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HARRISBURG — As restrictions on daily life during the pandemic are lifted, fewer people wear masks, and mass vaccination clinics scale back due to decreased demand, the same communities in Pennsylvania disproportionately harmed by the coronavirus are still more at risk.
About 73% of people who have received at least one dose of a COVID-19 vaccine in the state outside of Philadelphia are white, while 4% are Black and 4% are Hispanic.
While it’s impossible to precisely compare population numbers to state vaccine data — 398,000 non-residents are included in the count — a Spotlight PA analysis shows a significant equity gap in vaccinations persists six months into the rollout.
Philadelphia, where the local health department is handling the vaccination effort, is seeing a similar disparity for its Black and Hispanic populations.
Experts said communities of color — especially among those whose work requires manual labor or contact with other people — continue to be threatened by COVID-19 outbreaks as their white neighbors stop wearing masks and return to life as usual.
“We’ll have a population with much lower vaccination rates and much higher exposures, so that’s going to be a very worrisome picture,” said Dr. Usama Bilal, an assistant professor in epidemiology and biostatistics at Drexel University.
Since the start of the pandemic last year, the Wolf administration has faced criticism for not prioritizing specialized approaches to reach communities of color and non-English speakers, and instead being reactionary after programs and efforts were already launched.
For example, the state did not initially include Spanish translations for daily coronavirus updates and for resources like rental assistance. Gaps in the collection of race and ethnicity data about infections and administered vaccines persist, and will probably never be fully corrected.
Even as the vaccine rollout ramped up earlier this year, Spotlight PA reported that the state did not have plans for targeted outreach in communities that do not speak English.
Organizers and community groups said they are facing the same barriers in these communities that were apparent from the start — language, transportation, a general lack of health care, and inadequate education and public awareness about vaccines and safety.
In April, the Wolf administration acknowledged the disparity in vaccinations and hired Latino Connection, a Harrisburg-based marketing agency, with a $1.8 million grant to work on closing the gap. Latino Connection partners with community groups throughout the state to set up day-long, mobile vaccination clinics — often in an easily accessible location like a shopping center, church, or at a community event — to inform people about vaccines and get them signed up for appointments.
“It’s like starting from scratch,” George Fernandez, the CEO and founder of Latino Connection, told Spotlight PA last week. “It’s like starting in October of last year.”
Calling the partnership part of a recent “hesitancy campaign,” Acting Health Secretary Alison Beam said during a news conference last week that the state was leaning on community-based organizations to reach more people of color.
“I think we all know that we still have work to do to make sure more Pennsylvanians are vaccinated across all of our communities, but particularly those that might have less access to health care traditionally,” Beam said.
Of the more than 6 million people who had received at least one vaccine dose as of May 21, just 4.3% identified as Black, state data, which does not include Philadelphia, showed.
Pennsylvanians who identify as Black or African American and do not live in Philadelphia make up nearly 7% of Pennsylvania’s population, according to the U.S. Census Bureau.
The same trend holds for Hispanic people, who accounted for 3.9% of those at least partially vaccinated but about 6% of the state population outside of Philadelphia.
Roughly half a percent of all vaccines were given to those who identified as Asian or Pacific Islander, despite making up nearly 3% of the population. About 1.3 million people were listed as Native American, unknown, or multiple races in the state’s vaccine data.
Vaccination trends are similar in Philadelphia, which is running its own program and tallying data separately from the 66 counties under the state health department’s jurisdiction.
As of May 24, 46% of the nearly 880,000 people who had received at least one dose in Philadelphia were white, local health department data showed. Residents of the city are 40% white.
About 25% of those vaccinated identified as Black and almost 10% as Hispanic. Black people represent 42% of the city’s population, while Hispanic people make up about 14%.
Nearly 12% of partially vaccinated people were Asian, and 7% of Philadelphia’s population is Asian.
Asked what the Wolf administration was doing to support additional outreach to communities of color or the work of community organizations, a spokesperson for the health department reiterated the partnership with Latino Connection.
Pressed for details of any other initiatives, the department noted it has also supported vaccinations for farm and agriculture workers, as well as teachers.
The department has held several targeted outreach clinics. Back when vaccines were scarce in January and February, it supported events in rural areas without health-care systems for people who qualified for the vaccine in the state’s Phase 1A. One such clinic in Sullivan County was well attended and vaccinated 500 people.
In March and early April, the state used a portion of its allocation of the Johnson & Johnson vaccine to vaccinate more than 112,000 teachers and school staff throughout the state.
But both of those efforts focused on predominantly white populations. According to a 2020 study by the Philadelphia-based education advocacy group Research for Action, 94% of Pennsylvania’s district and charter school teachers are white.
About 91% of rural Pennsylvanians are white, census data compiled by the Center for Rural Pennsylvania showed, and about 95% of Sullivan County’s 6,135 residents are white.
Stretched thin
Without substantial resources focused on improving vaccine equity from the Wolf administration, groups like Latino Connection and other, smaller grassroots and community organizations have been straining to fill the gap, while meeting myriad other needs exacerbated by the pandemic.
Since launching its partnership program with the state, Latino Connection had held 25 clinics as of May 19, distributing 4,507 vaccines.
Fernandez, the CEO and founder, said he estimated that about half of those vaccinated at clinics hosted by Latino Connection so far were Hispanic and about 30% were African American, with smaller numbers of Asian, Arabic, Nepalese, and rural white residents.
People of color are not rushing to Latino Connection’s clinics, Fernandez said, because there remains a lack of resources and education around vaccines. Educating people about the vaccine and helping them navigate the logistics of getting signed up — whether it’s bringing a vaccine to a homebound person or helping them find transportation to a clinic — takes time.
And for many local organizations that work with communities of color, they have extremely limited resources and huge demand as a result of other pandemic-related hardships, like unemployment, housing assistance, and child care.
CASA, a nonprofit that works with immigrant communities throughout Pennsylvania and has partnered with Latino Connection on vaccine clinics, has tried to make it easier for people to access vaccines by combining clinics with events offering other services, like legal assistance, financial literacy training, and help finding jobs.
It’s also a way for the group, which has been stretched thin throughout the pandemic, to conserve resources, said Thaís Carrero, the group’s Pennsylvania state director.
“Our community comes to us, and we meet, and we are out and about every day, so we knew that there was a responsibility and a duty that we had to take to make sure that folks have the ability to get the vaccine,” Carrero said. “But it has certainly been a burden.”
Rep. Peter Schweyer (D., Lehigh), noticed a similar problem when he visited a vaccine clinic at the Bradbury-Sullivan LGBT Community Center in Allentown. Like Latino Connection’s clinics, the center’s were set up to serve people who may not feel comfortable or fear being discriminated against in other health-care settings.
Now, Schweyer is working with other area lawmakers to allocate a portion of recent federal coronavirus relief funding to community groups doing this work.
“Whether it’s a church in a neighborhood, if it’s a nonprofit organization that’s doing outreach — if they’re spending dollars on this, they should be compensated for that,” Schweyer said. “This is a public health crisis and therefore the public needs to help fund and pay for this.”
The center has held five clinics and vaccinated more than 1,000 people so far, said Adrian Shanker, executive director of the Bradbury-Sullivan LGBT Community Center.
With hundreds of people coming into the building, the center has had to spend extra on cleaning costs, along with utilities, like heating and water, on top of additional staff time. So far, the five clinics have cost more than $10,000 — which Shanker said is a significant portion of the center’s $1.2 million annual budget.
Separately, state Senate Democrats are working on a proposal to allocate $55 million of the latest federal coronavirus relief funding, the American Rescue Plan, to community organizations that have shouldered these responsibilities throughout the pandemic. Some of that money could go to initiatives like incentivizing vaccines through gift cards, hiring staff to work on outreach, or providing transportation to vaccine sites, Senate Minority Leader Jay Costa (D., Allegheny) said.
“With vaccine hesitancy, every day that goes by, it becomes more problematic,” Costa said. “That’s an area I think we have to work to get resources into the community as soon as we can.”
Costa said he hopes that funding will be rolled out by mid to late June.
A long way to go
Last week in Bensalem, just outside of Philadelphia, Latino Connection’s blue-and-white mobile unit sat in the parking lot of a shopping center, steps from a grocery store, a laundromat, and several family clinics run by the Trinity Health system’s St. Mary Medical Center.
The family health clinics serve about 5,500 people of all ages, and about 38% prefer to speak Spanish with their doctor. Based on sign-up forms, many people attending the vaccine clinic lived in the area, said Lisa Kelly, director of community health and volunteers.
People walked around the side of the building to check in under a pop-up tent, where administrators spoke Spanish and English and upbeat, electronic music played. Bilingual staff fielded questions about how to list allergies, prescriptions, and health conditions on sign-in forms.
The clinic also accepted various forms of identification, making it easy for anyone who is uninsured, undocumented, or concerned about revealing their immigration status to get a vaccine. The goal is to make the experience as light and positive as possible, said Jean Cubilette, a program manager for Latino Connection.
“Everything is no questions asked,” Cubilette said. “Zero barriers.”
The site was convenient: accessible by bus and walking distance from residential neighborhoods and apartment buildings.
“Transportation is one of the biggest barriers to health care,” said Joann Dorr, manager for community health and well-being at St. Mary Medical Center.
The clinic had 300 doses of the Moderna vaccine available and started the day with 182 appointments. It wound up vaccinating 124 people, and 22 of them were walkups — a lower turnout than expected, Kelly said.
Lingering fears about the Johnson & Johnson vaccine — the Centers for Disease Control and Prevention paused administration last month to perform a safety review, before allowing it to resume — might be one reason why people didn’t show up, Kelly said.
And if the clinic was administering the Pfizer vaccine — which, unlike Moderna, is approved for children 12 and older — more families might have come, Kelly said. Most of their clinics’ clients, about 4,100 out of 5,500, are children.
Some people also need more time to feel confident about the process and see first-hand how it affects people they know, she said.
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