Community health centers are gearing up for an expanded role in the state’s vaccination effort, widening the pathway into the neighborhoods hardest hit by COVID-19.
While much attention has focused on high-volume sites including Gillette Stadium and Fenway Park, the 52 community health centers in Massachusetts are emerging as a growing force in the vaccination effort, now that the eligibility guidelines have expanded to include people age 65 and older and those with two health conditions that put them at higher risk.
A few health centers are already running mass vaccination sites, but all are giving priority to their own patients and neighbors — the very people most likely to get sick from COVID-19 and least likely to get vaccinated. All are expanding their capacity to provide vaccinations, with support from the state.
“Our health centers want to make sure that the patients that are closest to the disease are closest to the vaccine,” said Michael Curry, CEO of the Massachusetts League of Community Health Centers. “They know their patients are more likely to be hospitalized, and most likely to die.”
In so doing, the health centers, which provide primary care and other services chiefly to low-income people, confront a paradoxical challenge: coping with a barrage of calls from people eager for the vaccine and also reaching and persuading those who aren’t sure about it.
“When you open up the doors, you’ll see that first flood of people, the strong yesses,” said Manny Lopes, CEO of the East Boston Neighborhood Health Center. “But you’ve got to stay focused on those that are on the ‘maybe’ list, and those that are saying the hard ‘no.’ ”
The health centers report that they’ve received enough vaccine to meet their needs so far. But they haven’t been vaccinating large numbers — mostly their own staff members and the few patients who are 75 and older. Life expectancy is lower among the people of color who make up 60 percent to 80 percent of many centers’ clientele, Curry explained.
With the expanded eligibility, health center officials expressed hope that the state supply will keep up with growing demand. Additionally, 15 Massachusetts health centers expect to get extra vaccine doses directly from the federal government within the next two weeks, under a new program to supplement the state supply. Curry said it’s not yet known how many doses will come through this route.
Health center patients represent a significant share of the state’s population, Curry noted. The centers serve one in seven of the state’s residents; in Boston, it’s one in two, he said. From among their own patients, they could eventually reach almost 700,000 people over age 16 as eligibility expands.
In the group newly eligible under Phase 2, which numbers about 1 million statewide, the health centers serve more than 60,000 people age 65 and above — plus many thousands of younger people who have two comorbidities, such as obesity, diabetes, smoking, and asthma.
Health center patients have high rates of such illnesses. They tend to live in the communities where the virus is spreading fastest and also face the biggest obstacles to getting vaccinated, such as poor Internet access, lack of transportation, or distrust of vaccines — all problems the centers say they are well-positioned to address.
In Massachusetts, 6 percent of vaccinations have been administered to Black people, while they represent 7 percent of the population and account for 8 percent of COVID-19 cases, according to new data from the Kaiser Family Foundation. The disparity is starker among Hispanics in the state: They make up 12 percent of the population, but account for 29 percent of COVID-19 cases — and have received only 5 percent of the vaccine doses.
With the floodgates now open for people older than 65, health centers are trying different approaches to manage this challenge. Some are teaming up with other community groups or the municipal government. They’re hiring staff and keeping their fingers crossed that federal and state money will eventually come their way. And some are getting help from the National Guard.
The Brockton Neighborhood Health Center has been so overwhelmed with phone calls from people seeking vaccinations that it had to hire eight additional telephone staff members and add 16 lines — and people are still sometimes getting busy signals, said CEO Sue Joss.
The center has been vaccinating about 450 to 500 people a week but expects that to increase to 3,000 after March 1, when a collaborative effort with the city opens in the city-owned Shaw Center.
“It’s a major leap,” Joss said.
The site will be open only to the health center’s patients and Brockton residents.
Meanwhile, even amid the high demand, the Brockton center is calling individual patients eligible for vaccination, urging them to make appointments. From its staff, who come from the local community, the center has learned the extent of the uncertainty over the vaccine. Only 43 percent of employees agreed to be vaccinated, and among the staff members who are Black, only 28 percent took the vaccine, Joss said.
The center made videos of staff members who have gotten vaccinated, talking about their decision, and it designated “COVID vaccine ambassadors,” one Haitian and one Cape Verdean, to spread the word in their communities.
Other community health centers have seen similar issues and taken similar approaches.
“Some of the challenges with vaccine confidence we’re seeing among our staff,” said Dr. Charles Anderson, CEO of the Dimock Center in Roxbury.
Countering that requires a sensitive approach, he said.
“It’s not just about providing information. It’s about allowing people to tell their stories,” Anderson said. Like Brockton, Dimock has made videos of staff members who were unsure of the vaccine but decided to get it.
“They tell their story about how they got comfortable with the vaccine and developed trust in the vaccine,” Anderson said. “Their story resonates with their neighbor.”
Dimock is also ramping up its efforts to meet the growing demand, repurposing a building on its nine-acre campus, with plans to open it March 1 for Dimock patients and people who live nearby. Dimock expects to administer 1,000 to 1,200 doses a week at the new site.
Likewise, the Codman Square Health Center, teaming up with other health centers and Boston Medical Center, last week opened a vaccine site in the Russell Auditorium, which had been a testing center. The site is starting at 400 a day but officials hope to increase to 1,000 a day, and it’s listed on the state vaccination website. But on Friday morning, the site was serving only a handful of people; a sign blamed weather-related delays in vaccine shipments.
When the Reggie Lewis Center opened in Roxbury, a mass vaccination site intended to serve the local community, the first customers seemed to be mostly white people from out of town. Sandra Cotterell, Codman Square CEO, said “there’s a risk that could happen” with the Russell site, but she doesn’t think it will, because health centers are calling their eligible patients and booking appointments for them.
“We’re aggressively reaching out to our own patients,” she said.
The Harvard Street Neighborhood Health Center in Dorchester is taking a hybrid approach — reaching out to its own patients but also vaccinating other community members by working with local organizations, such as Central Boston Elder Services, where vaccinations were underway on Friday.
Felice J. Freyer can be reached at firstname.lastname@example.org. Follow her on Twitter @felicejfreyer.