FDA Vaccine Approval, Mandates Persuade New York City Holdouts
(Bloomberg) -- Throughout the pandemic, Sharray Gray has been vigilant about wearing masks, using hand sanitizer and social distancing, even from her grandchildren. The 46-year-old Bronx resident has underlying health conditions, including asthma and kidney problems. Several of her friends and family members have died of Covid-19. Yet, for months, she declined to get a vaccine.
That changed this week, after the Food and Drug Administration approved the Pfizer-BioNTech SE shot.
“If it doesn’t get FDA approval, I’m not putting it in my body or my child’s body,” said Gray. The vaccine “came so fast. The government didn’t know what they were dealing with. I was not going to be a guinea pig.”
On Tuesday, Gray and her 12-year-old daughter, Amina Coleman, came across a mobile vaccine clinic at their library in the Allerton neighborhood of the Bronx and got their first shots.
Gray’s turnabout underscores how the FDA’s approval of one of the Covid-19 vaccines could prove to be an important step in boosting vaccination rates, particularly in communities where uptake has been low. It might convince holdouts, because it “adds to the crescendo of evidence that Covid-19 vaccines are both safe and effective,” said Dave Chokshi, New York’s health commissioner.
Full regulatory approval may also help indirectly, by giving workplaces and schools more reason to require the vaccine. “It gives them cover to issue more mandates,” said Liz Hamel, director of survey research at Kaiser Family Foundation.
Even so, much work remains to vaccinate hard-to-reach people, including those who weren’t affected by these latest developments. Community organizations with deep ties to their neighborhoods are poised to play a crucial role in that effort, leveraging trust they’ve built over years to help the vaccine campaign get more traction.
A Line Down the Block
Shots against Covid-19 are widely available in New York, but vaccine hesitancy has been one barrier to getting more residents protected. In the city, while nearly 70% of eligible adults are fully vaccinated, rates are much lower in some neighborhoods and demographics groups. In the Bronx, only 32% of Black adults and 43% of Latino adults are fully vaccinated.
On Tuesday, at a city vaccination bus near the Allerton Avenue subway station in the Bronx, a line of people stretched down the block.
Among them was Charles Taylor, 27, who was concerned that the vaccine was “experimental.” But the FDA’s stamp was a decisive factor in getting inoculated because he now believes he has more recourse if he has an adverse reaction. Taylor works as an Uber driver and in a veteran’s hospital that he thought would soon mandate the shot.
Also, Taylor also couldn’t use his gym without vaccination. “I have to lose my pandemic pounds,” he laughed. Recent city mandates require proof of vaccination to enter restaurants, fitness centers and other indoor venues.
Those kinds of rules, whether from governments or private institutions, are shaping vaccination decisions across the city.
Outside Allerton Library, Maya Myacepero, 19, reluctantly registered for the vaccine after her nursing school in Connecticut mandated it a week earlier. “I don’t trust the government,” she said, citing widely circulated misinformation about the shot’s effect on fertility. “I don’t know what it will do to my fetus when I get older.”
While FDA approval and institutional mandates may provide fresh motivation for vaccination, community organizations will be critical to getting more shots in the arms of people who are hard to reach. The city announced Thursday it will allocate $9 million to 33 local partners in neighborhoods with low vaccination rates across New York.
“They are playing essential roles serving neighborhoods that have not only been disproportionately impacted by COVID-19, but also a history of systemic racism, discrimination, and disinvestment,” said Torian Easterling, chief equity officer of the city’s health department.
Bronx Rising Initiative, a nonprofit, is an example of a group that has already played a significant role in the borough’s vaccine rollout. Since January, its staffers have knocked on more than 10,000 doors in Bronx public housing buildings, offering information on the shots and getting people to sign up for appointments.
In partnership with health providers, the group has hosted vaccine clinics in recreation rooms and lobbies of those public housing buildings, as well as churches, and in vans — including the one near Allerton Library where Gray and her daughter got their jabs. When the weather got warmer, they held clinics outdoors where passersby could also pick up flyers and ask questions. By late August, BRI had helped administer about 20,000 vaccinations.
Crucially, the nonprofit’s staff are from the Bronx and are often bilingual in Spanish and English. That is helpful in connecting with people in areas with largely Black, Puerto Rican and Dominican residents.
“Our job is never to force vaccines on people. We sit and listen and do community outreach so people feel more comfortable. You have to be patient,” said Jason Autar, chief operating officer of BRI.
Trusted messengers who speak the same language — literally and figuratively — are especially important for reaching immigrants and undocumented people. They often need reassurance that giving their personal information to register for vaccination will not jeopardize their immigration status. Fear still lingers from President Donald Trump’s administration, which targeted undocumented people with deportation, said Frankie Miranda, president of advocacy group Hispanic Federation.
A Familiar Presence
Having a multilingual staff is also important to the vaccine outreach efforts at Union Settlement, a nonprofit operating in Harlem. In addition to having Spanish speakers, some workers also speak Mandarin and Cantonese to serve a growing community of Chinese immigrants in the historically Black and Hispanic neighborhood.
The city government deployed a mobile vaccination van to Spanish Harlem earlier this summer, but people were less open to talking to strangers, said Ingrid Sotelo, community outreach director at Union Settlement. “But if folks know it’s Union Settlement, it’s a different conversation,” Sotelo said.
That’s because Union Settlement is already a familiar presence, offering child care, adult education and other community services. Those connections establish trust.
The group visits local businesses, chatting with unvaccinated people who often say they don’t have time or can’t leave their restaurants or shops. Union Settlement gives them information about when and where they can get vaccinated. Similarly, when people come to Union Settlement’s food pantry, staffers ask about their vaccination status and can help book appointments.
Thousands of Flyers
The tactic of combining existing social services with vaccine outreach may prove to be powerful. On Wednesday, nonprofit Vision Urbana set up its food pantry outside Baruch Houses, a large cluster of public housing high-rises on Manhattan’s Lower East Side. As hundreds of people picked up free groceries on a hot summer day, a city vaccination van was parked steps away.
The previous day, Vision Urbana and Baruch Houses tenants’ association put thousands of flyers about the vaccination clinic under apartment doors.
Eric Diaz, executive director of Vision Urbana, said Wednesday that a man who had recently been incarcerated had initially wanted to get vaccinated that morning, but balked. When the man said he would return to the van later, Diaz offered to accompany him for the whole process. “We are familiar faces holding people’s hands,” he said.
Jaime Contraras, 28, lives in Baruch Houses and got the jab at the mobile clinic parked near his doorstep. He didn’t know about the FDA approval, but he plays minor league baseball and the team had recently mandated vaccination.
Contraras was nervous, but he knows the organizers at Vision Urbana from youth services during his childhood. Messages about the vaccine are “not coming from a stranger. These are people who raised me as a kid,” said Contraras. “They wouldn’t lie to me.”
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