Although Massachusetts has one of the highest COVID-19 vaccination rates in the country, Hampden County has the lowest rate in the state — with major racial and ethnic disparities among who is getting the shot.
Local health departments are focused on making the vaccine as visible and convenient as possible for hard-to-reach populations, but that’s often not enough.
On a recent afternoon outside the Boys and Girls Club in Chicopee, a sound system plays festive music under a tent, next to a large bus that says “COVID-19 VACCINE” on the side.
Three volunteers are holding signs near the road, calling out “la vacuna” to passing cars, with the hope they will decide to turn into the parking lot. It looks a little like a car wash fundraiser.
This is an effort by several health organizations to bring the vaccine where it’s needed the most. The seats on the bus have been removed to make room for four vaccination wells, where nurses give the shots.
“We stand up on the sidewalk and wave, so people know we [are] here,” said Zaida Luna, one of the site supervisors. “And if they do come, they say, ‘Do I need an appointment?’ [or] ‘Oh, I don’t have an ID.’ I says, ‘You don’t need an appointment. You don’t need no ID. You can just get it right now.’”
Wide disparities
Earlier this year, the vaccine was hard to come by, even for the most motivated. But now appointments are relatively easy to get at pharmacies, clinics or mass vaccination sites.
Still many people are not getting them – especially people of color. According to the most recent state data, Black and Hispanic residents in several Hampden County cities are getting vaccinated at significantly lower rates than white people.
In Springfield, for example, only 17% of eligible Hispanic residents and 23% of Black residents have been fully vaccinated, compared to 44% of white residents. In Holyoke, it’s 18% of the Hispanic population and 28% of the Black population, compared to 42% of whites. And in Chicopee, Hispanic and Black people have been vaccinated at rates of 18% and 24% — compared to 38% of white people.
“As we’re finding more and more people who already got their shots, we try to identify those who have not gotten it and then figure out why they haven’t,” said Jay Breines, executive director of the Holyoke Health Center.
Breines’ organization is staffing the buses in partnership with Tufts Health Plan, which donated the buses. While Breines said the low-income patients of the health center are his priority, the goal is vaccinating everyone in the community.
“If I take care of half the people in Holyoke, I still want to get the other half vaccinated,” he said, “because – if they get the virus – they could give it to my patient.”
One limitation is the two-shot regimen, required for their most common supply – the Moderna vaccine. That means the bus has to return to each location exactly four weeks later to give everyone their second shot, limiting how many different locations the organization can hit.
The Johnson & Johnson vaccine would have been more convenient, since it’s only a single shot. But the government mandated a pause in that vaccine’s use – since lifted — while it investigated a small number of blood clots associated with the vaccine. Breines said he didn’t want to confuse his patients by returning to the J&J too soon, although he feels confident in its safety.
‘Some people, they just don't look at the news’
Luna, a former Springfield city councilor, said her outreach staff has had to be creative getting the word out about the vaccine bus. They go door-to-door, she said, in largely Hispanic neighborhoods.
“They get so happy. ‘Oh, thank you for being here, bringing this information, because I wasn’t sure. I haven’t heard a lot about it,’ even though it’s everywhere,” she said. “Some people, they just don’t look at the news.”
When her workers go to public housing complexes, though, sometimes the lobby is locked. In those cases, Luna said, they’ll press on the buzzer for individual apartments and wait until someone picks up.
“And just by talking to the intercom, we can give information, at least, if we can’t go in,” Luna said. “Sometimes we have to spend a little bit of time with some people just to let them know what we hear, why it’s good.”
Over the past few weeks, she says the number of people coming to the mobile clinics has dropped, even though the majority of those communities are still unvaccinated. Some health leaders say the next phase will likely come down to convincing vaccine skeptics.
‘Just too soon, too soon’
Maritza Caban was among those who had to be convinced to come to the vaccine bus, even though she works at the Holyoke Health Center.
“I’m still nervous a little bit about it,” Caban said. “I just feel like it’s just too soon, too soon, and it just came out. I’m not sure what may or may not happen.”
Caban said her husband, who is also nervous, had finally persuaded her they should both get the shot so they can travel and see her grandmother. Plus a colleague of hers recently got COVID, and she doesn’t want to expose her family to the virus.
“Now I have a one-year-old, so kind of looking out, thinking more for him than for myself,” she said.
Israel Diaz Moulier, who works at the mobile clinic, said he’s hoping that as people who were once skeptical get their shots, their friends and family will follow.
“OK, this is the person that didn’t want [the vaccine], was negative to get the shot. This person will probably convince them to come in,” Moulier said. “And then those people that were in that kind of group, the confidence comes to them.”
Even Moulier himself was squeamish, at first.
“Not the vaccine, just the needles,” he said. “But it just goes away. It's just the one pinch.”
The vaccine buses are only going to Holyoke and Chicopee, although Springfield is also lagging in vaccination rates.
At a recent press conference, Springfield Health Commissioner Helen Caulton-Harris said the city is working with Baystate Medical Center to set up clinics in hard-to-reach neighborhoods, including at churches and cultural centers.
“Everyone across the nation is experiencing a slowdown in vaccinations,” she said. “And so, smaller clinics may be the future for us.”
Breines said the Holyoke Health Center expects to keep sending the bus around for another four or five weeks.
The center is planning to hold informational meetings on the vaccine’s safety, in Spanish, which Breines hopes will engender trust among many Latino residents. And eventually, they hope to offer more vaccine clinics at the public schools and encourage students to bring their whole family.