On a chilly Sunday afternoon outside the Reggie Lewis Center in Roxbury, Rachael Williams greeted passersby with an offering of free masks, hand sanitizer and, if needed, baby food. The care packages served as an ice breaker so she could strike up a conversation with the person about getting vaccinated.
“Sometimes people get a little scared or apprehensive because they think that this vaccine was rolled out overnight,"Williams told GBH News. "But it wasn’t. It went through the same proper channels. It has been vetted, and it is safe,” .
Williams, a senior research coordinator at Massachusetts General Hospital who is African American, is considered a trusted messenger — a culturally competent person who volunteers to spread the word in communities less likely to get the vaccine.
Vaccine hesitancy has been identified as a barrier to vaccinating the general public equitably — particularly among the populations hardest hit by COVID-19. Programs to harness the trust and competence of volunteers like Williams are springing up locally and across the nation as a strategy to overcome skepticism.
Williams, 28, said she decided to volunteer after she lost her “nana” to COVID-19. The loss, she believes, might have been prevented had her grandmother been more informed.
“When it happened, I realized that I needed to be doing more,” she said. “I’m really here to help support other Black women and young girls to know that we can get back to normal as soon as it’s safe to do so. Step one is getting people vaccinated.”
Data from the Boston Area Research Initiative suggests achieving that goal will be a challenge.
Of the 1,626 Bostonians the initive polled last fall, one in five does not plan to get vaccinated. That figure includes nearly half of the survey's Black respondents and about a quarter of Latino respondents.
The state’s latest vaccination data shows that Black people account for about 5% of people who have received at least one vaccine shot, in cases where race is known. Asians and Latinos each account for slightly more than 4% of vaccinations.
Joseph Betancourt, chief equity and inclusion officer at MGH, acknowledged it’s an “uphill battle,” since messengers must counter more than mere hesitancy about the vaccine.
“There’s a history of racism, discrimination, medical experimentation, segregation, issues related to immigration, mistrust, you know, language barriers, difficulty engaging or understanding health care providers. For all those reasons, we believed and understand it's important to engage our communities of color around the vaccine,” Betancourt told GBH News.
Betancourt said MGH and the other hospitals within the Mass General Brigham health care network are now deploying about 140 caregivers of color across the state through social media town halls, question-and-answer sessions and appearances alongside the hospital’s outreach van in hot spot communities.
Michael Curry, CEO of the Mass League of Community Health Centers, said his organization is rolling out a similar strategy.
The league, which recently received a $1 million grant from the Baker administration, will soon start distributing funds for member centers to craft ad materials for target patient populations — Black and Latino residents, Portuguese speakers and immigrants from China, Vietnam, Haiti, Cambodia, Cape Verde and the Middle East.
“We want to make sure the resources are going where they’ll be best used,” Curry said Wednesday.
Health centers, which typically provide medical services in underserved neighborhoods, are well-suited to help persuade vaccine skeptics because their staffs know the faces, speak the languages and understand the fears in the communities where they’re situated. The centers serve a seventh of the Massachusetts population.
Curry said he expects the general population’s vaccination pattern to follow that of community health center workers — hesitant until they observe others receive it without extreme side effects. Informally, he added, the league’s 52 centers have vaccinated about 70% of their staff, a rate that was in the 20-30% range when the vaccine first became available to frontline workers in December.
Areliz Olivia Barbosa, a community health worker from Springfield, received the vaccine after observing others. She serves on the league’s advisory group and volunteers as a trusted messenger.
“I definitely didn’t want to be the first to opt-in,” Barbosa, 40, said of her own hesitation. After considering the likelihood of becoming infected, Barbosa scheduled her first shot and experienced a mild allergic reaction. The opportunity to build immunity to the virus, she said, was worth it.
Still, because of her awareness of systemic racism in health care, Barbosa, who is Latina, said she is careful not to push anyone else to take the vaccine.
“No one wants to be told what to do," she said. "They want to be heard. They want their feelings to be considered. My goal is for the individuals to be able to make an informed decision, whatever that decision is for them.” Then she added a second goal: "anyone who wants to get the vaccine and is eligible to be able to get it.”
Doctors vaccinating people agree and say equitable vaccine distribution will require double work — trusted messengers and dedicated resources. Hesitancy, they said, shouldn’t prompt the reallocation of vaccines.
“The intensity of resources needs to be in the areas where there is skepticism and hesitancy to overcome it,” said Bisola Ojikutu, infectious disease specialist at Brigham and Women’s and MGH. “You can’t remove the resource from the people just because maybe they’re mistrustful of it for real, honest, reasonable reasons.”
Williams, who has so far convinced only family members to get vaccinated, said she’s hopeful the trusted messenger initiatives will inspire more people to get vaccinated as time passes.
“If people who are on the front lines and engaged in the healthcare system can lead by example for some of these communities that have been left out of big decisions [and] left out of protective measures, hopefully that can encourage them to know that it’s safe and it’s okay to take this vaccine,” she said.
Clarification: This article has been updated to clarify that MGH and the other hospitals within the Mass General Brigham health care network are deploying the trusted messengers program.
