The Middletown Press (Middletown, CT)
Study aids outreach to Black and Hispanic residents on vaccination
Griffin Hospital nurse Laurice Masek, left, gives Christopher Graham of New Haven his second dose of the Pfizer vaccine on Oct. 15 on the New Haven Green.
NEW HAVEN — New research conducted in New Haven documents how it takes accurate information and trust built over time to overcome Black and Hispanic residents’ hesitancy to getting vaccinated for COVID-19.
Eight focus groups with 72 city residents, four in English
and four in Spanish, revealed that there is much work to do in order to lower the infection and death rates among people of color, the researchers found.
“There’s so many coalitions here to get people vaccinated, but I do think one of the most important things and what we talked about in the paper is that a lot of this work can’t be done in just a year or two. Building trust doesn’t happen overnight,” said Jessica Ainooson, a research assistant with the Community Alliance for Research and Engagement.
The need is critical, because Black and Hispanic people suffer from COVID at higher rates than whites, according to the Centers for Disease Control and Prevention.
Black people get COVID at about the same rate as whites and Latinos are about twice as likely to contract the virus, but both groups record almost three times as many hospitalizations and twice the number of deaths, the CDC reports.
CARE, which led the research, is a partnership between the Yale School of Public Health, where Ainooson is a student, and the College of Health and Human Services at Southern Connecticut State University.
The members of the focus groups had a lot to say about both past and current mistreatment of
people of color in the health care system, with the Tuskegee syphilis experiments still alive in many people’s memories. But the researchers also heard personal experiences of poor treatment.
According to one participant quoted in the paper: “Black women, when it comes to going to a hospital, it’s a fear. … They’ll tell somebody they know 100 percent what they’re going through and will get it undermined or get their opinion thrown away. … Black voices are regularly not listened to.”
“People just bring up this idea, if I feel like I can’t go to the hospital when I’m sick, because I’m scared of what will happen to me, why should I accept the COVID vaccine from the same people?” Ainooson said. “And I think it was really important ... to really create a space for people to share that.”
The focus groups themselves helped break down barriers and created “a healing space,” she said. “The participants who joined our conversation did a great job in encouraging each other to speak and also letting each other know that they were heard
and that they had similar experiences themselves,” she said.
In addition to distrust, people reported barriers to getting the vaccine, including difficulty in making appointments, getting time off from work, not being fluent in English or concerns they would need health insurance.
“We talked about this idea of the workplace being a facilitator for getting a vaccination and partnerships that employers made [so] people could get the vaccine straight at their jobs,” Ainoosin said. “They don’t have to worry about taking time off … or finding additional child care if they do get a vaccine on a certain day.”
She said it was important to realize that “burdens that we’re experiencing as an overall country might be multiplied based on your racial background or your income level. And I think that’s what this paper is really about and really highlighting disproportionate burden that we’ve seen throughout this whole entire pandemic.”
Bernard Macklin, a vaccination outreach coordinator at CARE, said it’s important to go where people gather and share information. Among the best places are beauty salons and barbershops, he said.
“That’s the best place to have a conversation, and you’re talking about stuff,” Macklin said.
“Some people generate their opinions of those type of conversations, right or wrong,” Macklin said. “… And sometimes if you get one or two people to go in with you, all of a sudden it’s a fact, because one or two people agree with you.”
To counter those kinds of rumors, consistent, accurate information must be delivered by “trusted messengers,” as the researchers called them: family members, clergy, friends, health care workers.
“People who know the community, people who know me, I think that’s the deciding factor that would make me actually want to get it,” said one study participant.
“Other things that our participants shared was the idea of having social support around the vaccine process from signing up at the beginning to actually going in and getting your vaccine, being able to have a family member with you or someone by your side,” said Dr. Lily Balasuriya, a psychiatrist at the Yale School of Medicine who is a member of the National Clinician Scholars Program and lead author of the paper.
“Another key thing our participants shared was the ability to have choice,”
Balasuriya said. “Our participants shared that it was so meaningful and valuable to be able to choose which vaccine manufacturer you wanted or choose which day you wanted to get vaccinated, or even choosing which lane or chair you were going to get to sit in when you were vaccinated. Those were so, so important.”
Finally, she said, focus group participants said diversity at the vaccination site gave them confidence. “It meant a lot to them to see people who look like them, but also see their health care providers, see people from different walks of New Haven, all present there working together to get vaccinated,” she said.
The researchers said it is just as important for public health workers to learn from those they are reaching out to in order to be more effective.
“I think our big takehome message was that community-informed insights have to inform the health care strategies that we use to maximize vaccine access and acceptance in the communities that have been hardest hit by the pandemic and moving forward in all that we do,” Balasuriya said.
“We want to make sure that we are working together and partnering with our communities.”
Those partners include Yale New Haven Health, Cornell Scott Hill Health Center, Fair Haven Community Health Care and the New Haven Health
Department.
“These partnerships need to continue beyond just the COVID-19 vaccine and that will make it easier for the next time,” Ainooson said.
“It doesn’t have to be a global pandemic and hopefully it won’t be, but just thinking about how relations can improve between like the health care system and New Haven residents on a general basis. … I think it’s really important to emphasize that there’s a lot of work left to be done and this is only the beginning,” Ainooson said.
In the end, CARE Director Alycia Santilli said the research affirmed CARE’s approach since its beginnings in 2007: “the importance of community involvement in any public health interventions that are being led in the community, and ensuring that the work that we do and the people who are leading the work that we do is reflective of the communities that we work in,” she said.
A website has been set up, vaccinatenhv.org, that lists locations and times when COVID vaccines are available. Also, clinics have been taking place on the New Haven Green from 10 a.m. to 4 p.m. Fridays, Saturdays and Sundays and 11 a.m. to 5 p.m. near the Long Wharf food trucks Saturdays and Sundays.