Hartford stepping up vaccination campaign
Officials reaching out to city residents to get them scheduled for inoculation
With Hartford lagging in the number of residents vaccinated against COVID19 amid severe structural obstacles, local officials have sought increasingly creative and aggressive ways of reaching people and signing them up for appointments.
That means not only organizing local vaccine clinics but also cold-calling residents and going door-to-door to answer questions and schedule appointments.
“We are doing many different things to reach as many people in as many different ways as possible, knowing there’s not a one-size-fits all approach,” Liany Arroyo, the city’s health director, said.
According to the latest state data, only 15% of Hartford residents have had at least one vaccine dose, fewest of any
municipality in the state and less than half the rate of most surrounding towns. Bridgeport, New Britain, Waterbury and New Haven are all below 20% as well, far short of neighboring suburbs.
Some of this effect likely owes to the fact Hartford and other cities have younger populations than most suburbs — and thus fewer people who have been eligible for vaccination. But the disparity between cities and suburbs also reflects deeper inequities in vaccine distribution, with Black and Latino residents of all ages far less likely to have been vaccinated so far than white residents.
“Fifty states are struggling with this challenge, Connecticut among them,” Josh Geballe, the state’s chief operating officer, said. “There’s much more that we need to do.”
Through a web of partnerships, health department staff, hospital officials, community organizations, faith leaders and others across Hartford have worked to combat these disparities and get vaccines into residents’ arms.
At the Hispanic Health Council on Main Street, for example, a Hartford HealthCare team vaccinates 100 locals every Friday morning as part of a recurring micro-clinic. Joan Cruz, director of administrative operations for the Hispanic Health Council, said the group has spread the vaccination gospel through outreach workers on the street, through Facebook and through word of mouth.
Those efforts, she said, have begun to pay off.
“After the first clinic, then things exploded, in a good way,” Cruz said. “Now we have people calling, calling, calling and lines are busy, busy, busy.”
Obstacles to access Hartford and other Connecticut cities face significant hurdles to getting a high number of their residents vaccinated. People who live in Hartford, and in particularly in its poorer neighborhoods, may have less access to technology to sign up for vaccination and less access to transportation to get to a vaccine site. Those with limited English may struggle to find information in their native language.
Jeremy L. Williams, pastor of Phillips Metropolitan C.M.E. Church in the North End, said these factors make disparities inevitable.
“In some ways what we are seeing is an accent on problems that existed prior to COVID, from access to health care to other types of really important resources,” Williams said. “Health care before COVID wasn’t universally distributed or accessible, so there’s no reason to believe it would be in the middle of a crisis.”
Williams said some residents have struggled to make time for vaccine appointments, especially if they work jobs that don’t allow for time off.
“The major [vaccine site] in our neighborhood only has weekday options,” he said. “And if somebody is working, or is an essential worker especially, like a lot of people in my congregation and in this neighborhood, those times don’t work because they have to
work.”
Meanwhile, Williams said, appointment slots in the North End are often filled by people from other parts of the city or from neighboring suburbs.
Arroyo said the city tries to direct as many doses as possible toward Hartford residents but can’t stop people from neighboring towns from visiting sites in the city.
“We most certainly prioritize Hartford residents at this point in time, but we don’t push other people,” she said. “If we have open slots and you’re calling us from another community, we will take you.”
Then there’s the language barrier. In a city where 43% of residents speak a language other than English at home, Cruz said getting information to locals can be a challenge.
“I’ve seen advertisements on the main Spanish channels. I’ve seen advertisements on Facebook pages,” she said. “Is it getting to them? We don’t know.” Reaching out
Hartford officials sought to combat these factors several ways, organizing a weekly clinic at Dunkin’ Donuts Park that will continue at least into April and coordinating vaccine sites at the Parker Memorial Community Center in the North End and at the South End Wellness Senior Center. On the city’s website, residents
can submit contact information through a form presented in both English and Spanish so they may be contacted to make appointments.
Meanwhile, the city’s health department has reassigned contact tracers to cold-call residents about the vaccine, using numbers from voter and tax rolls, elderly renters’ rebate applications, and the city’s list of residents who contracted COVID-19.
Arroyo said these phone calls have been highly useful in getting more residents signed up.
“People want to talk to someone,” she said, “to have a conversation.”
With that in mind, Arroyo said, health department employees have gone doorto-door speaking with residents about the vaccine and have begun using an app that lets them schedule appointments at the door. Soon, she said, the city hopes to expand that canvassing, to go not only door-to-door but also to grocery stores, laundromats and other places people may congregate.
Mayor Luke Bronin said vaccination efforts would become easier after April 1, when all Connecticut adults are eligible for vaccination.
“When we don’t have to target a specific age group, we can be a lot more aggressive about just showing up to a particular place and getting people vaccinated,”
Bronin said at a March 19 press conference. “It’s one thing to have to identify the eligible, 55-year-old person and get them to the site. It’s another thing to be able to go out and take all comers.”
“Whatever the work we’re doing in our cities right now, it needs to be more.”Max Reiss, spokesperson for Gov. Ned Lamont
Gov. Ned Lamont on Thursday announced $58 million in funding meant to increase access in Connecticut’s most vulnerable communities, with money going toward grants to health departments and community organizations to be used for door-to-door canvassing, outbound calling, mobile clinics and more.
“It is about ensuring access is easily available for everyone who wants a vaccine,” Geballe said. “That will build upon very similar activities that have already been going on in many of these communities: bringing vaccine to churches, to community centers. Going door-to-door, doing outbound calling, reserving appointment slots for people.”
The state has asked vaccine providers to allocate at least a quarter of their vaccine doses to vulnerable towns and cities — a goal some large providers have so far struggled to achieve — but has so far largely delegated the job of closing vaccine disparities to local
officials.
Meanwhile, this summer the state will launch teams to canvass neighborhoods in 10 Connecticut cities, much like a door-to-door political campaign. The effort will be paid for with federal money and run by a Hartford-based firm experienced in running political campaigns. Hesitancy fades
When vaccine distribution began, public officials worried Black and Latino residents may be hesitant to take the vaccine due to distrust in medical institutions bred from past and present-day racism.
But as the rollout has continued, polls have shown decreasing hesitancy among those groups. Arroyo said it hasn’t been a significant issue in Hartford.
“When we speak to people, we’re not necessarily seeing that level of hesitancy,” she said. “We see people that are interested, but the problem is they’re having issues making an appointment. They don’t necessarily have the time to wait on a phone line, they don’t necessarily have the computer skills or literacy, or they feel intimidated by the process of registering.”
When residents do have concerns, Arroyo said, they often just want more information.
“We rarely run into individuals saying ‘There’s no way I’m getting vaccinated,’ ” she said. “It’s more like, ‘I want to learn a little bit more. What are the differences between the vaccines?’ ”
Still, Williams said it’s rational for residents to have questions and fears about the vaccine. The coronavirus has existed for barely a year and the vaccine for just a few months. And not only have Black and Latino Americans experienced medical racism throughout history, they often face disparities in treatment even today.
Williams said this is where local leaders can play an important role.
“One thing that’s very important is for leaders to demonstrate that they are comfortable with the vaccine and that they are getting it,” said Williams, who announced to his congregation last Sunday that he’d received his first dose. “That helps to relieve some of the anxiety, to know that somebody you know has gotten it.”
Cruz, from the Hispanic Health Council, says she still sees plenty of hesitancy — but also plenty of people who only need a nudge. One employee, she said, told her that he didn’t want to get vaccinated out of fear he’d be used “as a guinea pig.” She didn’t tell him to get vaccinated, only that she had gotten her shot and that doing so would help life return to pre-pandemic normal. Just like that, he changed his mind.
“That individual conversation makes the difference,” Cruz said.
A role for hospitals
With the state taking mostly an indirect role in increasing vaccination in Connecticut’s city’s, local officials have turned to hospitals to coordinate their efforts.
In Hartford, St. Francis Hospital operates the vaccine sites at the Parker Memorial Community Center and the South End Wellness Senior Center and has vaccinated public school teachers and staff in the city.
“In opening those two centers, our goal was to bring the vaccine closer to home for some of our most vulnerable populations,” said Tom Burke, president of St. Francis. “It is our responsibility to bring the vaccine into local neighborhoods where people are, to ensure that it’s easy for them and it’s efficient access.”
Hartford HealthCare has set up not only large vaccination sites at the Xfinity Theater and the Connecticut Convention Center but also several dozen temporary sites across the city, which are chosen in coordination with local church leaders, community groups or city officials.
Dr. Jim Cardon, Hartford HealthCare’s chief clinical integration officer, said this effort depends on partnerships with local community leaders, who not only spread word of pop-up clinics but also “can connect us into those communities using their relationships.”
At the Hispanic Health Council site, for example, the community group’s staff provides the patients, while Hartford HealthCare supplies the vaccine. Miguel Reyes, 54, got his first shot Friday morning when he accompanied his wife to her appointment and was told there was an extra dose available for him.
“Everybody was nice. Communication was good. They treated you good,” Reyes said. “I thought they were selling candy or something the way it was here. It was like you won a prize.”
And yet the numbers don’t lie. For all the effort to spread vaccines far and wide, Hartford continues to trail every other city and town in distribution, leaving residents vulnerable to future COVID-19 outbreaks.
That’s evidence, Burke says, that the city needs more resources and more attention.
“We’ve done a lot, but [the data] clearly indicates that we need to do more and we need to think differently and make it even easier for our community to get the vaccine,” Burke said. “So while I think we’ve done an OK job, there’s obviously more to be done.”