As Vaccine Rates in Black Community Stall, County and Faith Leaders Team Up

As the state reopens, public health officials and Black leaders are ramping up efforts to remind the BIPOC community that the pandemic is far from over, especially for them.

Interim Health Department Director at Multnomah County Ebony Clarke "In Oregon, only 74% of all adults over the age of 18 have received one dose of the vaccine," Multnomah County Interim Health Department Director Ebony Clarke told The Skanner. "When you break that down to the Black and indigenous communities, less than 50% of adults have received one dose of the vaccine.

"That's concerning because as we focus on the Black, African American communities, we're also fighting against issues of chronic diseases, which puts us more at risk. As a result of that, we're seeing a higher rate of BIPOC individuals testing positive and ending up hospitalized."

A statewide 70% vaccination rate among adults triggered a rollback on mask mandates. But that rate isn't uniform throughout all regions and cities: Last week, Black residents of Multnomah County accounted for 10% of hospitalizations related to COVID, and 7% of deaths -- disproportionate numbers for 6% of the county population.

Bonnie King directs walk-ins to one of Highland Christian Center's free twice-monthly vaccine clinics, where visitors receive cash gift cards after each dose. (Photo/Saundra Sorenson)
The new Delta variant of COVID-19 is more contagious and fast-spreading than previous mutations. It has become the dominant strain of the virus in Oregon, hitting those who remain unvaccinated particularly hard. The Oregon Health Authority reported that in June, nine out of 10 positive COVID cases were patients who had not received the vaccine.

"And because we're seeing acuity in illness as a result of people testing positive and ending up in the hospital, we're highly concerned," Clarke said. "Fall is upon us, and we're expecting a much more significant flu season. Folks are going to be indoors -- it's' that perfect mix to really be a breeding ground for this highly contagious variant that we're seeing that's going around."

In the Black community, advocates say, it comes down to fear, distrust and access issues.

Making It Personal

Community healthcare worker Teresa Johnson works at Highland Haven, a service organization operating out of Highland Christian Center in northeast Portland. Highland Haven is one of many faith-based groups contracted with Multnomah County to offer vaccination clinics and to deliver wraparound support to those impacted by the virus.

"When people call in, or the county sends us names and says ‘This person has tested positive for COVID and they requested support,' we send them groceries and help them get their bills paid for 14 days if they're not vaccinated, and 10 days if they are," Johnson said. "

But if you're unvaccinated, we turn around and call you back.

"We say ‘Hey, we have a vaccination clinic in two weeks."

Johnson said vaccine hesitancy in her community is rooted both in historical abuses and systemic racism in the American medical system, as well as misinformation that has been propagated online and on social media. Common myths about the COVID vaccine include that it introduces the virus into your body, that it was developed too rapidly to be safe, that it alters one's DNA, and that it can cause all manner of debilitating conditions. (More information on how these myths have been debunked here: Interview: Portland Physician on Coronavirus Vaccine, Reaching Out to Wary Communities.

Dr. Bukhosi Dube of the Oregon Health Authority answers questions about the COVID-19 vaccine from younger members of Highland Christian Center. Dube has been recognized as a force for educating the vaccine-hesitant in the BIPOC community. (Photo/Saundra Sorenson)
Others cite the fact that break-through cases of COVID are still possible for the vaccinated. Public health officials counter the argument with plain numbers: no vaccine is 100% effective, although Pfizer is reported to be 95% effective at preventing infection from the disease. Of those who have been fully vaccinated, only 0.003% have had a breakthrough infection that resulted in hospitalization or death.

When Johnson talks to the vaccine-hesitant, she likes to tackle their fears one by one. While acknowledging the very reasonable misgivings many in the Black community harbor toward the medical system, Johnson points out that the highly effective vaccine now being offered was developed by a Black physician and researcher, Dr. Kissmekia Corbett. When someone tells her they refuse to get the vaccine because of severe side effects or fear of the unknown, Johnson points to trusted leaders in the community who have enthusiastically been vaccinated, like the church's Senior Pastor Shon Neyland.

"He speaks about it over the pulpit," Johnson said.

On the second and fourth Tuesday of each month, between 9:30 a.m. and 3:30 p.m., Highland Christian Center hosts a free vaccine clinic that is open to walk-ins. As members of the community wait in the hall, they can watch a video of Neyland receiving his vaccine and explaining why he opted to get one.

"I have heard many Christian leaders in the African American Church speak against the COVID vaccines," Highland's Pastor Yolanda Roseby wrote in a Facebook post earlier this week. "I have to admit, in the early stages I vowed that I would not get vaccinated because of too many unknowns and the history of the United States experimenting on Black folks. After praying and researching, I decided to get vaccinated in April 2021. I did it because I want to LIVE! I did it for my son! I did it for my community! We have been praying that God heal the land. The vaccine is here…

GET VACCINATED! God wants you to LIVE on this side of heaven."

Johnson said that for many, approaching the vaccine in a place of worship can help counter their fears.

"Because in the African American community, the church is your source," Johnson said.

"We go to our churches when we're hurting.

"We go to our churches when we don't understand the wrong that life is throwing us, this curveball. For many, COVID has been the worst curveball in history. So if the faith-based community is getting behind something, you will see more buy-in from a lot of African American people."

During Highland's first vaccine clinic, shortly after this year's ice storm, 465 people received their first round of Pfizer, Johnson said.

She said she had been impressed by how the virtual support clinic from Providence PMG responded to issues of cultural competency.

"They had an issue where Muslim women had come out to get the vaccine, and they couldn't undress. They couldn't roll up their sleeves in public. So (staff) went and got the side rails to cover up the tent, so they could enclose so the person could go in and comfortably get the vaccine."

Johnson added, "I don't want to come in your community and tell you what to do.

"I want to come into your community and help you get the shot in the most comfortable way that is respecting you and your religion and your beliefs."

Clarke also described the importance of the trust-based approach to vaccination.

"What we're seeing is people rely on a trusted source, and so when they have a friend or a family member, a loved one, who can either be there to support them or who can be there to say hey, I got my shot, here's information I received, or here's where you can go to get your questions answered, that works really well," she said. "With some of our immigrant and refugee communities, there's a language barrier. We're having individuals who have received their vaccinations and they're acting as ambassadors in a sense, and reaching those communities we have not been able to effectively reach."

She added, "What we're seeing is that individuals who right now are saying they're ambivalent or hesitant about getting vaccinated, it boils down to concern around whether or not they will have an adverse response to the vaccination. We're seeing that the individuals who change their mind to get vaccinated are the ones who talk to trusted sources, and a lot of times it's relatives they've spoken to."

Johnson agreed.

"We just have to have those conversations. Once we get vaccinated, it's time for us to reach down and grab one other person."

Incentivizing Health

The county's Racial and Ethnic Approaches to Community Health (REACH) program is trying to make that system of referral easier by offering $100 cash gift cards to those receiving their first shot, $50 to those receiving their second, and $50 to those who bring a friend to be vaccinated.

The incentive program is in effect at Highland and a number of other vaccine sites in the Portland area.

"I was so overwhelmed with happiness when I looked up and I saw a young man come in, he got his first shot, they gave him a gift card, and then he went and got in his car, went back to the homeless camp he was staying at, and brought back two more people," Johnson said. "He said, ‘If I have gas in my car, I will bring people back from our homeless camp.'"

"We still have a fair amount of individuals that are not vaccinated, and some of those reasons have to do with the choice between working to keep food on the table, to pay rent, or some folks just don't have child care, they don't have transportation," Clarke said. "The gift card might be a way to bridge that barrier and that challenge that individuals face."

It is part of the county's push to be innovative and creative in how it connects the public to the vaccine.

"There's a lot of quiet storm people," Johnson said. "I know a nurse who said she's willing to do vaccine parties at your home. I mean, we're trying every way we can think of to get people vaccinated. There's a lot of unsung heroes right now, from our African American community to our African community. I'm working right now with (Immigrant & Refugee Community Organization) and Arco-PDX, we're reaching out to the temples and the mosques, the Muslim community. We're trying to do our best to get out there and answer these questions and climb those hills together."