Bringing Vaccines to Reluctant Communities

Kelly Robinson preps a syringe in the mobile vaccine unit outside Wilson’s Barbershop in North Minneapolis. Photo Sarah Whiting

On Fridays and Saturdays, Kelly Robinson is set up outside of Wilson’s Barbershop in North Minneapolis. As president of Black Nurses Rock (BNR) Twin Cities, and the owner of a health-care business, Robinson organized BNR nurses to provide Covid-19 testing in 2020 and vaccination events each week in 2021.

“We have some people who come to the barbershop to get their hair cut, to get their kid’s hair cut, and then there are others who see our [mobile-unit] bus and know we are doing [vaccinations],” says Robinson. “You do not have to make an appointment, you do not have to go anywhere else. You can just pull over, or get off the bus, and get your shot.”

CentraCare nurses in the Saint Cloud area host mobile vaccine clinics to serve immigrant families.

“We have been going to churches, mosques, schools, community meeting spaces, Somali malls, Black community organizations. Anybody who will have us, we are ready and willing to go. We have been doing work with our vaccine equity team to brainstorm and make sure we are being equitable in every sense of that word,” says Hani Jacobson, a community health and wellness nurse with CentraCare.

One of the biggest challenges is misinformation and suspicion. Ashley Jude, an IT professional with CentraCare, says, “Across the continuum, it is a lot of the same fears about what we are putting in them, how they are going to be affected, and how it will benefit them. We come from that place of compassion. As long as they come to the table, we will have the conversation about what they need to know about the vaccine.”

Understanding the Fear

There is mistrust in many communities. Pew Research Center found that sparsely populated rural areas have twice the number of Covid-19–related deaths as urban areas.

“Rural residents are among the most vaccine-hesitant groups, along with Republicans, individuals 30–49 years old, and Black adults,” the report indicates.

According to a Kaiser Family Foundation (KFF) report, “Vaccine Hesitancy in Rural America,” half of rural residents say the seriousness of Covid-19 is “generally exaggerated” compared to 27 percent of urban residents and 37 percent of suburban residents. In rural areas, getting a vaccine is seen as a personal choice (62 percent) rather than as part “of everyone’s responsibility to protect the health of others” (36 percent). A majority of urban residents (55 percent) say getting vaccinated is part of everyone’s responsibility, as do nearly half of suburban residents (47 percent).

Heather Cox Richardson has written about the bipartisan nature of the divide in her blog. She says about 10 percent of Democrats eligible for the vaccine have refused it, and almost 40 percent of Republicans have. In October, 7.8 people per 100,000 died in counties that voted strongly for Biden and 25 out of every 100,000 died in counties that voted differently.

A June 2021 Chicago Policy Review detailed why some Black community members distrust medical institutions:

  • J. Marion Sims — “the father of gynecology” — used enslaved women for painful surgical experimentation
  • The Tuskegee Study of 1932 kept 600 Black men intentionally untreated for syphilis for 40 years.
  • The cells of Black woman Henrietta Lacks, who died from cervical cancer in 1951, were used for scientific research without notifying or compensating her family.

Additionally, many Black Americans feel like outsiders in the health-care system. According to KFF, “Amplifying Black representation in medicine would provide these individuals a sense of agency in decisions affecting their health.” The Association of American Medical Colleges supports pre- medical pipeline programs to bolster the success of students of color through mentorship.

Advocates for trauma-informed policies suggest that the fundamental question should not be “What is wrong with these people?” but “What happened to them to make them so fearful?” A coauthored essay at PacesConnection.com puts it this way: People who have experienced trauma — whether structural racism or a sense of exclusion — tend to be “hypervigilant toward threat and danger [and have] difficulty trusting others. Any perceived agenda from an untrusted source feels like a life threat that will be reflexively met with resistance.”

Says Jacobson, “Our goal is gaining trust by answering questions, and talking about their fears and anxieties related to historical trauma. Even if people do not get the vaccine, we are present in our community and building those relationships.”

— Mikki Morrissette contributed to the reporting of this story

Resources

Hospital bed capacity

Vaccination data