USA TODAY: They combat COVID vaccine hesitancy by going door-to-door. The goal? 10,000 inoculations.

NEW YORK – From the hallway, Nelson Washington leans in close to the front door of an apartment, listens to the voice on the other side, and makes his pitch.


"We're here offering our seniors and essential workers the registration for the vaccination of COVID-19," he said.


“I already have an appointment, thank you,” a voice responds.


And with that, Washington rejoins a handful of mostly young adults as they knock on each unit on the 12th floor of a public housing building in the Bronx, a few blocks away from the Yankee Stadium vaccination site in New York City.


They work their way down each floor and hallway of the building, talking in Spanish or English to seniors about the vaccine, gathering the resident's information, and leaving pamphlets at doors.


The group from The Bronx Rising Initiative works with the local Morris Heights Health Community Center to bring a mobile vaccination unit to the apartments to vaccinate the seniors who agree.


In all, the Bronx Rising Initiative hopes to vaccinate more than 10,000 people.


Lynmarie Francisco and Nelson Washington with the Bronx Rising Initiative go door-to-door registering residents for the COVID-19 vaccination at a Highbridge Gardens public housing building in the Bronx Feb. 24, 2021. The organization is informing residents about the vaccination and making it easier for those eligible to get registered and vaccinated if they'd like. They partnered with Morris Heights Health Community Center to bring a mobile vaccination unit to the apartments for the vaccination.


'I know what they are going through already'


Starting last March, the initiative has secured protective gear for Bronx hospitals and donated food as the borough has seen some of the highest coronavirus cases and deaths in the state. The positivity rate in the Bronx was still higher than most places in the state, as of March 3.


Tomas Ramos, founder of the Bronx Rising Initiative, decided to focus on public housing for this phase because he knew that many seniors would have a harder time getting to a vaccination site or even calling the number to make an appointment.


“I focus on public housing because I know what they are going through already,” said Ramos, also a former director of the Bronx River Community Center. “They don’t trust anything. So, I’m like, ‘Listen, I get it. I know where you’re coming from. I’ve been working here. I’ve been trying to bring in resources to our community.'"


The initiative is one of many in New York and around the U.S. that is working to bridge the gap to get inoculations to vulnerable communities already hit disproportionately by the virus. Also, many in the medical profession hope that by having these conversations around the virus, they can close other long-term health disparities in diseases such as diabetes and create a better wellness model.


But the road toward getting these communities vaccinated in particular is already proving to be tricky, as a mix of issues with access, historic distrust, language and other issues converge into a gap in vaccinations.


In New York, Black people represent 17% of eligible essential workers and 13% of the age 65-plus eligible group, state officials said last month. Hispanic or Latino people account for 12% of the population of New Yorkers age 65 and above eligible.


But only around 9% of people who identified as Black have received at least one vaccine dose, according to state data from early March. Hispanics represented around 10% of those who have received the first dose.


Lynmarie Francisco and Nelson Washington with the Bronx Rising Initiative help register a resident for the COVID-19 vaccination at a Highbridge Gardens public housing building in the Bronx Feb. 24, 2021. The organization is informing residents about the vaccination and making it easier for those eligible to get registered and vaccinated if they'd like. They partnered with Morris Heights Health Community Center to bring a mobile vaccination unit to the apartments for the vaccination.More


Those vaccination numbers come amid some racial disparities in coronavirus deaths in the state's largest city. Latino people make up 29% of the New York City population and 34% of coronavirus deaths, according to recent data from the state Department of Health. Statewide, Latinos in New York have died at a rate lower than their population percentage when the city's stats are removed.


Black people make up 22% of the population in New York City and 28% of the coronavirus deaths. On the state level, Blacks make up 9% of the population and 13% of the deaths.


Nekeisha Afful of Morris Heights Health Community Center said the key to getting Black and brown communities vaccinated for the virus will be access, availability and education.


Afful said access to care for underserved populations looks different, but community health centers are apt to do this work because they have the relationships.


“A lot of times people think access just means you build it and they would come,” she said. “However, in underserved populations what we have realized, whether it be the aging population or a population where there is less education within the demographics, people don’t always have that knowledge or the patience or even the time to take care of themselves the way that they should.”


Nationwide, community health centers serve about 30 million patients who mostly live at or below poverty, USA TODAY reported. Half of the patients are racial and ethnic minorities. Most are uninsured or on Medicaid.


At the Morris Heights Health Community Center, outreach has involved handing out flyers, establishing pop-up vaccination sites and employing staff who use their cultural kinship to alleviate the concerns of those who may be hesitant.


Still, Afful said, getting vaccinated remains a personal choice.


Marilyn Lucas, 84, tells Nelson Washington with the Bronx Rising Initiative that she's not ready to get the COVID-19 vaccination Feb. 24, 2021 at a Highbridge Gardens public housing building in the Bronx, New York.


Overcoming vaccine hesitancy is a problem


Back in the Bronx, Marilyn Lucas, 84, said she’s waiting to get vaccinated. She’s concerned that maybe after a year or so that she might see a commercial or something saying that the vaccine was unsafe.


“It’s just too soon,” Lucas said. “I think I’m going to see how it affects other people.”

But she did ask about the site’s location, perhaps an indication that the wait might not be much longer. If she had signed up to get the vaccine, she would’ve likely have gotten it downstairs.


The effort toward getting communities of color vaccinated could be working as reluctance toward the vaccine among Black and Latino populations dips, research shows.


In late December, 52% of Black people and 43% of Hispanics said they would wait and see on the vaccine. On Feb. 21, both groups' numbers had dropped by around 20 percentage points, according to the Kaiser Family Foundation. Black adults and young adults between ages 18 and 29are more likely to say they want to wait to get the vaccine.

“We’re seeing more Americans who want to get vaccinated, but Black, Hispanic and rural Americans will be left behind unless special efforts are made to increase vaccine confidence in those communities," KFF President and CEO Drew Altman said.


Lynmarie Francisco and Nelson Washington with the Bronx Rising Initiative go door-to-door registering residents for the COVID-19 vaccination at a Highbridge Gardens public housing building in the Bronx, New York, on Feb. 24, 2021.


Emerging from the pandemic


Mecca Mitchell recently held an information virtual session with communities to discuss the coronavirus vaccine. That session was followed by others in Creole and Spanish.

The work is an early step that Mitchell, senior vice president of diversity and inclusion at the Westchester Medical Center Health Network, is leading. She and a group of expert and community stakeholders from across the Hudson Valley are identifying prospective vaccination challenges and providing a recommendation for building community trust, among other issues.


“COVID-19 has ravaged our most vulnerable communities, communities that were already suffering from health disparities and other social inequities," she said. "Now, these same communities face unique vaccination challenges that must be addressed in a way that is respectful, culturally intelligent, and trustworthy to ensure greater participation in the drive for vaccination."


But the medical profession, she added, can’t be so singularly focused on vaccination that it missed the ability to engage with these communities and change health care once the pandemic ceases.


“We’re having conversations with vulnerable communities about COVID, let’s also talk about chronic illness, so that we can create, sustainable, holistic, overall health and wellness,” she said.


By Tiffany Cusaac-Smith


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