Some health centers are already operating mass vaccination sites, but all are prioritizing their own patients and neighbors – the same people who are most likely to fall ill because of COVID-19 and least likely to be vaccinated. All are expanding the vaccination capacity, with support from the state.
“Our health centers want to make sure that patients closest to the disease are closest to the vaccine,” said Michael Curry, CEO of the League of Massachusetts Community Health Centers. “They know that their patients are more likely to be hospitalized and die.”
In doing so, health centers, which provide primary care and other services primarily to low-income people face a paradoxical challenge: dealing with a flood of calls from people anxious about the vaccine and also reaching out and persuading those who are unsure about it.
“When you open the door, you see that first flood of people, the strong sims,” said Manny Lopes, CEO of the East Boston Neighborhood Health Center. “But you have to focus on those who are on the ‘maybe’ list and those who are saying the strong ‘no’. “
Health centers report that they have received enough vaccine to meet their needs so far. But they have not vaccinated a large number – mainly their own employees and the few patients aged 75 and over. Life expectancy is lower among people of color who make up 60 to 80 percent of the clientele in many centers, Curry explained.
With the increase in eligibility, health center officials expressed hope that the state’s supply will keep up with growing demand. In addition, 15 Massachusetts health centers expect to receive extra doses of vaccine directly from the federal government in the next two weeks, under a new program to complement state supplies. Curry said it is not yet known how many doses will come this way.
Health center patients represent a significant portion of the state’s population, Curry noted. The centers serve one in seven residents of the state; in Boston, it’s one in two, he said. Among their own patients, they can reach almost 700,000 people over the age of 16, as eligibility expands.
In the newly eligible group for Phase 2, which totals about 1 million across the state, health centers serve more than 60,000 people aged 65 and over – plus many thousands of young people who have two comorbidities, such as obesity , diabetes, smoking and asthma.
Health center patients have high rates of these diseases. They tend to live in communities where the virus spreads more quickly and also face the biggest obstacles to being vaccinated, such as poor Internet access, lack of transport or lack of confidence in vaccines – all problems that the centers say are well positioned to solve .
In Massachusetts, 6% of vaccines were administered to blacks, while they represent 7% of the population and account for 8% of COVID-19 cases, according to new data from the Kaiser Family Foundation. The disparity is most striking among Hispanics in the state: they make up 12% of the population, but account for 29% of cases of COVID-19 – and received only 5% of the vaccine doses.
With floodgates now open to people over 65, health centers are trying different approaches to address this challenge. Some are associating with other community groups or the municipal government. They are hiring employees and keeping their fingers crossed so that federal and state money will arrive. And some are receiving help from the National Guard.
The Brockton Neighborhood Health Center has been so overwhelmed with calls from people searching for vaccines that it had to hire eight more members of the phone team and add 16 lines – and people are still sometimes getting busy signals, said the CEO Sue Joss.
The center is vaccinating about 450 to 500 people a week, but expects to increase it to 3,000 after March 1, when a collaborative effort with the city opens at the city-owned Shaw Center.
“It’s a big leap,” said Joss.
The site will be open only to patients at the health center and residents of Brockton.
Meanwhile, even in the midst of high demand, the Brockton center is calling individual patients eligible for vaccination, urging them to make appointments. With his team, who come from the local community, the center learned the extent of uncertainty about the vaccine. Only 43 percent of employees agreed to be vaccinated and, among employees who are black, only 28 percent got the vaccine, said Joss.
The center made videos of employees who were vaccinated, talking about their decision, and designated “ambassadors for the COVID vaccine”, a Haitian and a Cape Verdean, to publicize their communities.
Other community health centers have seen similar problems and adopted similar approaches.
“We are seeing some of the challenges with confidence in the vaccine among our team,” said Dr. Charles Anderson, CEO of the Dimock Center in Roxbury.
Getting around this requires a sensitive approach, he said.
“It is not just about providing information. It’s about allowing people to tell their stories, ”said Anderson. Like Brockton, Dimock made videos of team members who were unsure about the vaccine, but decided to take it.
“They tell their story about how comfortable they felt with the vaccine and developed confidence in it,” said Anderson. “Their story resonates with the neighbor.”
Dimock is also stepping up its efforts to meet growing demand, redirecting a building on its nine-acre campus, with plans to open March 1 for Dimock patients and people living nearby. Dimock hopes to administer 1,000 to 1,200 doses a week at the new location.
Similarly, Codman Square Health Center, in partnership with other health centers and the Boston Medical Center, opened a vaccine facility last week at the Russell Auditorium, which had been a testing center. The site is starting at 400 a day, but officials hope to increase it to 1,000 a day, and is listed on the state’s vaccination site. But on Friday morning, the site served only a handful of people; a sign blamed delays in sending climate-related vaccines.
When the Reggie Lewis Center opened in Roxbury, a mass vaccination site was intended to serve the local community, the first customers appeared to be mostly white from outside the city. Sandra Cotterell, CEO of Codman Square, said that “there is a risk of this happening” with the Russell website, but she does not think it will happen, because health centers are calling their eligible patients and making appointments for them.
“We are aggressively reaching our own patients,” she said.
Harvard Street Neighborhood Health Center in Dorchester is taking a hybrid approach – reaching out to its own patients, but also vaccinating other community members working with local organizations, such as Central Boston Elder Services, where vaccinations were underway on Friday.
Felice J. Freyer can be contacted at [email protected]. Follow her on twitter @felicejfreyer.