With a potential vaccine for COVID-19 in the pipeline, low-cost medical clinics in the Chicago region are gearing up for yet another hurdle during the pandemic: convincing wary patients to get immunized.
On Thursday, new research from the Pew Research Center showed that overall, Americans are growing more confident about getting a COVID-19 vaccine.
But Black adults in particular are hesitant. From responses Pew collected from mid-to-late November, only 42% of Black adults said they would get a vaccine, compared with 83% of English-speaking Asian Americans, 63% of Hispanics and 61% of whites.
Those national survey numbers back up an issue local health clinics that serve mostly low-income people of color have long been concerned about when it comes to fighting COVID-19 — will those from communities hit hardest by the virus take the vaccine?
“My wife and I talk about this all the time, about whether or not you’re going to take the vaccine,” said Barrett Hatches, CEO of Chicago Family Health Center, which has six clinics on the South Side. “We say the same thing as I’ve heard a lot of people say: if Dr. Fauci says take it, I’m good with it.”
That’s a nod to infectious disease specialist Anthony Fauci, who has helped guide the U.S. through the pandemic as head of the National Institute of Allergy and Infectious Diseases.
Chicago Family Health Center is among a vast network of low-cost medical clinics that are the backbone of health care for people who don’t have a lot of money or health insurance.
But racial disparities long existed in health care before the pandemic hit, fueled in part by racism and a lack of money for doctors and hospitals that typically treat low-income patients of color, as well as a distrust among patients themselves.
Even with a vaccine in reach to slow the raging virus, studies show Black Americans aren’t eager to get immunized. The reasons are complex.
In a different survey in October, about half of Black adults cited safety concerns and mistrust as top reasons for why they would not want to take a coronavirus vaccine, even if scientists said it was safe and free, according to the study from the non-profit Kaiser Family Foundation and ESPN’s The Undefeated.
Black adults surveyed were concerned about whether the needs of Black people were taken into consideration as vaccines were developed, and if vaccines would be properly tested and distributed fairly.
Black Americans have haunting memories of medical experimentation, including the decades-long Tuskegee Study that didn’t treat some men who had syphilis.
And for Latinos who might be wary of a vaccine that would be approved by the federal government, consider federal immigration policies that have separated families and targeted a program that provides a temporary reprieve from getting deported.
Hatches said he believes if patients hear from authority figures who are medical experts, not necessarily politicians, they are more likely to trust the vaccine. Still, he describes an uphill battle.
“It is still going to be challenging in the Black community,” Hatches said. “We’re going to try hard.”
While clinics wait for a vaccine, emphasis will be on outreach
These health clinics are not first on the list to get the vaccine, and they told WBEZ that getting doses even by January would be optimistic.
That’s because public health officials have said there will be a limited amount of supply of vaccine at first, and hospital workers would get first dibs. That could happen in just a few weeks, Dr. Allison Arwady, Chicago’s public health commissioner, said on Wednesday during WBEZ’s Reset show.
Next comes other groups that are prioritized based on their risk of getting the virus, such as nursing home residents or so-called essential workers.
Many of these workers are people of color or live in neighborhoods that have been hardest hit by COVID-19, including teachers, police officers, grocery store workers, or others who can’t work from home.
To try to encourage more people to sign up to be vaccinated, Arwady said the city has been hiring outreach workers to help encourage Chicagoans to get the vaccine and help them work through the processes of booking appointments with their primary care providers or city clinics.
“There’s going to be so much work here around answering questions, making sure people understand the safety data … what side effects there may be so that communities feel comfortable really wanting to to take this vaccine,” Arwady said.
Dr. Magda Houlberg, chief clinical officer at Howard Brown Health, which has clinics spread throughout the Chicago area, echoed Arwady’s sentiments about focusing on communities hit hardest by the virus.
“We have a map of where to go to intensify vaccination efforts,” Houlberg said.
She’s referring to the stark maps that show where COVID-19 is flaring. In Chicago, the Southwest Side and the Northwest Side have some of the highest rates of infections, according to the Chicago Department of Public Health.
A WBEZ analysis has shown that access to getting a COVID-19 test, which is key to slowing the spread of the coronavirus, has been a major issue. Residents of majority-Black and majority-Latino ZIP codes in Chicago are getting tested at far lower rates than their counterparts in other areas of the city.
Medical providers will be on the lookout for another potential hurdle to getting a vaccine: whether access will be hampered by the type of insurance patients have, if they have any.
“Of course our fear is that similar to COVID testing, the distribution is initially really wealth based,” Houlberg said. “So individuals with power and influence will have access to vaccination. Others will not. There will be barriers in terms of insurance, in terms of out of pocket costs.”
COVID-19 testing, for example, is supposed to be largely free. But some doctor’s offices and private testing sites have charged people for evaluations to see if they even need a test, or required payment up front, then have patients try to get reimbursed from their insurance companies.
Making plans, building trust
While they wait for the vaccine, clinics are strategizing how to distribute it, and how to build momentum with their patients to agree to take them.
“Our success with reaching as many people as possible is only really going to be successful if this is done in a way that meets people where they’re at,” Houlberg said.
That might include offering the vaccine at the same time as people come for their drive-thru COVID-19 test. Clinics are scouring for big parking lots to host weekend vaccination events, as well as more staff at a time when competition for extra health care workers is fierce.
Howard Brown has ambitious goals to double the number of employees they have to provide COVID-19 tests and vaccines. To do so, Houlberg said the group of clinics is partnering with schools that offer medical training, like Malcolm X, one of the City Colleges of Chicago.
Heartland Health Centers, which has more than a dozen clinics on the city’s North Side, would likely use its drive-thru COVID-19 testing locations as a way to also immunize people. They would schedule appointments out three to four weeks in advance, depending on which vaccine they get, said Dr. Laurie Carrier, chief medical officer at Heartland.
Hatches said every one of his employees would help in some way, whether it’s marketing the vaccine, registering patients, actually immunizing them, then following up to see how they’re doing.
But at the top of the preparation list is this: building trust with people who fear a flu shot, let alone a COVID-19 vaccine.
“The first thing patients will ask is, ‘Did you get the vaccine, or are you getting the vaccine?’’’ said Dr. Lisa Green, who runs Family Christian Health Center, a group of three clinics in the south suburbs. “Besides being a physician, I’m also a mother. I’ve got three kids myself, and making sure that I get the information is just as important to me as it is to my patients.”
Kristen Schorsch covers public health on WBEZ’s government and politics desk. Follow her @kschorsch.