For little more than 45 seconds, McDonald’s worker Maria Cristina de Jesus and St. Paul Firefighter-Paramedic Kalya Sanchez teamed up to save the world. At the Consulado de Mexico en St. Paul — or the Mexican Consulate on St. Paul’s East Seventh Street — the two met, however briefly, to trade what one Ramsey County Public Health worker described as a dose of “liquid gold.”
Sanchez asked which arm she wanted her shot of the Moderna vaccine.
Moments later, it was done, and through de Jesus’ small frame traveled the best-known protection against the COVID-19 virus that has swept the world, upset everyday life for months and claimed the lives of 539,000 people in the U.S. alone.
The next day, the same scene played out at a Catholic Charities homeless services center in downtown St. Paul, albeit with different volunteers.
It took place again on Friday, at the Shiloh Missionary Baptist Church off St. Paul’s Front Street, where Kelly Robinson, president of the Minnesota Chapter of Black Nurses Rock administered a vaccine shot to her own adult son, Dwayne Robinson, among other members of the congregation and outside visitors.
On another day, Ramsey County Public Health will bring the Moderna vaccine to public housing high-rises. M Health Fairview and partners will distribute the Pfizer vaccine to the ethnic Karen community on St. Paul’s East Side. A mini-clinic was held Thursday for elderly nuns in a small Benedictine monastery in St. Paul.
TRUSTED COMMUNITY SPACES
The Minnesota Department of Health’s state-backed MINI Clinics, or “Minnesota Immunization Networking Initiative” events, have long brought flu shots to vulnerable communities that might not otherwise easily access them, working hand in hand with nonprofits, church leaders and other community agencies that already have the ear of their people.
During the pandemic, Ramsey County Public Health, M Health Fairview and key partners such as St. Mary’s Health Clinics and the StairStep Foundation used the same resources to pivot from the flu to COVID testing.
The network has now pivoted again, this time toward administering COVID vaccines.
The strategy is “to bring vaccination into trusted community spaces,” said Ingrid Johansen, Manager of Clinical Care and Outreach for M Health Fairview. “We vaccinate in temples, parks, you name it, and have this fabulous network and have this front-line understanding of barriers for different communities.”
Mobile vaccination clinics operate seven days a week in the Twin Cities, meeting vulnerable communities in the places they live, work and worship.
The goal is to create an inviting, low-barrier experience for the groups least comfortable navigating the medical system, and most underrepresented by recent state counts of the vaccinated. No one asks for medical records. No one asks for health insurance or proof of membership in a particular provider network.
Other than a state vaccination registry, everything is free, confidential and delivered whenever possible in the patient’s native language. Pre-registration is required, and “vaccine hunters” who show up uninvited are turned away.
In public health circles, experts say targeted outreach, community by community, has been key to fighting everything from cancer and AIDS to obesity and smoking.
“The more Black nurses get involved, and the community looks like their caregivers, we have more influence because we’ve had the COVID vaccine,” said Ekua Taylor Kregal, a retired United Hospital nurse and Ghanian immigrant, as she prepped her next patient at Shiloh Baptist. “I’ve had my two shots. We’ve already experienced it. Everybody’s different, but the vaccine is better than the disease. As human beings, we take in more information from people who look like us.”
Here’s why that’s especially important. Experts say achieving “herd immunity,” or stopping the spread of COVID by creating virtual firewalls of immunized patients, will require developing some form of immunity in as much as 80 percent of the general population.
That will be difficult to achieve without widespread vaccination, and communities of color — some of which have had some of the worst health outcomes when it comes to COVID — are lagging.
MINORITIES VACCINATED AT LOWER RATES
According to the Minnesota Department of Health, white Minnesotans account for 82 percent of the state population, but they represent 92 percent of the patients who have been vaccinated to date.
Asians are 5 percent of the population, but represent only 3 percent of those vaccinated to date. Blacks represent 6 percent of the state population, and 3.5 percent of those vaccinated. Perhaps most startling, Latin residents are 4.8 percent of the state population, but represent just 1.7 percent of residents vaccinated. Native Americans are 1 percent the population and .7 percent of those vaccinated.
The reasons are likely varied.
Immigrant groups tend to trend younger than the state population as a whole, so a state schedule that has until recently prioritized the most elderly is likely to skew whiter than the population as a whole at the outset. Other observers point to language, transportation and education barriers, difficulties for low-income workers who are the least likely to work from home to get time off work, and the historic disconnect between communities of color and the medical establishment.
Many major healthcare networks are going down their lists of active patients and calling them in for vaccinations based on the state’s eligibility schedule, which has prioritized the elderly, residents of long-term care facilities and front-line workers. Ethnic patients who don’t have health insurance or a regular provider may not appear on those lists.
“A lot of time, our people do not get the information like they should,” said Pastor Steve Daniels, who has led Shiloh Baptist for 30 years and recently proved to his congregation his faith in medicine by getting his second vaccination shot. “But the Black church has always been the galvanizing place. … A leader can’t lead from behind.”
To combat widespread misinformation about COVID and COVID vaccination, M Health Fairview has produced culturally-specific YouTube videos starring Black, Asian, Latin and Muslim religious leaders, among other groups, presented in corresponding languages. They’ve printed brochures in various languages, and held weekend vaccination clinics in ethnic neighborhoods.
Given the often widely disparate health outcomes for the general population compared to communities of color, it’s the type of outreach many hope will continue long after COVID is in the rear view.
“These disparities existed before COVID, but COVID really shined a bright spotlight on them,” said Nicole Beauvais, Vice President of Quality and Health Equity for the M Health Fairview system. “I hope that work and attitude continues even long after COVID is gone.”
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