By Nancy Lofholm
Emmanuel Rusaka, an asylum seeker from the Democratic Republic of Congo, normally works behind the scenes in the computer department at Centura Health. Lately, he has become a familiar face in Centura’s efforts to convince employees to get vaccinated against COVID-19.
Using enthusiastic persuasion, a video taken of him getting vaccinated, and some of the seven languages he speaks, Rusaka has taken every opportunity to urge fellow workers to get vaccinated in a hospital system where, as of late January, 44% fewer Black workers and 22% fewer Latino workers have opted to be vaccinated than their white counterparts.
“I say for them to look at me, look at me. I am well. I am healthy. I am fine. I am protected,” said Rusaka, who recently received his second dose of the vaccine and has tallied about 50 more vaccinations among coworkers due to his grassroots-level campaign.
That kind of person-to-person advocacy is just one piece of a slate of new efforts to make the distribution of coronavirus vaccinations more equitable to communities of color across Colorado in health care facilities, neighborhoods, parishes and other gathering places. Communities predominantly composed of Black, Indigenous and people of color (BIPOC) have lagged behind in coronavirus vaccination rates after soaring ahead in COVID-19 mortality rates since the early days of the pandemic.
A lack of access to the vaccine and mistrust both play a part in the disparity.
Newly released Denver Public Health data have found that vaccination rates are higher in wealthier Denver metro area neighborhoods than in low-income neighborhoods where more people of color live.
Statewide disparities in coronavirus vaccination rates are clear in new race and ethnicity data on the Colorado Department of Public Health and Environment’s (CDPHE) COVID-19 information dashboard. Initial state data was published on Jan. 22, and the numbers won’t be complete for a time because race and ethnicity information previously was not required.
The early numbers—with 78% of vaccinated individuals represented—show that statewide, nearly 68% of those vaccinated are white; Latinos make up 4.3% of those vaccinated while comprising 22% of the state population; and Blacks and African Americans represent less than 2% of those vaccinated and comprise about 4% of the state population.
CDPHE and Gov. Jared Polis’ office have requested funds to move the needle on those lagging vaccination numbers among BIPOC communities. Polis and CDPHE executive director Jill Hunsacker Ryan recently sent a letter to the Centers for Disease Control and Prevention (CDC) urging the agency to allocate a portion of funds from a federal act extending unemployment benefits to the State of Colorado to help in efforts to vaccinate marginalized populations.
The state is also pursuing a $6 million budget request to help achieve equitable coronavirus vaccinations and has asked the Black Democratic Legislative Caucus of Colorado and the Colorado Democratic Latino Caucus to help facilitate that.
The State of Colorado, along with a large web of partner groups that include major hospital systems, is making a new, concerted effort to address both the mistrust and access factors.
“We have to do something different, especially in the health care setting,” said Oswaldo Grenardo, MD, the chief diversity and inclusion officer with Centura Health. At Centura, that has included diversity councils at multiple Centura facilities stressing the importance of the vaccine, community outreach groups like Promotores and Promotoras de Salud, and “real people” like Rusaka.
The state’s new push for data from providers should help to quantify if such efforts are working. CDPHE last week announced they had asked vaccine providers to request race and ethnicity information for those vaccinated. That information is to be sent to the state each week.
That may be complicated by another recent state directive stating that identification won’t be required to receive a coronavirus vaccine. That is aimed at assuring non-citizens and those without homes will be able to access vaccines. Providers who ignore this directive risk losing their supply of coronavirus vaccines.
As of the third week of January, 16 states (with Colorado now the 17th) gather and publicly disseminate racial and ethnic information on coronavirus vaccine distribution, according to the Kaiser Family Foundation. Among the few states reporting such data, about 3% of Americans have received at least one dose of the coronavirus vaccine so far—but in most of the states tracking data by race, white residents are being vaccinated at two to three times the rate of Black residents.
This relative lack of vaccinations among people of color is occurring despite well-established disparities in viral transmission rates. Black, Latino and Indigenous populations have contracted COVID-19 at nearly three times the rate of white Americans, according to a New York Times analysis of CDC data last July.
While Colorado ratchets up its data collection, the state and its partners, as well as Denver Mayor Michael Hancock, are expanding educational outreach and vaccine availability to communities of color.
“We are working with community influencers. People tend to trust those who live in the neighborhood and look like them,” said Megan Mahncke, senior vice president of external communications for SCL Health.
Small pop-up clinics will be appearing in underserved neighborhoods and communities across the state. Mobile hospital vans will be deployed to neighborhoods, churches, schools and other community gathering places for vaccine events.
The first large vaccination pop-up in the Denver area will be a 5,000-shot clinic on Feb. 6 at the National Western Center. The clinic, being staged by SCL Health with dozens of nonprofit partners, is planned to draw residents of Globeville, Elyrea-Swansea, Park Hill North, Commerce City and southern Adams County.
The state has previously held pop-up vaccine clinics in the southern Colorado towns of Center and San Luis, which have high populations of Hispanics.
To get community members to vaccine clinics and get the shots in their arms, the state is also trying to remove other barriers. The state is providing transportation assistance to clinics for those without vehicles, and asking health departments across Colorado to augment their telephone-based services for those who don’t have internet access to sign up for shots. A Champions for Vaccine Equity program is being deployed to support vaccine literacy.
CDPHE’s prioritization of gathering ethnic-related vaccine data won’t trump the priority of getting shots in people’s arms. The state has made it clear that if those getting vaccinated don’t want to volunteer racial information, they shouldn’t be turned away. Mahncke said she recognizes that information is important, but it is ultimately up to individuals getting vaccinated whether they want to reveal their ethnicity.
Internally, hospitals are able to gather that information from employee records. That is how Centura determined that so many Black and Latino workers were not receiving the vaccine, and “that set off alarm bells for us,” Grenardo said.
In an example of how that data can be useful, it also set off multiple efforts at Centura to reach out to people of color both internally and externally. It also inspired Rusaka and his effective one-man campaign. He said he has been talking to people in his neighborhood and at his church in addition to his co-workers.
“I tell them, ‘If you want to get back to normal times, the only way to do that is to take the vaccine,’” he said. “I tell them, ‘Listen to me and let me give you hope.’”