New York was one of the cities hit hardest by COVID-19 and one of the first to scale a comprehensive response to the pandemic. We led a difficult but necessary reduction of local business activity and “normal” life. Almost a year later, tens of thousands of New Yorkers are receiving their Coronavirus vaccine jabs daily.
Amid ongoing federal and state-level vaccination campaigns, NYC has made steady progress in the last four months, with 30 % of the entire city’s population fully vaccinated. But there is still a lot to do to ensure vaccination efforts are far-reaching and equitable.
Current inequities include the misuse or disproportionate use of vaccine allocations by non-Black and non-Hispanic Americans; the digital access divide, where lower-income communities have reduced ability to easily book a vaccine appointment online; and a lack of vaccination hubs planned in communities primarily of color.
Programming and efforts to engage communities directly are a winning formula, reaching precisely those average New Yorkers that the government alone cannot. We spoke with community leaders from across the city about what’s working and where more attention is needed.
Problems of access that existed in the city at the top of the pandemic reappeared as vaccination commenced. “Many immigrant communities are not well-off and struggle with the idea of taking a day off to get vaccinated,” says Sheikh Faiyaz Jaffer, a chaplain at New York University serving its Islamic Center. The Sheikh also highlights a distrust in government that is not unique to Muslim communities in the city.
“Many immigrant communities are not well-off and struggle with the idea of taking a day off to get vaccinated”
Councilwoman Adrienne Adams represents New York City Council District 28 in Southeast Queens, which includes some of the city’s hardest-hit neighborhoods such as Jamaica, Richmond Hill, and South Ozone. The Councilwoman points to a trend of after-the-fact response to community need for resource allocation. “It’s been an issue for many communities of color, I would daresay across the country, to get attention. Across East Queens, it began with a lack of testing sites. Just like with testing last year, we now have ‘vaccination deserts.’”
Councilwoman Adams shares a tapestry of community-led efforts that are driving vaccine education and improving access in her district, “Hosting community forums on the vaccine in Bangla, launching PSAs on YouTube and social media, having a gurudwara [Sikh house of worship] host vaccine drives. We have really wonderful partners and it was critical to maintain these contacts, especially around language access, to help us debunk vaccine myths.”
Across the East River, before the impact of COVID-19 had been widely felt by the city, the Bronx Rising Initiative was one of few organizations articulating a vision for rapid pandemic response. The Initiative raised $3 million from March 13-17, 2020, a fundraising effort that increased ICU bed capacity in the Bronx by 30%. The Initiative’s founder and longtime community organizer, Tomas Ramos, knew that because of poverty, existing health issues, and high density, addressing the unique challenges that the pandemic posed to his Bronx community was non-negotiable.
A year later, the Bronx Rising Initiative zeroed in to increase vaccination capacity for small clinics, partnering with the Morris Heights Health Center to fund several locations across the borough. The Initiative also began organizing pop-up vaccination sites in senior centers, community centers, and public housing in January and has now launched a vaccination campaign for homebound elderly and disabled New Yorkers.
Recently, the New York Times highlighted a concerning trend in vaccine inequity, such as an under-vaccination of Latino Americans across the US in proportion to their percentage of the general population..
In speaking about barriers to getting a critical mass vaccinated, Ramos points to two separate issues. The first is vaccine hesitancy, often accompanied by a mistrust of government. “We started knocking on doors in January. There have been times that we spoke with people who are hesitant. Even if they are not sure, I left my card and our pamphlet. ‘If you change your mind, call us,’” Ramos says.
While taking on “vaccine hesitancy” is now a mainstream strategy, “there’s another issue that people are not talking about,” Ramos stresses, “That’s the economic issue. We don’t have the financial resources to hire more per-diem nurses to do 1.5 million vaccines.”
Part of this vaccine access dilemma is that the city and the state have only partnered with hospitals and clinics. “They haven’t partnered with people on the ground, grassroots organizations like us who know and have been serving communities forever.” Ramos points to the success of the partnership with the Morris Heights Health Center clinics as a way forward, a model that can be replicated by other grassroots organizations in the city and beyond.
“That’s the economic issue. We don’t have the financial resources to hire more per-diem nurses to do 1.5 million vaccines.”
“The biggest takeaway is that this needs to be a ground-up effort. For a lot of the clients we serve, ‘the news’ wasn’t reaching them,” says Anya Herasme, who directs ten senior centers and one residence for older adults in the Bronx. “The first day [of vaccination] at one of the senior centers, people came who were not interested, and they were able to speak to a doctor and ask questions. A doctor who speaks in their language or ‘gets them’ — a real person — makes a real difference.”
Opacity around eligibility requirements made it difficult to vaccinate efficiently from the start. While the vaccination rollout was “all well-meaning,” Herasme explains, “when you leave it up to the states… that was a mess. Asking governors who are not scientists to decide who is eligible first — that is not the appropriate role.”
The lack of a feedback loop between communities and decision-makers also meant that critical COVID hotspots were not given immediate attention. “We’ve had an extremely hard time in worst-hit neighborhoods, like Corona [Queens].”
In addressing communication barriers and increasing community confidence about vaccination, common sense abounds.
Herasme offers a simple solution: “There’s no effort I’m aware of to train older adults to be a peer leader or advocate. When people see their peers doing it [getting a vaccine], they feel a little more confident. Older adults want to advocate, but don’t know who to go to.”
“Everybody gets mail,” says Councilwoman Adams, “There should be more effort by way of mailers, in multiple languages, spelling out locations and the urgency of why vaccination matters.”
For the student communities Sheikh Faiyaz works with, online models of engagement have been very successful. While Sheikh concedes that this isn’t a replacement for face-to-face community interactions, they have opened the Islamic Center’s “doors” to more people and are effective in providing education around vaccines. “The Islamic Center’s email listserv goes out to over 13,000 community members and our reach on social media amounts to thousands more, where some of our video content has reached over a million hits.”
For a city of over eight million, vaccinating as many New Yorkers as possible (and quickly) is the clearest path to restoring the city’s economic vitality.
For a city of over eight million, vaccinating as many New Yorkers as possible (and quickly) is the clearest path to restoring the city’s economic vitality. Vaccination is how we dodge the same public health convulsions that locked us down last March. It’s the best way we can look out for ourselves, our loved ones, and our communities.
From Ramos’ long-term community projects to address food insecurity to East Queens’ grassroots organizers in Adams’ district tackling significant language barriers during the 2020 Census, communities trust the faces and names that are most familiar to them. Across New York, these experiences demonstrate how communities can secure essential resources and marshal momentum “without bureaucracy or red tape,” as Ramos puts it.