BATON ROUGE, La – Flossie West was not at all interested in getting the coronavirus vaccine.
Carla Brown, the nurse who oversaw her care, was determined to change her mind.
Mrs. West, 73, has ovarian cancer, congestive heart failure and breathing difficulties – conditions that put her at serious risk if she catches the virus. As it stands, Covid-19 killed many of its neighbors in Mid-City, a low, predominantly black community that extends east of the Louisiana state capital.
But West’s skepticism about the new vaccines has clouded his fears about Covid-19. “I’m just not interested because everyone tells me that the virus is a scam,” said West. “And besides, this injection is going to make me sicker than I already am.”
On Thursday morning, Mrs Brown, 62, entered Mrs West’s apartment and gave a severe lecture: The virus is real, vaccines are harmless and Mrs West must get out of bed, get her water tank. oxygen and get in the car.
“I’m not going to worry about whether I’m going to let this coronavirus take you,” she said.
In the past few weeks, Ms. Brown has been working frantically to persuade her patients to be vaccinated, and her one-woman campaign provides a glimpse of the obstacles that have contributed to worryingly low vaccination rates in the black community.
Despite the increasingly abundant supply of vaccines, African Americans are being inoculated with half the rate of white vaccines, according to an analysis by The New York Times. The disparities are especially alarming due to the disproportionate impact of the pandemic on communities of color, who die twice as often as whites.
The racial difference in vaccination rates is no less pronounced in Louisiana, where African Americans represent 32% of the population, but only 23% of those who have been vaccinated.
Part of the problem is access. In Baton Rouge, most mass vaccination sites are in white areas of the city, creating logistical challenges for older and poorer residents in black neighborhoods like Mid-City, who generally do not have access to transportation. Older residents have also been hampered by online naming systems, which can be daunting for those without computers, smartphones or fast Internet connections.
But much of the racial disparity in vaccination rates, experts say, may be linked to a longstanding distrust of medical institutions among African Americans. Many Baton Rouge residents can readily cite the history of abuse: starting with eugenics campaigns that forcibly sterilized black women for nearly half of the 20th century and the notorious government-run Tuskegee experiments in Alabama that prevented the penicillin of hundreds of black men with syphilis, some of whom later died of the disease.
“Mistrust among black Americans comes from a real place and pretending it doesn’t exist or questioning whether it is rational is a recipe for failure,” said Thomas A. LaVeist, a health equity expert and dean of the School of Publications Health and Medicine Tropical at Tulane University. Dr. LaVeist has been advising Louisiana officials on ways to increase vaccination rates.
Mrs. Brown, 62, the hospice nurse, has a good idea on how to change the minds of vaccine skeptics: encouraging one-on-one conversations with respected figures in the black community who can deal with doubts and provide reliable information, recognizing what she describes how the scars from hereditary trauma. “If you look back on our history, we have been lying and there has been a lot of racial pain, so it comes down to building trust,” she said.
It also helps when she tells people that she has already been vaccinated.
A Covid survivor, Mrs. Brown became a dervish crusade against the vaccine’s hesitation in Baton Rouge. His sense of mission is partly fueled by personal loss. Last May, while working as a psychiatric nurse at a hospital, Ms. Brown unknowingly brought the coronavirus to her home. Her husband, son and 90-year-old father became seriously ill and ended up in the hospital. Her husband, a cancer survivor she described as “the love of my life”, ended up on a respirator. He died in July.
With a newfound determination to care for the most vulnerable patients, she left her job at the hospital and last January started working with terminally ill patients.
“My husband was unable to get the vaccine, but I will be sure if I am not going to vaccinate all the human beings around me,” she said. “I don’t care if you are homeless. If I go to you, you will get in my car. “
On Thursday, she overreacted after learning that a pop-up vaccination site in East Baton Rouge had dozens of doses left over.
Mrs. Brown prefers to make her presentation in person, but with less than three hours to go before closing, she pulled her cherry red Toyota Scion into the parking lot of Hi Nabor Supermarket, took out her phone and opened a thick folder with contact information of the 40 patients she manages as the director of nursing at Canon Hospice, a palliative care provider in Baton Rouge.
“Is that Miss Georgia?” she asked. “Have you taken Covid’s picture yet? No? Well, then get dressed because we’re coming to get you. “
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There were several rejections – “I’m still not convinced it is safe to take,” said one woman – but in less than an hour she convinced five people to get vaccinated.
She then called the East Aging Council of Baton Rouge, the nonprofit group that operates the vaccination site, and asked them to dispatch some of their vans.
In addition to providing transportation, Tasha Clark-Amar, the organization’s chief executive, tries to ease the logistical hurdles by making appointments over the phone and getting employees to complete the necessary paperwork in advance. Next week, she hopes to start sending teams of health workers to vaccinate 4,000 residents across the city who are bedridden.
Ms. Clark-Amar is also driven by a sense of urgency: during the past year, she said, more than 140 of her clients have died from Covid-19. Her strategy for winning over the hesitant is no different than Ms. Brown, although she always tries to appeal to the leadership and respect that elders command in the black community. “I say to them, ‘You are the matriarch or patriarch of the family and you must set an example,'” she said. When that doesn’t work, she is more direct: “At your age, it’s the vaccine or the grave”.
Less than 30 minutes after Brown made his calls, a home health assistant took Dorothy Wells to the well-lit cafeteria at the senior center. Mrs. Wells, 84, a stroke patient, initially resisted being vaccinated, but was rejected by her son.
Wells’ aide, Rashelle Green, 45, was also reluctant to be vaccinated. She told stories she read on social media about people who get sick or die after receiving the vaccines, although health officials say that adverse reactions to the coronavirus vaccine are extremely rare.
But after seeing people being vaccinated and then leaving after 15 minutes of observation, Ms. Green changed her mind. While waiting for her turn, she nervously jumped up and down. When it came time to roll up her sleeve, she shivered, but barely noticed the prick of the needle. “It wasn’t too bad,” she said.
Then there was Mrs. West, the cancer patient whose home Mrs. Brown visited earlier that day. Last year, Mrs. West, who lives alone and has no children, looked forward to the exams twice a week with Mrs. Brown. In addition to occasional consultations with her oncologist, visits are the only occasions when she has face-to-face contact with another person. “I feel that Mrs. Brown really cares about me,” she said.
Given the deep confidence that has been cultivated in recent months, it didn’t take long for Mrs. Brown to win her over.
Sitting in the observation area at the vaccine site on Thursday, West said she was happy to have heard. “When I get home,” she said, “I’m going to text all my friends and tell them to try.”