New Haven Register (New Haven, CT)
Analysis: Higher income can mean more vaccinations
Almost two years into an earthshattering pandemic, so much has changed, and so much hasn’t.
Nearly 70 percent of Nutmeggers are fully vaccinated against COVID-19, but that leaves more than 1,00,000 residents left to vaccinate. And like with all aspects of life, some pockets of the state are doing much better than others.
Analysis from Hearst Connecticut Media Group shows that, among the 13 largest cities in the state — all with a population around or greater than 60,000 — median household income is a powerful predictor of how many people in a given community are vaccinated, even within communities with significant marginalized populations.
However, the same cannot be said statewide. When considering all 169 Connecticut municipalities, the relationship between income — or any other indicator of socioeconomic strain — and vaccination levels becomes more arbitrary.
Though vaccination rates trend higher in large, affluent communities, most municipalities didn’t dip into their coffers to fund their vaccination programs. Instead, they relied extensively on grants from the state and federal government, and despite the vast difference between different towns, all municipalities took remarkably similar approaches. Regardless of uptake among residents, almost every community heralds the benefits of targeting vulnerable communities, using trusted messengers and answering as many questions as possible.
Mayor David Martin of Stamford has spent the last several months touting the city’s successful vaccine program, and for a good reason. Of the large and diverse communities in the state, he’s said for weeks, Stamford has the highest vaccination rate.
“In fact,” he quipped during a recent coronavirus update, “... we actually have a higher vaccination rate than either Greenwich or Fairfield, which is really quite astounding given that those communities are (of ) higher socioeconomic (status) and not as diverse.”
As of Oct. 6, 78 percent of people in Stamford have received at least one vaccine dose. Just under 70 percent of residents are fully inoculated, according to the state’s numbers. As per Hearst’s analysis, only West Hartford, a town with less than half of Stamford’s population, had a higher percentage of fully vaccinated residents. Out of the 13 towns evaluated, it had the fourth-highest jump in vaccination from June 2 to Oct. 6, clocking in at 17.5 percent.
Hearst’s analysis showed that Greenwich and Fairfield are clear outliers among the baker’s dozen of the state’s biggest cities. Though the two towns have some of the highest median household incomes in the state — $152,577 and $139,122 respectively — their vaccination rates lag behind Norwalk, Stamford and West Hartford.
The successes in Stamford are no accident, Jennifer Smith — manager of community vaccination initiatives for Family Centers — told Hearst. Family Centers worked closely with the mayor’s office to implement its vaccination strategy. Smith managed Family Centers’ community health workers, an army of canvassers and healthcare professionals who help educate and vaccinate residents without a shot.
Community health workers are not unique to Connecticut’s secondbiggest city. Aside from Stamford, Norwalk, Hartford, New Haven, and Bridgeport all use similar tactics.
Deploying community health workers in communities with lower vaccination rates was central to the Stamford strategy, according to Smith. So was consistency.
“Beginning back in mid-May, we put this team of community health workers in the community knocking on doors, going through these neighborhoods once or twice a month over the course of four months,” she said. “We were doorknocking every house that we needed to go back to at least once a month. People then also saw us at the neighborhood park, or they saw us at the corner store or at the laundromat earlier in the day, or they saw us at the park on the weekend.”
In Danbury, the health department received a $970,000 grant to work with community organizations to bring vaccines directly to hard-to-reach communities.
Across all of Connecticut, 27 municipalities received grants from Gov. Ned Lamont, first announced in May, to promote vaccine equity through community partnerships. Danbury, for example, set up vaccine distribution and education sessions at supermarkets, parks and other locations.
“That was very effective in getting people vaccinated, bringing the vaccine to where people are going in their normal, everyday lives,” said Kara Prunty, Danbury’s health director. Since June 6, Danbury’s vaccination rate has jumped by about 19.5 percent, one of the biggest gains in Hearst’s analysis.
Working with churches and civic organizations was also effective because the public trusted them, she said.
“Sometimes the best way to spread the word about vaccines is listening to your peer groups,” Prunty said. “If your friends are vaccinated and they had no issues with it, then you’re more likely to trust someone who you have a relationship with.”
Danbury has tried to convince those who are hesitant by having nurses and health care professionals available to answer questions. They focus on the facts.
Across the state in Middletown, which has vaccinated 69 percent of people fully, the “trusted messengers” strategy served a central purpose too. The city used its state grant money to contract COVID counselors to make house calls “in vulnerable communities to address questions and concerns that people have about COVID and vaccines.”
“It has been very successful,” Acting Health Director Kevin Elak saisd. “I think people appreciate the one-on-one conversations with someone that can provide them with facts.”
New Haven, where the vaccination rate is lower, coupled its community health worker initiatives with near-constant pop-up clinics, which served as another common thread among all the towns’ pushes. New Haven Health Director Maritza Bond said, with its community partner Griffin Health, the city Department of Health hosted 550 pop-up vaccine clinics during the drive to get more shots in arms.
“We have noticed that canvassing efforts work well when coupled with a vaccine clinic happening simultaneously in the neighborhood,” Bond wrote in an email. “We’ve also seen a positive impact in the community when we pair up canvassing with fun events which include not only vaccines, but other things like health screenings, resource tables, car seat information, incentives, free food, popcorn, (or a) live DJ.”
Norwalk Director of Communication Josh Morgan told Hearst the city’s Health Department saw a similar positive impact after holding community clinics “in locations where people felt comfortable,” like churches and libraries. Norwalk, like Stamford, has fared well in getting more shots in arms. Nearly 69 percent of people in the city have both shots, and the vaccination rate jumped more than 17 percent in four months.
“Many clinic locations have been consistent,” Morgan added, “And by using the data, we were also able to identify locations where pop-up vaccine clinics would be effective.”
Smith from Family Centers put equal value on consistent clinic locations. Stamford’s Director of Health Jody Bishop-Pullan called it the “pick-and-stick” model.
“If you’re just there for a day, people might not be quite ready or they don’t have time that day or they’re afraid,” she said. Staying for a week or a month or a summer gave the community health workers more credibility, she said.
“People kind of recognize us, and that builds some trust over time,” Smith added.
For the Elm City, ensuring that residents trusted the COVID shot has presented the most constant hurdle, according to Bond. New Haven has spent considerable resources drafting vaccine factsheets, booster and mask messaging, vaccine FAQs, and COVID myth-busting blurbs.
More recently, the city embarked on a “vaccine influencer” campaign in an attempt to get younger residents vaccinated.
All in all, Bond said these efforts have “helped tremendously” in terms of New Haven’s overall vaccination rate. State data shows that 62 percent of residents were partially vaccinated; just under 57 percent of people overall are fully vaccinated.
Though most large cities have made gains in the last few months, they all say there’s more to be done. The Connecticut Department of Health allowed municipalities to extend their vaccine equity initiatives through December.
For many towns, that means more outreach and more pop-up clinics. The end goal, of course, if to get everybody vaccinated.
“I think you will probably always have a small percentage that we’re not able to get for some reason,” Bishop-Pullan from Stamford said. After a pause, some hope kicked in: “But, I think for the most part we could encourage most people to.”
“There are still people out there who are willing to have the conversation,” Director Prunty said. “I try to be optimistic.”