Despite efforts to ensure the COVID-19 vaccines are distributed equitably across Massachusetts, predominantly Black and Latino communities, where the risk of infection is greatest, still have among the lowest inoculation rates in the state, according to a new analysis by physicians and researchers at several Boston-area institutions.
The data review led by Dr. Scott Dryden-Peterson, an infectious disease specialist at Brigham and Women’s Hospital, analyzed COVID-19 testing and vaccination statistics in 291 Massachusetts communities, including 15 Boston neighborhoods, with populations exceeding 3,000 residents.
The analysis found that the communities with the lowest vaccination rates relative to their risk of COVID-19 infection — such as Lawrence, Everett, Chelsea, and East Boston — tended to be poorer and have higher proportions of Black and Latino residents. By contrast, wealthier communities — including Newton and Brookline — tended to have higher vaccination rates despite having lower COVID-19 caseloads.
Uneven vaccination rates could imperil the state’s ability to control the coronavirus outbreak, especially as schools and businesses reopen and more contagious variants spread, Dryden-Peterson noted.
“I think Massachusetts is one of the best of the larger states in terms of the efficiency that we have been administering vaccines, but in general, we are not maximizing the potential to reduce risk in the future,” Dryden-Peterson said. “COVID transmits throughout our state relatively efficiently — through all layers of socioeconomic strata — and so a risk in one community is a risk for everyone.”
For the analysis, Dryden-Peterson collaborated with doctors and public health experts at Brigham and Women’s, Massachusetts General Hospital, and Tufts University School of Medicine. He calculated each community’s vaccination-to-infection-risk ratio by dividing the number of fully vaccinated people by the number of confirmed coronavirus cases. He also compared the communities’ demographic compositions and socioeconomic levels using Census Bureau data and the Centers for Disease Control and Prevention’s Social Vulnerability Index.
According to the Department of Public Health, roughly 1.9 million people been fully vaccinated, or about 27 percent of the state’s population. White residents have received the lion’s share of the doses, and are more likely than residents of other races or ethnicities to have been inoculated, DPH data show. As of April 13, about 44 percent of the state’s white population had received at least one dose of the vaccine, compared with 33 percent of Asian residents, 29 percent of Black residents, and just 23 percent of Latino residents.
On Wednesday, Governor Charlie Baker announced a new initiative aimed at encouraging more residents of color to get their shots. From April 19 through 25, in what will be known as “Red Sox Week,” 20,000 first-dose appointments at the Hynes Convention Center will be reserved for residents of the 20 hardest-hit cities and towns, including Boston, Lynn, Chelsea, and Lawrence.
But even within these communities, racial and ethnic disparities are stark. In Lawrence, for example, where 82 percent of residents are Latino, just 8 percent of the Latino population has gotten at least one dose of a vaccine as of April 13, and 5 percent are fully vaccinated, according to state Department of Public Health data. Meanwhile, 94 percent of Lawrence’s white residents, who make up just 12 percent of the city’s population, have received at least one injection and 63 percent are fully vaccinated.
Local physicians and community leaders in Lawrence say the vaccination disparities between Latino and white residents are not a consequence of limited supply or narrow eligibility. Rather, access to the vaccine appointments remains a significant challenge, according to Dr. Zandra Kelley, chief medical officer of the Greater Lawrence Family Health Center, which serves a largely Latino patient population in the Merrimack Valley.
“Our community members have multiple jobs. They are working all day long. They’re not online all the time looking for vaccine appointments. They may have transportation difficulties,” Kelley said. “There are lots of other components that may lead to people not making it their first priority to look for a vaccination.”
Local advocates point out that many vaccination sites are open only on weekdays or close at 5 p.m., when workers are clocking out for the day. And for many Lawrence families, taking time off work to get vaccinated — or recover from the shots’ unpleasant side effects — is financially unfeasible. To reduce these barriers, the Greater Lawrence Family Health Center has begun offering some evening hours at its vaccination clinics and is partnering with local businesses to offer the injections on site.
“Families are like, ‘I can’t take days off. I can’t afford it. So do I really want to take this on?’ ” said Jamill Martinez, director of network organizing at the nonprofit Lawrence Community Works, where she is leading a coalition of volunteers to spread the word about the vaccines through WhatsApp, Spanish radio, door-knocking, and fliers.
Fear and distrust are also a barrier, especially among the city’s undocumented immigrants, noted Walter Mena, lead organizer of the Merrimack Valley Project. The large police and firefighter presence at the city-run vaccination site at the Arlington School in Lawrence’s densest and poorest neighborhood “makes people uncomfortable,” Mena said. “They are very reluctant to go out [because of] that.”
Martinez said she has personally escorted more than 20 undocumented families to vaccination appointments at the school to ensure they feel safe and comfortable. She hopes they’ll share their positive experience with others, so fears about the site will subside.
But misinformation about the vaccines is rife in Lawrence, where rumors and conspiracy theories have proliferated on social media, sowing doubt about the vaccines’ safety. At a vaccination clinic last Saturday at the Lawrence Senior Center, Martinez witnessed a few local churchgoers trying to dissuade patients waiting in the parking lot from getting vaccinated with unfounded rumors about the side effects. They were polite, Martinez said. Still, she had to demand they leave.
“There’s mistrust because they feel like [the vaccines] came out way too soon, and not everybody has the ability or the knowledge to do the research on their own,” Martinez said, adding, they think “this is just about money, money, money, or ‘we’re just guinea pigs.’ ”
Martinez can empathize with this deep skepticism about the vaccines. She didn’t trust them either and was adamantly opposed to getting vaccinated, until last month, when her godmother in Puerto Rico died of COVID-19. A realization suddenly dawned on her: She wanted to hug her parents again. She scheduled her first shot a week later.
She felt the side effects almost immediately. She developed a fever, body aches, and chills within hours. She had migraines that lasted days. Still, Martinez doesn’t regret getting vaccinated. In fact, she’s more passionate about promoting the vaccines than ever. She’s due for her second shot of the Moderna regimen this Saturday.
“The pandemic became more real. It became more personal to me, and I was angry. I’m still angry at COVID,” Martinez said of her godmother’s death and her subsequent change of heart. “At the same time, [I was] just like, ‘What can I do to keep myself safe?’”
Deanna Pan can be reached at firstname.lastname@example.org. Follow her on Twitter @DDpan.