On February 17, Bethel AME Church on Goffe Street in New Haven looked a little different than normal. On that day, some 90 congregants and community members didn’t go to church to attend service—they went to get a COVID-19 vaccine shot. It was the first, but would not be not the last time that the majority Black church would be transformed into a vaccination clinic. In March, the New Haven Department of Health will return to host a popup clinic for the second dose and Yale New Haven Health System will host its own separate clinic.
Reverend Steven Cousin, the church’s pastor, was enthusiastic about having the New Haven Department of Health host a popup clinic at his church. “[A popup clinic] was what I wanted all along. I’ve seen the same story play out far too many times where they have organizations…come to the church to advocate for [COVID-19 vaccine] programming and bring awareness, without actually having access to the program,” Cousin said in an interview with The Politic.
For Cousin, Black access to COVID-19 vaccines shot translates into higher vaccination rate. On the day of the popup clinic event, 80 people, many of whom were Black, signed up to get a COVID-19 vaccine, filling up every single time slot. By the end of the day, ten more fortunate individuals were able to get a vaccine due to spare doses that did not go to waste. Bethel AME Church, however, does not tell the full story about the state and local vaccinate rollout because in Connecticut and New Haven, Black and Brown communities are not getting vaccinated at the same rate as their white counterparts.
Data shows that disparities in healthcare access in Connecticut are prevalent. An Access Health Connecticut report estimated that in 2018, Black people were 1.33 times more likely to be uninsured than the general population; Hispanic people were 2.5 times more likely to be uninsured.
On February 10, the state Department of Public Health released its internal data on first COVID-19 vaccine doses administered by race and ethnicity. Their results were disheartening. As of February 3, just 4.4 percent of the Black 16 and older population and just 5.2 percent of the Hispanic non-white population of the same age group have received their first doses of a COVID-19 vaccine. Comparatively, 8.9 percent of the white 16 and older population in Connecticut have received their first doses.
Access to the vaccine is not the only reason behind the disparity. In particular, Black hesitancy toward vaccines is not uncommon. In fact, it is rooted in a long history of medical mistreatment from the Tuskegee syphilis study (1932-1972) and the nonconsensual use of Henrietta Lacks’ cells. The Tuskegee syphilis study was a decades long study in Macon County, Alabama where US health officials deceived Black men into participating in an experiment and withheld proper medical treatment from the participants. Henrietta Lacks was a Black woman who visited John Hopkins Hospital in 1951 to get treatment for cervical cancer. Unbeknownst to her, a sample of her cancer cells was sent to a nearby lab and are now frequently used to study the growth of cancer. Recent data suggests that even through the COVID-19 pandemic, Black Americans are not as enthusiastic about getting a vaccine than their white counterparts. A January 2021 Harris poll found that while 69 percent of Americans said they would take a COVID-19 vaccine as soon as it’s made available to them, only 58 percent of Black respondents said they would accept the vaccine.
Cousin believes that Black churches like Bethel AME can solve the two-folded access and hesitancy issues. “There is a level of trust and culpability within the Black church, especially for our congregates, where they may feel more comfortable attending their own church as opposed to going to a hospital or going to a place they may not be so familiar with,” Cousin said. But there are also other key stakeholders at play that can help address racial disparities in vaccination rates.
Just a few blocks east of Bethel AME Church lies the western edge of Yale’s Ezra Stiles College. Yale, despite its $31.11 billion endowment in 2020, has not always stepped up for the New Haven community. Given the legal implications of Yale’s $157 million tax break from the city of New Haven, Yale must recognize its moral obligation to help the Elm City tackle the ongoing pandemic. Thus far, the university has successfully made vaccine equitability the centerpiece of its vaccine distribution efforts. But as Connecticut expands COVID-19 vaccine eligibility, Yale must continue to expand its current efforts.
‘It’s not safe.’ ‘It was rushed.’ ‘It changes your DNA.’ ‘If I’m undocumented, then I can’t get the vaccine.’ These are just some of the concerns that Melissa Campbell, a clinical fellow at the Yale School of Medicine, and Marietta Vazquez, a Professor of Pediatrics at the Yale School of Medicine, have heard during multiple COVID-19 vaccine information Zoom meetings from minority residents in New Haven and nationwide. In fact, Campbell heard some of these same concerns even before the FDA approved the Pfizer and Moderna COVID-19 vaccines.
In late 2020, Campbell assisted Pfizer’s COVID-19 phase 3 trials in New Haven, a city that the company particularly valued because of its diversity. However, enrolling Black and brown community members proved to be particularly challenging for the study’s medical team. “There were liaisons with the Yale Center for Clinical Investigation who established a relationship with this church,” Campbell said about local churches generally in an interview with The Politic. “And then we used that pastor and their family as kind of an example to pull in more of the Black community…. We had to go out and look for them.”
After her experience working on the Pfizer trial, Campbell understands that minority hesitancy to vaccines is widespread, but also that solutions exist. That’s why in February, she spoke on a panel of health experts presenting COVID-19 vaccine information to Spanish-speaking Latinos affiliated with Unidad Latina en Acción in New Haven.
Campbell and her fellow panelists answered vaccine-related questions about eligibility requirements, allergic concerns, and immigration-related inquiries in Spanish—a piece that Campbell says is important when addressing Latino communities. “These town halls, [is about] making sure we talk to people in their language and also in a non-medical language. I can talk about mRNA vaccines this and that, but if you’re not a science person, I might as well be speaking in another language,” Campbell explained.
In addition to language, Campbell said that she emphasizes the role that minorities played in the Pfizer phase 3 trials to reassure Black and brown communities that the vaccine is safe and has been tested on them. Campbell acknowledges that reaching out to marginalized communities that have been historically the subject of grotesque science experiments is a difficult task, but luckily she is not alone.
Vazquez, a professor of pediatrics at the Yale School of Medicine and one of Campbell’s colleagues, was also on the ULA panel in February. Unlike Campbell, Vazquez attends COVID-19 informational town halls much more frequently. On a typical day, she attends one to two different events with audiences ranging from curious citizens in Ohio to healthcare professionals in Virginia to minority populations in New Haven. Ironically, Vazquez’s clinic and her patient population are not yet eligible to receive the COVID-19 vaccine. Nevertheless she still sees it as her duty to help spread correct information about the vaccine.
“It’s more important than ever that people understand there is value in the information that scientists have to share…. It’s my duty as a healthcare provider, as a citizen, it’s my duty as a Latina to share what I know [about the COVID-19 vaccine].”
Importantly, Vazquez does not go into a Zoom townhall with the goal of changing people’s mind about the vaccine. Instead, her goal is to present objective facts, answer questions, and squash misinformation. She hopes that her expertise, in conjunction with the presence of respected community leaders on Zoom calls, will help guide people to make informed decisions about taking the COVID-19 vaccine. Ultimately, Vazquez believes her work is part of the Yale community’s responsibility to ensure vaccine distribution is equitable.
Elsewhere on campus, Yale New Haven Hospital has taken steps to ensure that its substantial minority service workers population knows how and where to get a COVID-19 shot. When Connecticut entered phase 1a—the start of vaccine distribution—healthcare workers, including those working in hospital service jobs, were the first to gain access to the vaccine..
Richard Martinello, Yale New Haven Hospital Director of Infection Prevention, sits on the University’s Public Health Advisory Committee Subcommittee on Vaccinations, a committee which is chaired by Stephanie Spangler, Yale’s COVID-19 Coordinator. Martinello told The Politic in an interview that Yale New Haven Hospital keeps an internal database of the number of vaccinated employees by job category. The data show that vaccination rates are not equitable among hospital workers.
“What we have certainly found is that those who are in other positions like our housekeeping staff, food nutrition staff, they have not decided to get vaccinated at the same rate as our physicians and nurses have.”
While Martinello said that he hasn’t seen the hospital’s data about the race or ethnicity of its workers, he believes that the non-physician staff are disproportionately minorities. Like Campbell and Vazquez, Martinello has identified some of the barriers that these workers face when trying to receive the COVID-19 vaccine. A primary one was the availability of information because many of the non-physicians did not readily check emails about scheduling appointments. To address these problems, Yale New Haven Health Hospital installed new computers in its lounges so that housekeeping staff can check emails about vaccine information, ensured that staff wide meetings include segments discussing the availability of vaccines to works, and sent MyChart invitations to schedule appointments. Martinello says that even though some non-physician staff were initially hesitant at first, improved communication has played into rising vaccination rates for them. Going forward, the hospital continues to use its data to make sure that different directors and bosses are telling their employees to get vaccinated.
Beyond Yale New Haven Hospital, Martinello and the Subcommittee on Vaccinations has helped guide vaccinate distribution efforts. According to Martinello, the committee is using the CDC’s social vulnerability index, a tool that uses zip codes, census tracts, and 15 different variables to understand where the most vulnerable in society reside. The committee uses this information to determine who is getting vaccinated and where they reside, taking into account if vaccination rates in vulnerable populations are lagging behind. The committee has identified communities with lagging rates of vaccinations and adopted robust, targeted measures to serve their needs.
Sandy Bogucki, Professor Emeritus of Emergency Medicine at the Yale School of Medicine, is one of Martinello’s colleagues on the Subcommittee on Vaccinations and reports directly to Spangler. In an email correspondence to The Politic, Bogucki explained that equitable distribution is top of mind in the university’s distribution efforts. Through initiatives like “offering assistance with scheduling for those with limited computer skills or equipment, offering assistance with transportation, on-site assistance, and education efforts targeted toward groups with low acceptance rates to the invitations to get vaccinated,” the university is working to “encourage all who are eligible to get vaccinated.” All of these initiatives certainly address the access issue that people like Reverend Cousin understand far too well. However, Bogucki’s comment understates just how committed Yale is to distributing the COVID-19 vaccine to the greater New Haven community.
On January 20, Yale New Haven Health System announced that 12 different vaccination sites would open across Connecticut to assist with the state’s vaccination rollout. The sites are spread across the southern Connecticut corridor in towns ranging from Milford to Trumbull and still actively accept for vaccination appointments.
Of the 12, two were opened in New Haven—one at the Floyd Little House near Hillhouse High School and another one at the Lanman Center in Yale’s Payne Whitney Gymnasium. Both these sites reside in the Dixwell neighborhood, a part of New Haven that is home to many minority communities. According to the most recent data from the American Community Survey in 2019, the census tract in which the two sites are located is 55 percent Black, 20 percent Hispanic, and 17 percent white. The Floyd Little House also sits on the border of the Beaver Hills neighborhood, a part of Elm City with similar demographics.
The strategic location of these sites suggest that Martinello, Bogucki, and the university’s Subcommittee on Vaccinations are truly taking into account the CDC’s social vulnerability index when making decisions about vaccination distribution in New Haven. But just two vaccination sites won’t be enough if Yale wants to do it’s part in helping the community vaccinate the most vulnerable. That’s why Martinello believes that Black churches like Reverend Cousin’s Bethel AME Church are essential to ensuring minority communities receive the COVID-19 vaccine.
On March 2, Yale New Haven Health System and Cousin’s church had a popup clinic from 9:00 a.m. to 1:00 p.m. Cousin’s church happens to be located in the same exact census tract as the Floyd Little and Lanham vaccination sites.
Yale, with its financial prowess and its star-studded professors, has managed to step for New Haven during the vaccination rollout. However, as more and more of the population becomes eligible to receive a vaccine, both public health coordinators or professors should realize that success entails perpetual effort.
Health professors must continue to attend workshops and panels to spread COVID-19 information that will empower people to make their own decisions. Yale must double-down on its current vaccination sites, partner with more Black churches in more POC communities, and deploy mobile vaccination clinics if it is serious about equitability. These actions need to be taken in consultation with majority-minority groups like the largely Black Greater New Haven Clergy Association and the mostly Hispanic Unidad Latina en Acción. Minority New Haveners like Reverend Cousin know that this has to continue to be Yale’s plan.
“Let it be us, let it be our choice whether we’re gonna take [the COVID-19 vaccine] or not. Bring it to us, bring it to the communities and you can see the turnout, you can see the numbers dramatically increase.”