vaccine” to encourage residents to obtain their shots and provide information on the vaccine. It has also compiled a “#CRUSHCOVID” support toolkit for those that have already been vaccinated to encourage friends and family to get vaccinated when they are able.
Local organizations are stepping up to fill the information gap as well. Unidad Latina en Acción, also known as ULA, coordinated a door-to-door vaccination drive Saturday evening. The drive, according to the Hartford Courant, gathered volunteers, community organizers and Mayor Justin Elicker to knock on over 5,000 people’s doors in Fair Haven to encourage them to get vaccinated. But John, who participated in Saturday’s event, said “Black and brown residents,” especially low-income and undocumented people, need more robust health services to address persistent health inequities.
She laments the spread of disinformation but attributes it to health care’s troubled history in using “Black and brown people [as] lab rats.” She also believes essential workers who live in urban, more densely populated areas and “have carried the Connecticut economy” need greater access to information and vaccination than they are currently receiving.
“I’ve had one person say to me that they know the government gave Joe Biden a different type of vaccine,” John said. “Where are these stories coming from?”
John Lugo, a ULA organizer, echoed John’s sentiment surrounding disinformation.
He told the News in Spanish that ”there isn’t sufficient information nor services for the immigrant community.”
“People educate themselves through Facebook or WhatsApp, where messages say the vaccine is fake or that it causes illness, and [ULA] wants to be a part of the effort to educate people,” Lugo said.
The price of ineffective communication
Lugo said undocumented community members often think there are “obstacles” to vaccination such as documentation they must provide, when that is not the case. ULA, he said, aims to help get as many people vaccinated as possible by referring them to local clinics so they can make appointments.
Lugo is also hoping to get all members of the community, regardless of age, vaccinated. He said that ULA is organizing a car caravan to the State Capitol building on Friday to urge the state government to invest in the health of immigrant communities, especially since many are essential workers.
Marilu and Luis Rodriguez are two undocumented immigrants who have resided in New Haven for thirty years. They told the News about the uncertainty and lack of information around access to health care and vaccination during the pandemic.
“Our leaders did not give us the necessary information, and when they did, it was too late,” Luis Rodriguez said. “The pandemic has affected us, as immigrants, gravely with consequences from unemployment to death.”
In August of last year, all five members of the Rodriguez family became infected with the virus after Luis caught the virus while on the job as a construction worker. His partner, Marilu Rodriguez, got COVID-19 a second time in February of this year with worse symptoms than the rest of her family due to her pre-existing conditions.
While Luis Rodriguez received two weeks’ worth of compensation from his job after he became infected, Marilu Rodriguez did not. Instead, she told the News, she was compelled to take a month off from work both times she was infected.
“I have a part-time job and it was extremely hard for me because I didn’t get the help my husband did,” Marilu Rodriguez said. “We need more help. We work hard and we do the jobs that nobody wants to do. It’s unfair that we don’t even have low-cost health care insurance … It’s really stressful and depressing.”
Since returning to work, Luis Rodriguez has been dealing with long-term effects of his COVID-19 infection, but, he said, he feels a responsibility to continue providing for his family.
A “multipronged approach” to bridging disparities
“I still think there’s more we can do, and there’s more ideas we’re fleshing out right now, but for now, we’re really trying to do a multipronged approach,” YNHHS Chief Medical Officer Thomas Balcezak said in a press conference on Feb. 18.
Balcezak described a number of initiatives that the health care system is engaging in to get COVID-19 vaccines to vulnerable populations. In New Haven, for example, they are using reverse 911 calls, which automatically go out to telephone numbers that are linked to zip codes that have been underrepresented in registrations for vaccine appointments.
In the call, people are given a special phone number for the YNHHS COVID-19 line, to which they can ring to be prioritized for an appointment in one of their sites. Similarly, the system also has a way of geocoding where individuals are calling from so that they can prioritize those in “communities where we are not seeing a high penetrance of vaccination,” Balcezak said.
The YNHHS has also been making efforts to address struggles that some have experienced navigating their virtual system. Now YNHHS is receiving calls at 833-ASK-YNHH, where questions about the vaccine can be answered and appointments can be facilitated over the phone.
Collaboration between the community, health care systems as well as city and state governments has been crucial to bringing these efforts to fruition. Ballou noted that she was able to work with community organizers and government officials who she had not known as well before. According to her, this work will leave a positive legacy of the pandemic that she thinks will carry over into the future.
“I know these folks pretty well now, much more so than I did prior to this, and I think that’s a good thing that will continue,” Ballou said.
Join efforts by YNHHS, community leaders and the state have also enabled the creation of pop up clinics –– the first of which was held at the Bethel AME church in New Haven on Feb. 27, and the second of which was held at the Christian Tabernacle Baptist Church in Hamden on March 4.
According to Connecticut Health I-Team, as of March 11, over 1.2 million COVID-19 vaccine doses have been administered in Connecticut.
Larissa Jimenez | larissa.jimenez@yale.edu
Zaporah Price | zaporah.price@yale.edu
Maria Fernanda Pacheco | maria.pacheco@yale.edu
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