As the COVID-19 vaccine rollout began, Jewelean Jackson, 72, sought reassurance from Dr. Chris Reif, his longtime physician at the local Community-University Health Care Center in South Minneapolis.
Could he trust her? What would you say to your fellow black neighbors when they asked if it was safe?
Similarly, doctors sought her out for information on how they could help instill confidence in vaccines in communities of color.
“I had the second vaccine today and Dr. Reif gave it, so it was special,” Jackson, a certified community health educator, said Friday.
More than 80% of the clinic’s patients are black, Indian or other people of color, said the clinic’s executive director, Colleen McDonald Diouf. Many have chronic illnesses, such as diabetes and hypertension, need language assistance, or are homeless. A couple of years ago, the largest homeless camp in town was right across the street.
All of those factors combined, the center’s patients are especially vulnerable to contracting and experiencing complications from COVID-19, making the clinic an anchor for patients amid the pandemic.
It is a family history at federally qualified health centers, commonly known as community health centers, throughout the country. Designated clinics provide health care to underserved communities, and with people of color continuing to suffer disproportionately from the virus, the centers could be essential in vaccinating the worst-affected populations, experts say.
Nationwide, community health centers serve about 30 million patients. Two-thirds of them live in poverty or below it, and half are racial or ethnic minorities. Most are uninsured or have Medicaid.
As part of its plan to improve the equitable distribution of vaccines, Biden’s administration targets community health centers as distribution centers.
Dr. Marcella Nunez-Smith, chair of the COVID-19 Health Equity Task Force, announced earlier this month that the administration would begin shipping doses to 250 centers, at least one in each state or territory.
Initially, the effort would focus on health facilities that serve specific populations, including migrant workers, agricultural workers, people with limited English proficiency, residents of public housing complexes, and the homeless, Nunez said. Smith. The administration recently published a list of the clinics.
As hesitation, fears and rumors surrounding the vaccine multiply in communities, Jackson, a former chair of the committee at the center, has been having conversations with friends and family to help dispel the myths.
When she received a vaccination, other African American older adults in her book club said she was “crazy.” His 31-year-old daughter, skeptical of the vaccine she took, was terrified when she found out that her mother took it. “I want you to live a long life,” Jackson told him.
Jackson said community health centers are essential for communities like his, with a history of medical injustice and lack of access to healthcare.
“This system still doesn’t work for us the way it should,” Jackson said. “That’s why, when you think about all of that, the Community Healthcare Center and the university literally walk on water.”
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‘We don’t have enough’
Many health centers are experiencing unique challenges in providing care to their underserved patients during the pandemic.
A report from the National Association of Community Health Centers found that health centers reported delayed coronavirus test results, a lack of personal protective equipment, and significant staff shortages – challenges that, according to the advocacy group for the medical attention is expected to increase.
“After taking into account the estimated costs related to vaccines, the total financial impact on health facilities through June 2021 is estimated to be $ 13.5 billion,” said another report from the advocacy group, echoing from one of the Kaiser Family Foundation.
In December, Congress passed a bipartisan coronavirus relief bill that included $ 4 billion reauthorized to the Community Health Center Program. The bill became law during the final days of the Trump administration. President Joe Biden has asked Congress to allocate more money to support health centers.
The Southeastern Mississippi Rural Health Initiative clinic staff are eager to receive the additional allocation. They need more doses of vaccine.
Operations Director Janice Robinson said that across the network’s 17 community health centers, there are 3,000 to 4,000 patients on waiting lists for vaccines.
“We don’t have enough,” Robinson said. “This will definitely make a change.”
‘It’s life or death’: Non-English speakers have a hard time getting the COVID-19 vaccine in the US.
The mission of the network is to help control chronic diseases in the state, where half the population is black. The state suffers from the highest prevalence of obesity in the nation, and blacks suffer from it and other health problems disproportionately.
Since the start of the pandemic, the network has struggled to make sure that patients receive the preventative care and regular appointments they desperately need. While hospitals and primary care clinics relied on telehealth for virtual appointments amid social distancing, many rural Mississippians lack broadband access, Robinson said.
While Biden’s new plan allocates more vaccines to these underserved communities, there are staff shortages and other logistical challenges. About 39% of the healthcare facilities surveyed, for example, said staff shortages are a barrier to administering a vaccine, according to a weekly report from the Health Resources and Services Administration.
Robinson cited the same challenges. “Having enough staff to manage everything” is a problem, he said. Holding hard-to-fill, high-paying jobs like nursing positions is difficult during periods of low patient volume and declining income.
The initiative provides transportation services for patients in sparsely populated rural areas, but new options had to be added during the pandemic, Robinson said. As transmission rates increased, carpooling with some patients was no longer safe.
“Trying to find them where they are so that we can continue to serve them the best we can in the midst of the pandemic … bring its own set of challenges,” said Robinson, who has been with the network for more than a decade. “We have had to increase our transportation services to make sure they can make their appointments and receive the care they need.”
Transportation will be essential for the administration of the vaccine to those communities. “For many of our patients, we are all they have,” added Robinson. “If we weren’t there, some people would have nowhere to go.”
Dr. Heather Leisy treats patients at Hope Health in Florence, South Carolina. About 43% of Florence’s residents are black, and the state also suffers from a high rate of obesity and other health disparities.
Leisy also cited a shortage of nurses amid a surge in testing during the surge in COVID-19 cases.
“We don’t want to stop the normal workflow, but we also have these additional job tasks, like testing or administering the vaccine, and that’s a very specialized team,” he said. “There has been a shortage of nurses… they are being hired at very high hourly rates. That has been a difficulty, but I think that happens in (all) health centers. “
Trusted physicians allay vaccine fears
Back at the Community-University Health Care Center in South Minneapolis, Diouf says that many of the center’s patients live in multi-generational households in the diverse area of Somali refugees and other large ethnic groups.
With that in mind, health center leaders advocated lowering the minimum age requirement to receive the vaccine. The state recently lowered the age limit to 50.
The staff has worked to build trust with the community for years. During the most difficult times, it has paid off, especially in the fight against doubts about vaccines. The medical staff is diverse and multilingual, helping to provide care, dispel myths, and answer questions about the vaccine.
“There’s a lot of misinformation – they want the right information,” said Dr. Roli Dwivedi, chief clinical director.
She recalled a patient who made an appointment with her just to discuss her fears about the vaccine and ask questions. “She wanted to know about me. I wanted to process those feelings, to hear that there are no genetic modifications, that there is no fetal tissue in this vaccine, “Dwivedi said.
Another patient who has various health conditions and is on dialysis three times a week told her: “‘I’m only going to get the COVID vaccine if you’re in this room and you can watch me.”
Now, Dwivedi says he tells all vaccinated patients: “You have the vaccine, now you are a leader. Go out there and talk to your friends and family and share your experience so they know that we need 65% to 70%.” % of people who get vaccinated before we can be safe. “
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This article originally appeared on USA TODAY: COVID Vaccine: Low-income Clinics Prepare for Extra Doses