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Should Rhode Island cities with the highest COVID-19 rates get the vaccine early?

The push to protect at-risk communities may be hampered by mistrust and misinformation, officials say

Central Falls health ambassadors Yanina Zuniga, left, and Elvin Toro stopped by City Hall to replenish their supply of packaged information and face masks to distribute during the coronavirus pandemic.Pat Greenhouse/Globe Staff

CENTRAL FALLS, R.I. — By the end of 2020, an estimated 50 percent of Central Falls residents will have been infected with the coronavirus, health officials said Thursday, underscoring the need to quickly vaccinate the state’s densely populated communities.

But while they called for moving Central Falls and other high-density areas to the front of the vaccine line, officials acknowledged that communities that need the vaccine the most – including communities of color and communities with undocumented immigrants – are often the ones that trust the government and the vaccine the least, making it more difficult to protect those vulnerable populations from COVID-19.


Central Falls, a 1.29-square mile city of 19,383 people, has had one of the highest rates of COVID-19 infections not only in Rhode Island but the entire nation, noted Dr. Pablo Rodriguez, medical director for community affairs at Care New England and host of the “Nuestra Salud” radio talk show.

“So Central Falls residents should be the first to get the vaccine, regardless of whether they are in hospitals or nursing homes or not, regardless of whether they are documented or not,” Rodriguez said. “This is a public health emergency.”

Dr. Pablo Rodriguez, medical director for community affairs at Care New England and host of the “Nuestra Salud” radio talk show.Courtesy of Dr. Pablo Rodriguez (Custom credit)

According to the most recent state Department of Health data, 58 percent of the Central Falls population has been tested, and 3,036 (or 27 percent) of those residents have tested positive.

But Rodriguez, who is a member of the governor’s COVID-19 Equity Council, said the actual rate of infection is undoubtedly higher, including those who have not been tested or display no symptoms. On Wednesday, a state health official told the council that an estimated 50 percent of the Central Falls population will have been infected by the end of year, which is just two weeks away.

“It’s a tragedy,” he said, “a complete tragedy.”


Department of Health spokesman Joseph Wendelken noted that the cumulative rate of COVID-19 cases in Central Falls stands at 15,664 per 100,000 people – by far the highest in the state. Providence has the second highest rate at 10,490 per 100,000.

“We recognize that, given the number of people who have tested positive and the behavior of the virus, that a substantial portion of people in Central Falls will have contracted the coronavirus by the end of the year,” Wendelken said. “That is the projection.”

Dr. Michael Fine, chief health strategist for the City of Central Falls, noted that the Centers for Disease Control director has estimated that for every case of COVID-19 reported, there could be 10 other infections.

Central Falls residents should receive the vaccine early in the process, Fine said, because the city has been ravaged by the virus and has no other good way to stop its march.

Dr. Michael Fine, chief health strategist for the City of Central Falls, Rhode Island.Tia Thuong/Snicca Photography

“We don’t have the ability for people to be isolated,” Fine said, noting the city contains lots of triple-deckers and packed apartments. “People in Central Falls have none of the ways of protecting themselves that people in Barrington and East Greenwich do.”

Rodriguez noted that some of communities of color in densely populated Central Falls, Pawtucket, and Providence have been especially devastated by COVID-19.

Since April, attention has focused on how the virus is taking a disproportionate toll on Latino and Black Rhode Islanders. But Rodriguez said new data show the disparity is worse than many realized.


For example, the hospitalization rate among Latinos stands at 1,009 per 100,000 people, compared to 608 among Black residents and 150 among white residents, according to age-adjusted data that takes into account that the overall Latino population is younger than the white population in the state.

Given the limited supply of the vaccine, Rodriguez said it is crucial that the state begin vaccinating the hard-hit, high-density communities now. He acknowledged it will be “politically difficult” to speed up vaccinations for those communities. But, he said, “It’s the right public health measure.”

The Department of Health has already outlined a four-phase vaccination plan that would provide the shots first to high-risk health care workers, first responders, and people at nursing homes. Next in line are older adults, incarcerated people, and teachers; then young adults and children; and finally everyone else.

Wendelken said state officials are weighing where to place high-density communities within the four-phase vaccination plan, but no decisions have been made. Governor Gina M. Raimondo announced Thursday that the state would be receiving about 36 percent fewer doses of Pfizer’s COVID-19 vaccine than expected next week, which further complicates the issue. The state’s COVID-19 Vaccination Subcommittee is scheduled to meet at 7:30 a.m. Friday.

“It would be a travesty to vaccinate teachers and students in Westerly, Barrington, or Middletown, when their positivity rates are below 5 percent for their communities, and even less than that in their schools” without first vaccinating people in cities overwhelmed by the virus, Rodriguez said. Officials could face pressure to provide the vaccine to employees in certain businesses, such as restaurants, in order to spark the economy, before reaching out to at-risk communities, he added.


Protecting people of color and immigrants in densely populated areas comes with additional challenges, Rodriguez said, one of which is combating mistrust in government and misinformation about the vaccine.

Undocumented people in at-risk areas are wary of the government and may fear deportation, he said, and false information about the COVID-19 vaccine has been spreading on social media for months. Going forward, public health officials will need to dispel the misconception that the vaccine contains a tracking device, changes a person’s DNA, or causes infertility, for example, he said.

“We are already behind the information flow,” Rodriguez said. “We have to dispel rumors and re-educate.”

Fine agreed, saying he has heard “considerable concerns” about the vaccine from members of the Cape Verdean community in Central Falls and Pawtucket. He said he’s concerned that people will avoid getting vaccinated if they have to go online and set up accounts that require personal information, so the Central Falls “health ambassadors” will pivot from providing face masks to registering residents for vaccines.

Fine said he is just hoping that enough doses of the vaccine arrives before 100 percent of the Central Falls population is infected with COVID-19.

“This is the time for us to be clear and transparent and to explain the importance of the vaccine compared to the threat of the virus,” he said.


Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him on Twitter @FitzProv.