New state data revealing town-by-town COVID-19 vaccination coverage shows that the rollout in some areas of Connecticut is happening at a faster rate than in others.
The preliminary numbers confirm what some public health experts and health equity advocates have suspected all along, which is that vulnerable and underserved communities, including Black and brown neighborhoods already suffering high infection and mortality rates, are at risk of falling through the cracks.
“If we’re going to change the way we do business and how we look at health care systems, we have to start thinking about those people who have been left behind in the past in the way of health, that they are serviced,” said state Sen. Marilyn Moore, who represents the city of Bridgeport.
Nearly 460,000 vaccine doses so far have been put into the arms of Connecticut residents and workers, state data show. The focus is now on people 75 years and older and those in congregate living facilities after the vaccination of health care workers.
As surveillance and tracking data comes out, state officials acknowledge early indicators of inequity in the rollout so far. They say it could foreshadow disparities in vaccination coverage by race and ethnicity, which the state has yet to publish data on.
In predominantly white cities and towns such as Wilton, Roxbury, Oxford and Hebron, more than 80% of eligible seniors have had at least their first dose of a vaccine.
But less than one-third of seniors in major cities like Bridgeport, Waterbury and Hartford -- which have majority Black and Hispanic populations -- have received the same.
Meanwhile, Connecticut as a whole is limited to the number of vaccine doses that come into the state every week as nationwide supply remains tight.
“This is a challenge we’re seeing around the country,” said Josh Geballe, the governor’s chief operating officer, “and we have to be very deliberate as a state to bring vaccine to communities that have been underserved and disproportionately impacted by COVID.”
But those on the ground say the state has yet to overcome the barriers to equitable distribution.
Residents Face Multiple Barriers In Accessing Vaccines
City leaders and health experts say it’s not just one thing affecting their vaccination rollouts. In addition to being responsible for vaccinating a larger number of people in general compared to other smaller towns, they say residents in their vulnerable communities are more likely to experience transportation, technology, communication and language barriers.
The state relies on its electronic Vaccine Administration Management System -- or VAMS -- to schedule appointments, and for some, that’s proving to be the first barrier.
“You have to have an email. You have to be technologically savvy,” said Liany Arroyo, director of Hartford’s health department. “It’s likely easier to use a tablet or a computer than doing it on a smartphone. You also have to be able to read and speak English to get through that system and navigate that system.”
Arroyo found that these limitations resulted in people from the suburbs grabbing vaccination appointments in the city’s system at a time when supply is so low, edging out city residents.
Rowena White, spokesperson for the city of Bridgeport, said some of that access can depend on what type of housing situation their residents are in.
For example, older residents living in nursing homes and assisted living facilities have been getting vaccinations on-site through a federal program with CVS and Walgreens since late December. But White said this only represents a small percentage of the city’s eligible population.
“Which means we have more seniors who are individuals on their own who now have to take the responsibility or find someone who will help them with the responsibility of getting onto a VAMS system,” she said.
White said these residents are more likely to also face mobility and transportation issues, making it more difficult or time consuming in getting people vaccinated.
Waterbury Mayor Neil O’Leary said there’s also still a significant amount of vaccine hesitancy among the city’s Black and brown populations that can be linked to past and ongoing experiences of systemic racism.
Others have cited shortfalls in local leadership and planning for these foreseeable issues. In a Jan. 29 letter to Deidre Gifford, state Department of Public Health acting commissioner, Moore wrote about her concerns around Bridgeport’s vaccination plans and the absence of “qualified persons in charge” who lacked education or significant experience in public health.
“I think they are well-intentioned, and I think they are doing the best they can, but that is not enough when you’re talking about the health and well-being of so many Black and brown people in this vaccination,” Moore said.
The senator requested that the state assign a health professional to help lead and oversee COVID-19 vaccination efforts, specifically to ensure that Black and brown residents were getting the information, support and access they needed for vaccines.
“I don’t want people to be discouraged because they have to wait,” Moore said. “And I don’t want the process so convoluted that people who don’t have access to internet, who don’t have a computer, who don’t know how to do all these other things are left behind, because that exasperates the inequities in health and that just creates more health disparities.”
In a Feb. 2 emailed statement to Connecticut Public, DPH did not comment directly on Moore’s request but said it has been in daily communication with local health officials “to support their work and ensure that they have the guidance and resources necessary to carry out the city's critical public health efforts,” including vaccination.
Local Partnerships, Collaborations Filling The Gaps
Benjamin Bechtolsheim, DPH COVID-19 vaccination program director, said during an allocation subcommittee meeting this week that the state is carefully tracking data in order to make improvements on allocation and distribution strategies to benefit areas that need more resources.
He said local and community-based initiatives and collaborations are already in the works to improve vaccine rollout.
In Bridgeport, White said that includes a new partnership with nonprofit Career Resources to create mobile teams that will soon go into apartment complexes and other types of housing where seniors live in order to get them registered for appointments in person.
“We know a lot of our seniors are eligible and may not have the capability to either get on the VAMS website or may not even be able to travel to get there,” she said, “or they just don’t know how to do it, because it’s so complicated.”
To help Hartford seniors claim their appointments, Arroyo cut down the number of slots allotted to the VAMS site, reducing access to more privileged suburban residents. And then, she and her staff contacted city dwellers directly to sign them up.
“We determine if they’re eligible for the vaccine and if they are, then we work with them to schedule them into the clinic days that we know we’re going to hold,” she said.
One of the issues with this approach though, is generating that list of names. SEIU union official Eva Bermudez-Zimmerman has pledged to help -- she’s offered Arroyo a list of union members that includes contact information. Bermudez-Zimmerman represents thousands of local Care4Kids and child care center providers -- many of whom are people of color.
“Race plays the card here,” said Bermudez-Zimmerman. “A lot of the workers do not have access to the technologies that are necessary in order to sign up.”
In Waterbury, O’Leary said officials are taking it a step further. Mobile teams will host pop-up clinics at housing complexes throughout the city and, using portable fridges, will vaccinate seniors where they live.
White said age-eligible residents in Bridgeport can now register and get their first dose of a vaccine on-site in the same visit at a city-operated vaccination clinic on Wednesdays, offering another option for seniors struggling with appointment scheduling.
Bridgeport has also recently distributed more than 7,000 informational cards printed in five languages to community-based organizations in an effort to get to hard-to-reach residents, White said.
Bechtolsheim said cities and towns are collaborating with health providers, local faith leaders, NAACP chapters, housing departments, transportation companies and others in order to get vaccines to people faster and reduce the barriers that many continue to face.
For Marilyn Moore, this patchwork of efforts can’t work fast enough.
“This is a major health crisis we’re in,” she said. “Every day when I see the governor sends over his numbers, there’s some days that I can’t even look at it. I’m afraid to even look at what the deaths are, because those are real people. What is that like when you look at that, when you look at the human part of this?"