Believing that Philadelphia's COVID-19 vaccine rollout process has not prioritized the needs of marginalized communities, local community leaders are leading efforts to provide greater vaccine accessibility and information about the vaccines to combat racial disparities in the rollout process.
Since its first vaccination on Dec. 16, 2020, the City of Philadelphia has fully vaccinated 203,824 of its residents as of March 27. Evidence, however, shows a widening racial gap. Between March 15 and March 21, white residents made up 27.3% of vaccinations, while Black residents made up 14.1%, despite being 44% of the Philadelphia population.
Penn experts believe that distrust in vaccines is a contributing factor, as well as a lack of accessibility to vaccines and information on them — issues that local faith leaders and nonprofits are looking to combat by creating vaccine clinics within their communities.
Racial inequalities in Philadelphia's vaccine rollout
While the Philadelphia Department of Public Health prioritizes getting the vaccines out quickly and in a way that saves the most lives, a PDPH spokesperson, who requested anonymity, wrote in an email to The Daily Pennsylvanian that it is also the department's priority to distribute vaccines in a way that is racially equitable.
PDPH spokesperson James Garrow previously told The Daily Pennsylvanian that Philadelphia's decision to begin allowing walk-ins on March 17 at the Federal Emergency Management Agency-run site in the Pennsylvania Convention Center in Center City displayed signs of early success in improving the racial equity of the city's COVID-19 vaccine distribution.
According to the anonymous PDPH spokesperson, beyond the 150 vaccination sites available around the city — located in hospitals, federally qualified health centers, and pharmacies — the city is working to set up city-run mass vaccination sites in order to vaccinate more residents and help close the racial gap in vaccinations.
In addition, the spokesperson wrote to the DP that the city will soon be launching a media campaign that will “highlight medical providers from communities of color and purchasing ad space in community and ethnic news outlets” in order to communicate with communities of color.
Philadelphia is not the only city that has seen a racial gap at its vaccination sites. Despite Black, Hispanic, and Native American citizens dying at about three times the rate of white citizens, they are being vaccinated at lower rates in at least 38 states nationwide.
Ezelle Sanford III, a postdoctoral fellow in Penn's Program on Race, Science, and Society, said that racial inequalities in terms of vaccine rollout have also been reflected in COVID-19 rates of infection and outcomes, which Sanford believes is a result of a larger foundation of racial inequality.
Sanford said that because of Black communities' past experiences with medical studies — such as the Tuskegee Experiment, in which Black men with syphilis were misled into participating and were not given adequate treatment for the disease — the Black community has been wary of getting the vaccine.
“While addressing medical mistrust is important, we have to understand that it’s been centuries long in the making,” Sanford said, adding that this distrust of medicine is still present among marginalized populations as a result of the American medical system's failure to treat their needs.
“We understood that COVID-19 was ravaging communities of color — Black communities, Indigenous communities, Latinx communities — those should have been the groups that were prioritized,” Sanford said about the nation's vaccine rollout process. “I want the structural accessibility of vaccines to be the primary concern, rather than blaming communities of color for their distrust.”
Sanford added that one barrier to vaccination has been the distribution of vaccines in more white, affluent areas as opposed to in working-class communities and communities of color that have borne the brunt of the pandemic's effects.
Finding ways to build vaccine trust and access among marginalized community members
Community leaders have been leading public initiatives and partnering with organizations in efforts to rebuild Black residents' trust in the medical community and encourage vaccinations.
On Jan. 22, Father Martini Shaw, the rector at the African Episcopal Church of St. Thomas in Philadelphia, received the COVID-19 vaccine in a filmed media event in order to ease any discomfort in his community regarding the vaccine.
“My being vaccinated was hopefully to communicate to communities of color the importance of the vaccine, as well as the efficacy and safety of the vaccine,” he said in an interview with the DP. “Clergy are held to a certain standard within communities of color, and seeing a clergyperson receive the vaccine did relieve some of the hesitancy and fear that some may have been experiencing at the time.”
Shaw said that Black residents have become more comfortable with getting vaccinated after he explained to them the science involved behind vaccine development and reassured community members that Black scientists, such as Kizzmekia Corbett — an immunologist at the National Institutes of Health — have been at the forefront of vaccine research and development.
Shaw added that the city's racial health disparities that have been exacerbated by COVID-19, like the rising death rate in his own community, served as motivation to partner with Lankenau Medical Center to begin administering vaccines to the West Philadelphia community at St. Thomas beginning in early February.
Lankenau Medical Center President Phillip Robinson said in an interview with the DP that vaccine equity was a top concern for him and his staff.
“When we started getting access to vaccines, we decided to set aside a portion of what we got to dedicate to the Black and brown community — to the people who have been most impacted by COVID-19,” he said.
In addition to setting up vaccine clinics in churches like St. Thomas, Robinson said that Lankenau has also held seminars, educating community members about the importance of getting vaccinated, as well as addressing any concerns they might have. As of March 19, Lankenau vaccinated about 2,400 West Philadelphians.
Shaw said that making the church a vaccination site was significant because it would provide people a greater feeling of comfort than a hospital or medical center.
Agreeing with Father Shaw, Sanford said that the position of churches within communities of color and the implementation of vaccine clinics in places such as St. Thomas aid in alleviating the structural barriers to vaccine accessibility.
“We can’t forget about the local leaders and institutions. When you prioritize the local, that’s a more direct connection to the people you want to target in terms of making the vaccine available,” Sanford said.
Nicole Brown, a licensed practical nurse at Penn Medicine's Helen O. Dickens Center for Women, stated that, in addition to the history of racism in the medical field, Black residents may be fearful of the vaccine because they have received less information about the vaccine development and rollout process compared to other populations.
Brown, who lives in a predominantly white neighborhood, said that vaccination information is shared a lot more in her own neighborhood than it is in Black neighborhoods.
“[In a neighborhood blog], all the time, the vaccines come up,” Brown said. “They are constantly sharing where to get a vaccine, what links to go to, which supermarkets, or pharmacies, or local community centers — people are constantly sharing information.”
Brown stressed that more discussions about how to get vaccines and the effectiveness of vaccines are needed to alleviate vaccine-related fears in the Black community.
“It’s okay for you not to want to take the vaccine, but continue to read about it, continue to watch the news and see what the statistics are,” she said, adding that people who do not take the vaccine should not discourage others from taking it.
Prioritizing the city's most at-risk populations, including those facing homelessness and those who are incarcerated
According to the Centers for Disease Control and Prevention, individuals experiencing homelessness are some of the most at-risk people in terms of COVID-19 vulnerability. Because only a few states have started vaccinating homeless populations, some nonprofit organizations have made it an effort to prioritize vaccinating people experiencing homelessness.
In Philadelphia, a nonprofit organization called Project Home — which provides housing, medical care, education, and opportunities for employment to Philadelphians experiencing homelessness — has begun vaccinating individuals experiencing homelessness.
Monica McCurdy, the vice president for health care services at Project Home, supervises the organization's two vaccine clinics, one of which is located in the Hub of Hope under Suburban Station — which serves as a place where individuals experiencing homelessness can grab a cup of coffee, take a shower and wash laundry, or talk to experts about finding a permanent home. The Hub, which served as a COVID-19 testing facility throughout the first months of the pandemic, was quickly converted in February to become a vaccine clinic.
In a matter of weeks, the team at Project Home had to find enough staff to start administering vaccines, relying on retired nurses, former employees, and nursing volunteers from local colleges.
Although the organization has been able to overcome its lack of initial labor infrastructure, McCurdy said it has had to tackle the health care industry’s long history of breaching the trust of marginalized communities.
“The medical system has done a poor job of building trust,” she said. “People are saying they don’t trust the vaccine yet because the medical system hasn’t done a good job of trying to build that trust.”
In order to rebuild this trust, Project Home has held weekly town hall meetings for both staff and residents, giving out information about the vaccine, as well as accessibility.
“We try to communicate in those town halls a message of acceptance — of recognition, that it’s okay if you don’t want to take the vaccine. It’s totally understandable if you’re skeptical, and we accept where you’re at, and there’s no judgment — but at the same time, here’s some information based on the science as it’s known now about the vaccine," McCurdy said.
Another vulnerable community in need of vaccines are people who are incarcerated.
Despite the CDC recommending that all 50 states prioritize people who are incarcerated in their vaccine rollout plans, the outcomes of vaccinations vary from state to state. In Pennsylvania, three out of 23 of its prisons have offered vaccines to their staff and inmates, and at two of the facilities, over 70% of the inmates have been vaccinated.
According to Shawn Hawes, a media relations worker at Philadelphia's Department of Prisons, the city is equitably distributing vaccines to people who are incarcerated as they volunteer to receive the vaccine.
In addition, Hawes stated that the department has been following all CDC guidelines “for safety in congregate settings, including social distancing, constant sanitation, and wearing PPE" while administering the vaccine in the city's prisons.
As of March 28, 2021, there have been 284 symptomatic cases and 1,165 asymptomatic cases of COVID-19 in Philadelphia's prisons.
Shaw emphasized his mission to improve the health of his community, and to help people remain optimistic when the pandemic seems so bleak.
“We will continue our efforts as long as there is the need — as long as there is a pandemic,” Shaw said. “We will be better as people than we were a year ago. We will come out stronger and more knowledgeable, more loving, more caring, more compassionate than we were a year ago.”