Critics Say Mass. Vaccination Disparity Shows 'Equity Was An Afterthought'

Salvador Sanchez of Chelsea had been worried about getting COVID-19. But on Thursday, he got a vaccine at a new clinic that opened up at the offices of La Colaborativa, a community organization in Chelsea.

"I don't have to worry about nothing today, you know," he said.

That's a feeling of relief a lot of people in this community are eager to have. But vaccination appointments have been hard to come by.

COVID-19 vaccination sites are beginning to open in some of Massachusetts' predominantly Black and Hispanic communities that have been hardest hit by the pandemic. But new state data show there are huge continuing racial disparities in who's gotten the vaccine so far. And community activists say much more needs to be done to correct inequities in the state's vaccine distribution system.

Kathy Devitto of Chelsea tried to get a vaccine at CVS.

"They wanted to give me an appointment in Pittsfield,” she said. “What do I want to go to Pittsfield for?"

The Berkshires city is roughly 140 miles from Chelsea.

Instead, she lucked out and was able to get a shot on the first day at La Colaborativa.

"This is not enough,” said Gladys Vega, executive director of La Colaborativa. “We need many other [of these] types of these vaccination centers in communities of color in order for us to begin to see their path to normalcy in our communities."

The state's weekly vaccine report released Thursday shows that of the more than 680,000 people who have received either one or two vaccine doses so far, just 3 percent are Black and less than 4 percent are Hispanic. More than 42 percent of them are white.

The vaccine site at La Colaborativa is run by the East Boston Neighborhood Health Center and in partnership with the state. However, it's not listed on the state's vaccine registration website.

“We really felt like, at least initially, we want to make sure the residents of Chelsea have access to the site," explained Manny Lopes, president and CEO of East Boston Neighborhood Health Center.

The same is true for vaccine clinics that East Boston Neighborhood Health Center opened this week in East Boston, the South End, and Revere.

Outreach will also be different from what the state’s doing.

"They have their plan, and we have our own in our own plan,” Vega said. “And our own plan is what we know how to do best. We're going to go all out in the community with our health care promoters, knock on doors and say ‘the East Boston Neighborhood Health Center is at La Colaborativa, this is the number you need to call to make an appointment.’”

That’s the kind of outreach some advocates say is necessary to overcome a significant disparity, especially as communities of color tend to be more hesitant about being vaccinated.

"I think the roll out has shown that equity was an afterthought," said Dr. Attyia Martin, a member of the Black Boston COVID-19 Coalition.

"The places we ended up setting up for people to access the vaccine are places that are hard to get to for the people who are disproportionately bearing the burden of COVID-19," she said.

In particular, Martin noted the mass vaccination sites at Gillette Stadium and Fenway Park. But even the Reggie Lewis Center in predominantly Black and Hispanic Roxbury has drawn crowds of white people from outside the immediate community.

"It's not rocket science,” said Dianne Wilkerson, another member of the Black Boston COVID-19 Coalition. “It's because there's been no on the ground marketing information, education, PSAs, nothing. It's all being driven by the level of tech savviness that the person who's looking for the vaccine or their family members have."

Until now, the only way to sign up for an appointment at one of the mass vaccination sites is through the state's website. In addition to presenting a challenge for many seniors who aren’t online, advocates like Wilkerson have argued that disadvantaged communities may have less access to the internet.

On Friday, Gov. Charlie Baker launched a phone hotline that allows callers to make vaccine appointments, as well as a public awareness campaign on vaccination.

The Black Boston COVID-19 Coalition is working with CIC Health, the organization running the state’s mass vaccination sites, to set aside the last weekend of February for just members of the surrounding community to get vaccinated at the Reggie Lewis Center.

Wilkerson said the coalition is getting ready to spread the word.

"We're doing barbershops, beauty salons, the WIC offices, outside the grocery stores and the churches that are all doing the virtual church services,” she said.

A bill introduced this weekby state Sen. Rebecca Rausch would mandate the appointment of a state director focusing specifically on issues of equity in vaccine distribution and would require greater outreach efforts in hard-hit communities.

Baker acknowledged this week the roll out hasn't gone as well as he'd like. He pointed to sites like La Colaborativa as being key to the effort.

"The strategy here, obviously, is to try to make sure that in many communities that have been hard hit by COVID, we have familiar and trusted providers available to them to provide them with the opportunity to get vaccinated," Baker said on Wednesday.

Baker said more vaccination sites are opening at CVS and Walgreens in the hardest hit communities — in part because of a new federal program that’s distributing doses directly to pharmacies.

Baker also highlighted that about 50 community health centers are doing vaccinations in those hard-hit communities. Most of those sites don’t appear on the state’s map of open vaccination sites, though, because they’re not open to the general public.

"We are first focused on the piece of the puzzle that we own, which is the million patients that we serve," said Michael Curry, president and chief executive officer of the Massachusetts League of Community Health Centers.

Many community health centers were already at their capacity with conducting COVID-19 tests, Curry said, and now they’re working on vaccinating their own patient populations. Some are looking into opening clinics off-site, like the East Boston Neighborhood Health Center has. But a lot goes into a project like that.

“If you want to open up a gym tomorrow and you’re a health center, it requires ventilation, it requires PPE, it requires transporting your electronic medical record systems to that location,” Curry said. “It requires the infrastructure — the partitions, the chairs, the 15-minute waiting room so that people after they get their shot have the time to stay so we can see if they have any adverse reactions."

And all that costs money.

Curry said community health centers are currently looking for funding from the federal government, from the state, and from wherever they can get it, to make that happen.