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A few health centers already run mass vaccination sites, but all prioritize their own patients and neighbors – the people most likely to get sick from COVID-19 and the least likely to get vaccinated. All are expanding their capacity to deliver vaccines, with state support.
“Our health centers want to make sure that the patients closest to the disease are the closest to the vaccine,” said Michael Curry, CEO of the Massachusetts League of Community Health Centers. “They know their patients are more likely to be hospitalized and die.”
In doing so, health centers, which provide primary care and other services primarily low-income people face a paradoxical challenge: dealing with a barrage of calls from people wanting to be vaccinated and also reaching and persuading those who are not sure.
“When you open the doors, you will see that first flow of people, the strong yes,” said Manny Lopes, CEO of the East Boston Neighborhood Health Center. “But you have to stay focused on those who are on the ‘maybe’ list, and those who are saying the difficult ‘no’. “
Health centers report that they have received enough vaccines to meet their needs so far. But they haven’t vaccinated many – mainly their own staff and the few patients aged 75 and over. Life expectancy is lower among people of color, who make up 60 to 80 percent of many centers’ clients, Curry said.
With the widening of eligibility, health center officials have expressed hope that the state’s supply will keep pace with growing demand. In addition, 15 health centers in Massachusetts expect to receive additional doses of the vaccine directly from the federal government within the next two weeks, as part of a new program to supplement the state’s supply. Curry said it was not yet known how many doses would go through this route.
Health center patients make up 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 says. Among their own patients, they could potentially reach nearly 700,000 people over the age of 16 as eligibility expands.
In the newly eligible group for Phase 2, which numbers about 1 million statewide, health centers serve more than 60,000 people aged 65 and over – as well as several thousand young people who have two comorbidities, such as obesity, diabetes, smoking and asthma.
Patients in health centers have high rates of these diseases. They tend to live in communities where the virus spreads the fastest and also face the greatest barriers to getting vaccinated, such as poor internet access, lack of transportation, or mistrust of the vaccine. vaccines – all the problems that centers say they are in a good position to solve. .
In Massachusetts, 6% of vaccinations were given to blacks, while they make up 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 pronounced among Hispanics in the state: They make up 12% of the population, but make up 29% of COVID-19 cases – and have received just 5% of vaccine doses.
With the floodgates now open to people over 65, health centers are trying different approaches to manage this challenge. Some team up with other community groups or the municipal government. They hire staff and keep their fingers crossed that federal and state money eventually gets to them. And some are getting help from the National Guard.
The Brockton Neighborhood Health Center was so overwhelmed with phone calls from people seeking vaccinations that it had to hire eight more phone staff and add 16 lines – and people still get busy signals sometimes, the said CEO Sue Joss.
The center has vaccinated around 450 to 500 people per week, but expects that figure to increase to 3,000 after March 1, when a collaborative effort with the city opens in the city-owned Shaw Center.
“It’s a big step forward,” Joss said.
The site will be open only to patients of 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. From its staff, who come from the local community, the center has learned the extent of the uncertainty about the vaccine. Only 43% of employees agreed to be vaccinated and among black staff members only 28% took the vaccine, Joss said.
The center has made videos of staff members who have been vaccinated talking about their decision and has appointed “COVID vaccine ambassadors,” a Haitian and a Cape Verdean, to spread the word in their communities.
Other community health centers have faced similar problems and have adopted similar approaches.
“Some of the challenges with vaccine confidence that we see among our staff,” said Dr Charles Anderson, CEO of the Dimock Center in Roxbury.
To counter this, a sensitive approach is needed, he said.
“It’s not just about providing information. It’s about empowering people to tell their stories, ”Anderson said. Like Brockton, Dimock made videos of staff members who weren’t sure about the vaccine but decided to get it.
“They’re telling their story of how they got to know the vaccine and developed confidence in the vaccine,” Anderson said. “Their story resonates with their neighbor.”
Dimock is also stepping up efforts to meet growing demand, reorienting a building on its nine-acre campus, with plans to open it on March 1 for Dimock patients and those who live nearby. Dimock plans to administer 1,000 to 1,200 doses per week at the new site.
Likewise, the Codman Square Health Center, in conjunction with other health centers and the Boston Medical Center, last week opened a vaccination site in the Russell Auditorium, which had been a testing center. The site starts at 400 per day, but officials hope to increase to 1,000 per day, and it’s listed on the state’s immunization website. But on Friday morning, the site only served a handful of people; one sign blamed weather-related delays in vaccine shipments.
When the Reggie Lewis Center opened in Roxbury, a vaccination site to serve the local community, the first clients appeared to be mostly white people from out of town. Sandra Cotterell, CEO of Codman Square, said “there is a risk that could happen” with the Russell site, but she doesn’t think it will as health centers call their eligible patients and make appointments. you for them.
“We are actively reaching out to our own patients,” she says.
The Harvard Street Neighborhood Health Center in Dorchester takes a hybrid approach – reaching out to its own patients, but also vaccinating other community members by 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.
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