One afternoon last week, Humaira Choudhury called outside the eastern New York office of the nonprofit where she works, drawing the attention of Johnny Flynn, 63, who lives around the corner. from the street. Like most residents of Brooklyn’s 11208 zip code, Flynn had yet to receive his first stroke of COVID-19 – but not due to a lack of interest. It turned out to be more difficult than he had expected.
Flynn first inquired at his local pharmacy, but they weren’t offering it. “They said ‘try online, something will happen’,” he recalls, but he hit it over there too. “So, I just waited.
As the city moves closer to Mayor Bill de Blasio’s goal of vaccinating 5 million people by July 1, it becomes increasingly important to understand why some have not been able to get vaccinated or have postponed. Health experts cite reluctance as one of the main reasons herd immunity may not be achievable in the United States. But barriers to access also prevent people from getting vaccinated. Labor organizations in New Jersey, for example, coordinate nighttime shots for warehouse workers.
About 44% of New Yorkers have received at least one COVID-19 vaccine and about 32% are fully immunized. But some neighborhoods are much more advanced than others. In wealthier, whiter zip codes, more than two-thirds of residents are at least partially vaccinated (a zip code in the financial district is 89%). Most neighborhoods in upper Manhattan, Queens, the Bronx, Brooklyn and Staten Island are well below half of their population being fully vaccinated.
The three East New York zip codes, on average, are 34% with at least one vaccine and 24% fully vaccinated, even as the governor and mayor lift restrictions on social venues and city offices. city. By the time Israel rolled back its lockdown in mid-March, 50% of its residents had been fully vaccinated and 60% had taken a dose. The population of Israel is similar in size to that of New York.
Community organizations, such as the Bangladesh American Community Development and Youth Services (BACDYS) where Choudhury works, are working to increase the immunization rate in their neighborhoods, person by person. BACDYS is culturally aligned with the local Bengali and Muslim populations of eastern New York City, but also serves the wider area, which is predominantly black and Latino. But responding to people’s complex needs and concerns can be a slow process.
Flynn was intrigued when Choudhury handed him a leaflet with a list of vaccination sites in the city that now allow walk-in visits. But, with limited mobility following a stroke, he said the scene was too far away. BACDYS was planning a pop-up for vaccines but had not yet set a date. Choudhury wrote down Flynn’s number and said she would keep him posted. “If they do, I’ll go fast,” Flynn said.
Now that the city has vaccinated the ‘impatient group’ with the time and enthusiasm to get vaccinated quickly, it is essential to focus on streamlining the process, said Dr Wafaa El-Sadr, professor of epidemiology. and medicine at Columbia University. She recommended deploying trusted messengers to disseminate information about vaccines and the vaccines themselves.
When it comes to convenience, it’s about solving practical obstacles, “whether it’s financial shortcomings or problems with transportation or mobility or language or internet access,” El said. -Sadr.
I know they are trying hard in New York City, but they are not getting the results they need.
After months of navigating people through a maze of websites and phone numbers to get an appointment for a COVID-19 shot, Blasio’s administration announced on April 23 that it would start authorizing walk-in visits to all city-managed sites. State officials emulated this decision days later.
“We need to do more work in communities hardest hit by COVID,” de Blasio said at a press conference on April 29. “What I find is that the more we make vaccination convenient, the better we do.”
Those working on expanding access to vaccines say the move could be a game-changer.
“Online registration was a challenge because people didn’t necessarily have time to navigate or access the correct computer,” said Colette Pean, executive director of East New York Restoration Local Development. Corp. challenge because you might get a date that doesn’t match your working hours or babysitting. Walk-in tours are therefore always better. “
So far, walk-in visits have not reversed the downward trend in demand for COVID-19 vaccines, as judged by the number of New York residents receiving their first doses each day. Some groups are much harder to reach than others, such as the city’s 500,000 undocumented migrants.
Read more: COVID cases drop in New York – just like demand for vaccines does the same
“We have a lot of customers who are unwilling to show photo ID,” said Afsana Monir, executive director of BACDYS. “We do our best to tell them that everything is fine; it will not be shared. They say, ‘No, they’re going to put my name in the system.’ “
Deployment is not completely stalled in Eastern New York, with share covered increasing by about 6% in two weeks. But because the city does not provide data on changes in vaccination rates in postal codes from week to week, it is difficult to compare the rate of progress in different communities and target interventions accordingly. said Dr Tom Frieden, former director of the Centers for Disease Control and Prevention and former commissioner of the city’s health department. He said cumulative vaccination rates only show part of the picture.
“What gets measured can be better managed,” Frieden said. “I know they’re trying hard in New York City, but they’re not getting the results they need.”
Primary care physicians can help move the effort forward, Dr El-Sadr said. After giving a minimal share to private practices during the first months of the deployment, the state recently began to allocate doses to doctors in the SOMOS Community Care network.
But people living in low-income communities often have less access to primary care and benefit from receiving health information and services through community activities, Pean said. She noted that there was food, free masks, blood pressure tests, and assistance with setting up vaccine appointments at a recent event hosted by Brookdale Hospital.
“In a community that has so many health issues, the whole discussion is how to get into preventive health, of which the vaccine is one aspect,” Pean said.
Carrying out this work requires resources that are not distributed evenly. East New York Restoration and BACDYS are among seven organizations that recently won $ 10,000 each from the Brooklyn Community Foundation to promote access to vaccines and fight hesitation.
Only 25% of Far Rockaway residents got their first chance.
But in Far Rockaway, Queens, Jeanne DuPont, executive director of community organization RISE, says she doesn’t have the resources she needs to lead aggressive advocacy. Only 25% of residents of Far Rockaway got their first chance, compared to 71% at the wealthier, whiter Breezy Point on the other end of the peninsula.
DuPont said she had tried unsuccessfully to convince the city to send a mobile vaccination van or help it turn its building, which is no longer used for in-person activities, into a hub.
“On the street, when I talk to people and ask them questions about it, they tell you that they don’t feel comfortable getting the shot,” DuPont said. “And that includes children in our program. This includes families. There needs to be more people on the ground to educate people about vaccinations and also to literally get people vaccinated.
A city spokesperson retorted that Far Rockaway’s 11691 “has several vaccination resources, including a hub and additional sites, as well as a pharmacy.” Appointments are available now and we encourage everyone to roll up their sleeves and get vaccinated as soon as possible. “
The city has launched more initiatives to reach deeper into backward communities. In March, Blasio’s administration announced that it was setting aside funds for groups able to coordinate networks of local actors to educate people about vaccines and direct them to other resources related to the recovery of the disease. COVID-19. The city is still targeting 33 neighborhoods first identified by the mayor’s task force on racial inclusion and equity when disparities in access to vaccines became apparent in January.
The question is whether all of these efforts will be enough to secure New York’s collective immunity without leaving behind pockets of the city that could be vulnerable to further spread. Across the city, some 31% of white New Yorkers have received at least one dose, compared to just 17% of blacks and 19% of Latinos – a trend that reflects racial disparities across the country. Based on existing trends, researchers at Stanford University predicted that people of color in New York state would achieve 75% immunization coverage three to four weeks after whites, leaving them exposed to the virus more. long time.