Coronavirus

‘Shockingly low’: How Mattapan came to have Boston’s lowest COVID-19 vaccination rate

"There's still that hesitancy."

Pharmacist Mark Cepeda, with Legacy Care Group Boston, prepares doses of the Pfizer-BioNTech COVID-19 vaccine, to be delivered to the Haitian Creole community, at the Church of the Nazarene in Mattapan on June 27. Pat Greenhouse / The Boston Globe

More than half of Bostonians have been fully vaccinated against COVID-19.

The latest numbers from the Boston Public Health Commission show 55.7 percent of all residents have received their second dose of either the Moderna or Pfizer vaccine, and another 3.5 percent have gotten a single dose Johnson & Johnson shot.

In the South End, the neighborhood with the most fully vaccinated residents, 72 percent of people had gotten the jab as of July 6 — the date of the most recent data provided by the city. In Allston-Brighton, that number is 70.5 percent, and in South Boston, it’s 68.1 percent.

But as the vaccine rollout appears to have given way to the so-called return of normalcy amid the pandemic, the anticipated vaccination disparities public health and city officials long warned of are now in clear and sharp contrast.

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While 72.8 percent of the city’s Asian and Pacific Islander residents and 59.8 percent of white residents are fully vaccinated, only 45.2 percent of Latinx residents and 43.2 percent of Black residents are vaccinated.

In Mattapan, where Black residents account for approximately 75 percent of the neighborhood’s population — a greater percentage than anywhere else in Boston — a mere 39 percent of all individuals are fully vaccinated, less than in any other neighborhood, city data shows.

“That number in itself is shockingly low — and that is a ticking time bomb,” said Dr. Cassandra Pierre, associate hospital epidemiologist at Boston Medical Center.

Boston COVID-19 Vaccination Report July08 2021 by Christopher Gavin on Scribd

Pierre worries about how the emergence of the highly contagious Delta variant of COVID-19 could potentially thrive among such a large unvaccinated population.

While the prevalence of the new variant has remained relatively low in New England, coronavirus infections and hospitalizations have trended upward again in Massachusetts (significantly less so than previous increases, however).

“It feels inevitable that our unvaccinated areas will be seeing this,” Pierre said.

Experts and medical professionals have feared the longstanding mistreatment of Black populations by the medical community would lead to mistrust of the vaccines in communities of color.

In January, only 47 percent of people who took part in city-sponsored focus groups in Mattapan and Dorchester said they would take a vaccine. Nearly 44 percent of participants in the surveys were Black or African American.

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“I think it’s always been and it was going to be more challenging (to vaccinate) in certain communities — communities with more immigrants and communities of color — because there is a distrust that exists in these communities because of health disparities, lack of connection and deep connection with some of our health organizations,” District 4 City Councilor Andrea Campbell, a Mattapan resident and mayoral hopeful, told Boston.com. “So that distrust is real for a whole host of reasons. It’s going to take even more investment for the city to be strategically responsive to these communities.”

Language barriers among the city’s immigrant populations and a hearty slew of misinformation about the vaccines on social media have also presented formidable challenges.

“There’s a lot of misinformation that is professionally done. … That’s what we’re trying to combat — this level, and the volume, and the noise of all this misinformation,” said Guale Valdez, CEO of the Mattapan Community Health Center.

‘Almost like an overnight drop’

As Massachusetts broadened vaccine eligibility this spring, Mattapan Community Health Center, which operates a vaccination clinic, quickly hit its peak for patients getting their shots.

According to Valdez, the clinic saw its most patients for vaccine appointments in mid-March, with a quick decline over the course of the following month and another at the end of May.

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“It was almost like an overnight drop,” he said. “It happened within about two weeks to where we saw dramatic decreases in numbers.”

Thirty percent of the health center’s patients reside in Mattapan, and another 20 percent live in Hyde Park, Valdez said. He notes that 79 percent of patients identify as Black — a statistic that essentially mirrors the neighborhood’s overall population.

“I think the vaccine was available, there was a rush by a lot of people who wanted to get it, and then when those individuals received the vaccine, it just, it just dropped,” Valdez added. “And then we start hitting the population that they’re just really hesitant to receive a vaccine.”

City officials have always known that first rush — the first 30 or 40 percent of people vaccinated — would be much easier to achieve than the next 30 to 40 percent or so of individuals, according to Marty Martinez, Boston’s chief of health and human services.

The city set an initial goal of getting at least 50 percent of people in every neighborhood to receive at least one shot — a vision Martinez noted is close to being a reality. All neighborhoods are measurably higher than 50 percent except in Mattapan, which hung at 44.7 percent as of July 6.

Martinez said there is no other benchmark City Hall is hoping to reach at the moment.

The focus is on making continuous progress, period.

“The mayor has been really clear she wants to see improvement, obviously in Mattapan and a couple zip codes in Dorchester, that right now are under the citywide average, and really making sure that our Black and Latinx populations, that those numbers go up as well,” he said.

‘A combination of reasons’

There is no one reason Mattapan hasn’t kept pace with other areas of the city, rather the cause is “likely a combination of reasons,” Martinez said.

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Mattapan has a smaller population than many other neighborhoods, particularly those that are also home to large communities of color, Martinez noted.

Other areas, such as Dorchester, although racially diverse, still have much larger white populations than Mattapan — populations that have been more quick to take up the vaccines, he said.

Only 6 percent of Mattapan’s residents are white.

“Part of it is making sure we’re creating true access for the Black African American and African immigrant populations, and that’s why we’re seeing, I would argue, some of the numbers that we’re seeing in Mattapan: that there’s a concentration of a community that needs to have the access, needs to have equitable, not only access, but information to ensure that there’s accuracy and that we’re doing the true grassroots work needed to create access for folks,” Martinez said.

Vaccine infrastructure in some sections of the city also arrived later than in others, Campbell said.

“I think we’ve seen a jump in folks getting vaccinated here, and we’ll continue to see that as we get more, as we make it easier for folks in these neighborhoods to get vaccinated,” the councilor said.

At the Mattapan Community Health Center, every patient who walks through the door is offered the vaccine.

Valdez said patients who decline to receive it often tell staffers they are concerned about the long-term effects of the vaccine and the speed at which it was developed. (Doctors have said the mRNA vaccines were able to be created quickly in part due to how the vaccine development process has improved.)

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Others raise worries about things they read or watched online, such as that the vaccine can cause infertility — a false claim.

“There’s still that hesitancy,” Valdez said.

‘It’s going to take some time’

For Martinez, the work ahead must continue to focus on vaccine accessibility, which includes having mobile vaccination clinics where they are most needed and making resources available to community groups engaged in the rollout.

“We see this next phase as creating easy, really accessible opportunities for folks to get vaccinated, while celebrating how important it is that people do that,” he said.

On July 10, for example, the city held the “Day of Hope” to honor the lives lost during the pandemic, but to also mark the progress made and promote vaccinations.

The public health commission said 101 people were vaccinated at events in Mattapan, Roxbury, and East Boston.

Officials must also keep constant attention on awareness to educate the public, Martinez said.

“You can do a couple of commercials on TV, but it’s got to be an ongoing, consistent sort of effort,” he said.

Campbell said she thinks the city is heading in the right direction, but “it’s going to take some time.”

“I think there can be greater investment, of course, (in) more community-based organizations and more mobile sites, and more of these clinics — we’re seeing pop-up clinics for folks along the (MBTA’s) Fairmount Line — so there are creative things happening,” Campbell said. “We should continue to invest in that.”

Battling misinformation, the Mattapan Community Health Center has held town halls for the community with a medical provider, including one spoken in Haitian Creole to serve the neighborhood’s Haitian immigrant population.

The center is also looking at launching advertisements on a local Haitian-language radio station, and maybe getting a doctor onto one of the talk shows, Valdez said. Another possible public awareness campaign staffers are considering is one that focuses on conveying trust in the vaccines, not from doctors, but through patients’ friends and families.

The facility is also a consultant for vaccination clinics at Morning Star Baptist Church and the Greater Boston Nazarene Compassionate Center, both in Mattapan.

“I think the best message we can deliver is that we are going to continue to be engaged, and we’re going to continue to do this work, and we’re not looking for easy. We’re looking for effective,” Valdez said, when asked about what he holds close as he and his team navigates their work. “And the message has to change now.”

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