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How Boston closed racial gaps in vaccinations and is tackling new disparities in bivalent boosters

A teenager received a COVID vaccination at a clinic co-hosted by CIC Health last year in Roxbury.Craig F. Walker/Globe Staff

As COVID cases, hospitalizations, and deaths climb in Massachusetts and across the country for the third winter in a row, public health officials worry that only 11.8 percent of Boston residents have received the Omicron-specific bivalent booster. Those numbers are even lower in communities that have disproportionately struggled with COVID-19, such as Black and Latino communities.

Only 8.1 percent of Boston’s Hispanic residents and 9.3 percent of Black residents have received the bivalent booster, according to the Massachusetts Department of Health, compared with 14.1 percent of white residents and 11.7 percent of Asian residents.

Citywide data also show alarming inequalities in overall booster rates for Black and Latino children. As of Dec. 5, 7.9 percent of Black children and 7.8 percent of Hispanic/Latino children ages 5 to 9 have received a booster shot, compared to 24.7 percent of Asian and 37.7 percent of white children of the same age.

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The gulf in booster rates among ethnic and racial groups opened not long after Boston succeeded in closing many gaps in the rates of first and second vaccine doses. Last December, 72.5 percent of white residents in Boston had received at least one dose of a COVID-19 vaccine compared to only 65.1 percent Latino residents and 62.5 percent of Black residents, according to state data.

But, as of April “we really don’t see a difference in fully vaccinated status in our city. Asian individuals do have a higher vaccination rate, but if you look at just Black, white, Latinx individuals, we don’t have the disparities that we initially saw,” said Dr. Bisola Ojikutu, Boston’s public health commissioner. Native American residents continue to have much lower vaccination rates than other groups.

The city currently has higher rates of vaccination for Black and Latino residents than the state as a whole. In Boston, 83.9 percent of Black residents and 76.8 percent of Hispanic/Latino residents are vaccinated, compared to 75 percent of Black residents and 67 percent of Hispanic residents in Massachusetts.

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Black and Latino residents can be slower to adopt COVID-19 vaccines and boosters than other races due to “significant barriers to care faced disproportionately by Black and Latinx individuals, as well as fear and mistrust toward medical institutions resulting from centuries of exploitation and neglect by medical establishments,” said Ojikutu.

She said a major factor in closing several of those gaps was listening to the needs of affected communities and mobilizing community-led coalitions, important practices to apply now that the city is facing a similar issue.

Growing evidence, including two studies released Friday by the US Centers for Disease Control and Prevention, show that bivalent boosters reduce urgent care visits and hospitalizations for people of all ages, including those who have been fully vaccinated.

In September, the Boston Public Health Commission partnered with Cambridge-based CIC Health to open vaccination and testing sites across the city, focusing on neighborhoods that have been disproportionately affected by the pandemic, including Roxbury and Dorchester.

The goal of these sites is to remove barriers that members of these communities face, “whether it’s access, lack of insurance, lack of a permanent address,” when it comes to protecting themselves from COVID-19, said Katie Cardarelli, CIC Health’s director of operations. “We want people to feel comfortable.”

None of the sites require appointments, identification, or insurance to increase accessibility and convenience. In addition, material is available in 10 languages, and each site posts signage in the three languages most common to their area to increase accessibility.

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Working with community partners who can offer expert advice on best practices has been a key part of CIC Health’s strategy from the beginning, she said. They’ve worked with over a hundred community organizations such as the Brazilian Workers Center, Boys and Girls Club of Dorchester, and African Community Economic Development of New England.

Every community is diverse in how trusting it is of the vaccine and where that skepticism comes from, said Rev. Dieufort Fleurissaint. The executive pastor at the Voice of the Tabernacle Church in Mattapan and a prominent figure in the Haitian-American community, he said working with spiritual leaders is key for the city’s health commission in the Haitian community, given that some of those doubts are religious in nature.

“Some people think if you’re vaccinated, you’re not a true Christian because God can heal all diseases,” said Fleurissaint, also known as Pastor Keke. “We have to tackle that as religious leaders and tell them we are serving a God of science.”

One of CIC Health’s key partners has been the Black Boston Health Coalition, formerly the Black Boston COVID-19 Coalition, a group of more than 250 Black civic, business, and public health leaders working to mitigate the effects of the pandemic on communities of color. Dianne Wilkerson, the group’s co-founder and former state senator, said CIC Health’s successes have come from its willingness “to respect the credibility and knowledge of the people working in the communities” and applauds their approach.

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However, she notes that a significant reduction in state and city funding available to organizations like hers has reduced their capacity to be as effective as they were earlier in the pandemic.

“We wound down our activity because the energy and the alarm is not there [anymore]. And when the alarm and energy is not there, the resources are not there,” she said.

For example, the health coalition used to rent a van to take seniors from their residences to get vaccinated and rewarded them with $25 gift cards, a service Wilkerson said they can no longer afford to provide.

However, the organization continues to provide expertise to CIC Health, most recently recommending the Lena Park Community Development Corporation in Dorchester as the location for its newest site.

Selina Hernandez, a Puerto Rican resident of Roxbury, has worked at CIC Health sites since 2020. She has been part of the team operating the site at Lena Park, which opened three weeks ago.

Hernandez, who lives 10 minutes from the site, said being from the area helps her better understand and anticipate the needs of prospective patients as the team works to gain visibility in the community.

“I’ve been in situations where I haven’t been able to do certain things because I’m worried about how much something is and sometimes not everybody can relate to that,” she said.

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Since September, the sites have administered COVID vaccines, boosters, and flu shots to over 3,000 people, of whom 37.5 percent were Black and Latino residents.


Zeina Mohammed can be reached at zeina.mohammed@globe.com. Follow her @_ZeinaMohammed.