CLEVELAND, Ohio — Steven Boggan has worked in the restaurant industry most of his life, bringing him into contact with many people.
Boggan, who lives in Cleveland’s West Park area, knew getting COVID-19 vaccine would be essential to him feeling safe working with the public during a pandemic. Boggan was hesitant at first, but he took the shot because he knew he’d have to work around a lot of people.
While some, like Boggan, are vaccinated, many Black residents of Cuyahoga County have not received vaccinations at the same rate the county’s white residents have.
“I was (hesitant) in the beginning,” Boggan, who is Black, said of taking the vaccine. “But I wanted to give it time to see how the results were, and then I had to wait for my time to get the shot.”
As of Thursday, 56.63% of Cuyahoga County’s white residents have received their first round of vaccinations, whereas just 31.85% of the county’s Black residents have received their first round. However, of the 655,253 residents who have taken at least one dose of a vaccine, 18,331 people did not disclose their race, so countywide data isn’t a complete picture of who is vaccinated.
Public health officials, experts and community leaders point to several reasons why vaccinations rates in Black communities lag behind some other groups. They include lack of access to the shots, a historical mistrust of the government and vaccines in some corners of the Black community and lack of sound knowledge about the vaccines themselves.
Many of these problems stem from the exclusion of Cleveland-area’s Black communities from conversations about COVID-19 during the pandemic’s infancy, said Yvonka Hall, executive director of the Northeast Ohio Black Health Coalition.
“Nobody bothered to tell African Americans just how impacted they were by COVID,” Hall said. “So you started out the gate wrong. Not telling the community their risk factors. The issues around the disease, even what we knew. The little that we knew.”
According to the state’s COVID-19 dashboard, Black Ohioans make up 13%, or 2,640 people, of the 20,309 deaths. Black residents make up 14% of the state’s overall population. Black Ohioans comprise 11% of 1.1 million total cases, and they account for 19% of 60,662 hospitalizations.
The lack of equitable access was a primary issue for Black residents during the winter when mainly older Ohioans were eligible to receive the vaccine. During the winter, Hall noted the potential lack of access to transportation posed a hurdle — and it could still pose problems for residents. But as summer surges on, accessibility problems are diminishing in some corners of the community as more places have the vaccine available.
The Cleveland Clinic’s Langston Hughes Health and Education Center offers vaccines, with walk-ins available Mondays from 7:30 a.m. to 3:30 p.m. Cleveland Clinic’s Lutheran Hospital has walk-ins available Tuesdays during the same time frame.
“Vaccinations are available daily, and they’re available for extended hours at Langston Hughes,” said Dr. Lee Kirksey, a vascular surgeon at the Clinic. “And that’s another issue. You have to recognize that people work, people have different shifts, people have home care issues. And those are issues that sometimes affect certain communities more than others, so providing access in a non-traditional way, we found that to be very important.”
Since April, the Cuyahoga County Board of Health has offered vaccinations once a month at the Salvation Army in East Cleveland, said health commissioner Terry Allan. The board of health has also vaccinated residents at the Cleveland Heights Community Center, Bedford Heights Community Center, and the Imani United Church of Christ and River of Life Church in Euclid.
Along with its endeavors to vaccinate at various locations, the health board offers mini-grants with money it received from the CDC’s Racial and Ethnic Approaches to Community Health program to barbershops, salons, churches, restaurants and businesses so they can promote the vaccine. Allan said the board of health received $629,640 from the CDC’s REACH program.
“There’s a social vulnerability index that the state has in identifying the zip codes where the lowest vaccination rates are occurring, and of course they are in many cases they’re in African American neighborhoods,” Allan said. “And so we’re focusing on reaching new locations there, and we’re going to continue to do that through the summer and into the fall.”
Allan said some of the targeted locations include East Cleveland, Maple Heights, Warrensville Heights and Euclid.
But despite the improved access, some Black residents are still unsure of whether they want the vaccine.
Danielle Sydnor, the Cleveland NAACP President, was working closely with the state and the NAACP’s local partners to develop transportation strategies for the Wolstein Center vaccination site and messaging about the vaccination. The Wolstein Center has a bus station next to it. While Sydnor didn’t have any involvement with choosing the arena as a vaccination site, she said access to the Stephanie Tubbs Jones Transit Center was considered.
Sydnor said in what she and others heard from people, residents were aware the COVID-19 vaccine was widely available, but they chose not to take it.
“And even the efforts to make the vaccine more available through community sites, (we) still did not see the increased participation that many had hoped for,” Sydnor said.
She said in the coming weeks, the NAACP will implement a messaging campaign that will provide reliable and accurate information about the vaccine.
“Because from all of the information that we’ve been able to obtain thus far, it’s not a lack of access,” Sydnor said. “It’s an intentional choice for people not to get the vaccine because they don’t trust the federal government. They don’t understand how the vaccine was able to be created so quickly. They don’t understand the technology behind the vaccine. And there’s a significant amount of misinformation that’s happening.”
Sydnor added that people who don’t have a strong relationship with a primary care physician where they can get reliable medical advice are making decisions in groupthink with others who have similar hesitancies.
The lack of education and information is critical in explaining why vaccinations rates among Black residents continue to lag behind public health officials’ expectations.
Hall offered one example of how a lack of information contributed to the low vaccination rate. When vaccines began at some inner-city clinics and recreation centers, residents who lived by the recreation centers didn’t know vaccinations were happening.
“And if you looked at some of those lines, they were all white,” Hall said. “So how can white people in the suburbs get some information about a vaccine clinic that’s going on in your neighborhood, and you don’t know it?”
Inner-city and rural Ohioans suffer from a similar lack of access to broadband internet, meaning they lack access to information and easy methods to make vaccine appointments as required by many clinics and pharmacies.
“If the message went out in avenues that African Americans did not have a larger access to, then that means stuff could be going on right under our nose, which it was, vaccination clinics,” Hall said. “And we had not a clue in the world. And we can’t do that. So that means that the message has to come to us in a different way.”
As overall vaccine demand wanes across the country, churches and community centers that serve as vaccine sites will continue to be important because they’re trusted locations in the area’s Black communities. Black residents who already received their shots play an important role as well, noted David Miller, a professor at Case Western Reserve University’s Jack, Joseph and Morton Mandel School of Applied Social Sciences.
Miller said those who have received the vaccine could tell people how it will protect them and the surrounding community.
“We’re the ones who are dying from this,” Miller said. “We’re the ones who are in the multi-generational households, who are essential workers, who are being exposed because of transportation. Having to take the bus or crowded vehicles. That becomes a part of it as well. Getting that information out. I think the job has been done, or they’re doing it, but I think it could be much better. Particularly when you have these numbers such as this. That is such a wide, wide disparity.”
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