When distribution of the COVID-19 vaccines began, Jewelean Jackson, 72, approached Dr. Chris Reif, her longtime physician at the local Community-University Health Center in South Minneapolis, to reassure herself.
Could she trust that? What would she say to her black neighbors when asked if it was safe?
Likewise, doctors sought her out to see how they could help inspire confidence in the vaccine in communities of color.
“Today I received the second immunization and Dr. Reif administered it, so it was special,” said Jackson, a certified community health educator, on Friday.
More than 80% of the clinic’s patients are black, indigenous or other people of color, said the clinic’s CEO, Colleen McDonald Diouf. Many suffer from chronic diseases, such as diabetes and hypertension, need linguistic assistance or are homeless. A few years ago, the largest homeless camp in the city was across the street.
All of these factors combined, patients at the center are especially vulnerable to contracting and experiencing complications from COVID-19, making the clinic an anchor for patients in the midst of the pandemic.
It is a family history at Federally Qualified Health Centers – commonly known as community health centers – across the country. Designated clinics provide health care to underserved communities and, as people of color continue to suffer disproportionately from the virus, centers can be essential in vaccinating affected populations, experts say.
Throughout the country, community health centers serve approximately 30 million patients. Two-thirds of them live in or below poverty, and half are racial or ethnic minorities. Most have no insurance or are on Medicaid.
As part of its plan to improve equitable distribution of vaccines, the Biden administration targets community health centers as distribution centers.
Dr. Marcella Nunez-Smith, president of the Health Equity Task Force COVID-19, announced earlier this month that the government would begin sending doses to 250 centers, at least one in each state or territory.
Initially, the effort would focus on health centers that cater to specific populations, including migrant workers, agricultural workers, people with limited English proficiency, residents of public housing estates and homeless people, said Nunez-Smith. The government recently released a list of clinics.
As hesitation, fears and rumors surrounding the vaccine ran rampant in the communities, Jackson, former chairman of the committee at the center, has been talking to friends and family to help dispel the myths.
When she received the vaccine, other elderly African Americans at her book club said she was “crazy”. Her 31-year-old daughter, skeptical of the vaccine she took, was terrified when she found out that her mother had taken it. “I want you to live a long life,” Jackson said as she told her.
Jackson said community health centers are essential for communities like hers, with a history of medical injustices and lack of access to healthcare.
“This system still doesn’t work for us as it should,” said Jackson. “That’s why, when you think about it all, the University-Community Health Center literally walks on water.”
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‘We don’t have enough’
Many health centers are facing unique challenges in caring for their marginalized patients during the pandemic.
A report by the National Association of Community Health Centers found that health centers reported delays in coronavirus test results, a lack of personal protective equipment and a significant shortage of staff – challenges that the health advocacy group says should increase.
“After accounting for estimated vaccine-related costs, the total financial impact on health centers by June 2021 is estimated to be up to $ 13.5 billion,” said another report by the advocacy group, which was repeated by one of the Foundation of the Kaiser Family.
In December, Congress passed a bipartisan coronavirus bill that included $ 4 billion reauthorized for the Community Health Center Program. The bill was sanctioned in the last days of the Trump administration. President Joe Biden asked Congress to allocate more money to support health centers.
The clinical staff at the Southeast Mississippi Rural Health Initiative is looking forward to receiving the extra quota. They need more doses of vaccine.
Operations director Janice Robinson said that in the network’s 17 community health centers, 3,000 to 4,000 patients are on vaccination waiting lists.
“We don’t have enough,” said Robinson. “It will definitely make a change.”
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The network’s mission is to help control chronic diseases in the state, where half the population is black. The state suffers from the highest prevalence of obesity in the country, and blacks suffer from this and other health problems disproportionately.
Since the beginning of the pandemic, the network has endeavored to ensure that patients receive preventive health care and regular consultations that they desperately need. While hospitals and primary care clinics relied on telehealth for virtual consultations amid social distance, many rural Mississippi residents lack access to broadband, said Robinson.
While Biden’s new plan allocates more vaccine to these underserved communities, there is a shortage of staff and other logistical challenges. About 39% of health centers surveyed, for example, said that staffing shortages are a barrier to administering a vaccine, according to a weekly report by the Health Resources & Services Administration.
Robinson cited the same challenges. “Having enough staff to manage everything” is a problem, she said. Keeping jobs that are difficult to fill and with high salaries, such as nursing positions, is difficult during periods of low patient volume and declining revenue.
The initiative provides transportation services for patients in all sparsely populated rural areas, but new options had to be added during the pandemic, said Robinson. With the increase in transmission rates, the solidary ride of some patients is no longer safe.
“Trying to find them where they are, so that we can continue to serve them in the best possible way in the midst of the pandemic … brings its own set of challenges,” said Robinson, who has been on the network for more than a decade. “We had to increase our transportation services to ensure that they can make their appointments and receive the care they need.”
Transport will be essential for the administration of the vaccine in these communities. “For many of our patients, we are all they have,” added Robinson. “If we weren’t there, some people would have nowhere to go.”
Dr. Heather Leisy treats patients at Hope Health in Florence, South Carolina. About 43% of residents are black in Florence, and the state also suffers from a high rate of obesity and other health disparities.
Leisy also cited a shortage of nurses amid an increase in testing during the increase in COVID-19 cases.
“We don’t want to interrupt the normal workflow, but we have these extra tasks beyond that, like testing or applying the vaccine, and this is a very specialized team,” she said. “There is a shortage of nurses … they are being hired at very high prices per hour. This has been a difficulty, but I think it occurs in (all) health centers. “
Reliable doctors dispel vaccine fears
Back at the Community University Health Center in South Minneapolis, Diouf says that many of the center’s patients live in multigenerational families across the diverse area of Somali refugees and other large ethnic groups.
With that in mind, health center officials advocated reducing the minimum age required for the injection. The state recently lowered the age limit to 50 years.
The team has worked to build community trust for years. In the most difficult moments, it was worth it, especially in combating the hesitation of the vaccine. The medical team is diverse and multilingual, which helps with care, unmasking myths and clarifying doubts about the vaccine.
“There is a lot of misinformation – they want the right information,” said the clinical director, Dr. Roli Dwivedi.
She remembered a patient who made an appointment just to discuss her fears about the vaccine and ask questions. “She wanted to hear from me. She wanted to process those feelings, to hear that there are no genetic changes, there is no fetal tissue in this vaccine, “Dwivedi.
Another patient, who has several health problems and undergoes dialysis three times a week, told her: “‘I will only get the COVID vaccine if you are in this room and can see me.”
Now, Dwivedi says he says to all vaccinated patients: “You have the vaccine, now you are a leader. You go out and talk to your friends and family and share your experience to let them know that we need 65% to 70% of people who received the injection before we were safe. ”
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Reach Nada Hassanein at [email protected] or Twitter @nhassanein_.
This article was originally published in USA TODAY: Vaccine COVID: Low-income clinics prepare to receive extra doses