Health care disparities have plagued Massachusetts’ rollout of the COVID-19 vaccine, but many of these issues have deeper roots.
“Our communities of color in greater Boston have been disproportionately affected by the pandemic,” said Melanie Gleason, the medical-legal partnership attorney at Lawyers for Civil Rights Boston.
Lawyers For Civil Rights Boston sent an open letter Feb. 1 to the Governor’s Office, the Executive Office of Health and Human Services and the Department of Public Health, addressing vaccine equity concerns.
The letter cited a November study by Harvard researchers, which found that the state’s Black and Latinx populations each suffered 10 percent more COVID-19 cases in the first half of 2020. The letter also noted that the COVID-19 death rate for Black and Latinx residents is three times that of white residents.
Gleason said the vaccine rollout has been difficult for disadvantaged communities.
“There are mass vaccination sites at Fenway [Park], and there’s another big vaccination site at Gillette [Stadium],” Gleason said. “There’s not been a lot of specific plans that have been set up by the administration in order to ensure, for example, transportation for different communities in order to get to those two sites.”
CIC Health, a Cambridge-based testing and vaccination organization partnering with the Commonwealth, began operating a third mass vaccination site at Roxbury Community College in late February.
Gleason said, ideally, there would already be public infrastructure to deal with health crises, but “absent of such an apparatus, the burden is really on the State.”
Gov. Charlie Baker announced a new vaccine equity initiative Feb. 24, but Gleason said specific information about equity operations has been sparse.
“There’s a lot of talking points that the administration has made,” Gleason said, “but the needle hasn’t really moved.”
Other city and state officials, like Liz Miranda, who represents the fifth Suffolk district in the Massachusetts House of Representatives, have been working with their communities throughout the pandemic.
“She was the first legislator in the Commonwealth to establish a district-led community care program, which actually did outreach to over 4,000 constituents,” Kevin Higgins, Miranda’s legislative aide, said.
Higgins said he hoped grassroots COVID-19 outreach organizations would receive more funding from the State government.
“That’s really what it takes,” Higgins said. “Knocking on doors, getting flyers translated, making phone calls, texting, that’s really what it is.”
Higgins added that white Massachusetts residents get vaccinated at a substantially higher rate than Black residents, and that number has to change to “achieve equity.”
The vaccination rate among white Massachusetts residents is over one and a half times the rate among Black residents.
Higgins said Miranda’s district was hit hard by the pandemic, as it’s “one of the most impoverished districts in the Commonwealth.”
“The folks in her district, they were already facing crisis,” Higgins said. “They were already one injury, one job loss and even sometimes one missed shift away from an emergency, a real emergency.”
He added that medical racism contributed to the hardships felt by COVID-19.
Gleason cited comorbidities such as diabetes, hypertension and asthma as disproportionately affecting residents of color and immigrant communities.
Janelle Baptiste, a pulmonary and critical care physician at Beth Israel Deaconess Medical Center, said COVID-19 made it more difficult for those who rely on public transportation to travel for lung cancer screenings.
“They’re weighing their risk of getting COVID versus coming in to get a screening,” Baptiste said.
Baptiste said this is especially dangerous for lung cancer patients, since the disease is usually asymptomatic until it has transitioned into later stages — adding that patients in disadvantaged populations tend to start smoking at earlier ages.
The issue of transportation isn’t new, Baptiste said, but COVID-19 “magnified” the disparity.
Additionally, Baptiste said COVID-19 made it more difficult to contact patients.
“You have to be able to get in contact with the patient, so they have to have a telephone where you can call them,” Baptiste said. “These are times when patients are also out working and they can’t pick up their telephones while they’re at work, or they’re using their telephones to work and they don’t have a landline.”
Baptiste said she was hopeful for the future, citing next year’s guidelines from the U.S. Preventive Services Task Force, which Baptiste said would lower the age of eligibility for lung cancer screenings.
“Next year is going to be more of an exciting year for lung cancer screening,” Baptiste said. “What I do just hope is that in the next coming months … we can get back to where we were pre-COVID.”
Groups like the Vaccine Equity Now! Coalition are pushing the Massachusetts government to address health care disparities. The coalition sent a list of five demands to Gov. Baker’s office, including $10 million for community organizations and 20 percent more vaccine doses for communities that are impacted the most.
“I would like to see an actual strategy,” said Atyia Martin, a co-chair of the Vaccine Equity Now! Coalition.
Lawyers for Civil Rights Boston and Rep. Miranda are also involved in Vaccine Equity Now!
Martin said she hoped for better communication in the vaccination rollout process.
“If you’re not at least going to talk to the coalitions that are closest to communities, at least talk to local public health, who tends to have a better relationship with folks closest to the work on the ground,” Martin said. “I say ‘tend to,’ because there’s no one monolithic situation across the Commonwealth.”
Martin said the issues with mass vaccination sites could be addressed through mobile vaccinations — adding that she believes their implementation will ultimately be necessary.
“You need that multi-pronged strategy,” Martin said. “It’s not optional, it’s literally the best practice.”
