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D.C.’s vaccine disparities are as big as ever. Here’s why poor Black areas are so far behind.

James Campbell, 65, receives a coronavirus shot at a Community of Hope health clinic in Washington on Feb. 26. (Jahi Chikwendiu/The Washington Post)

D.C. officials have struggled for months to narrow the gap in vaccination rates between the city’s most affluent neighborhoods and those hit hardest by the coronavirus — prioritizing certain Zip codes, launching clinics at churches and apartment complexes and reaching out door-to-door.

But stark disparities remain.

About 12.2 percent of residents in Ward 3, which include some of the Whitest, wealthiest neighborhoods in the city, were fully vaccinated by last Friday, according to data the city released this week.

That’s compared to 5.4 percent and 3.9 percent, respectively, in Wards 7 and 8, the poorest parts of the city and the areas that have some of the highest death rates from covid-19.

Efforts to distribute the vaccine equitably emerged late and were underdeveloped, advocates and D.C. Council members said in interviews. Some initiatives — like lowering age eligibility or prioritizing Zip codes — unintentionally backfired, opening up a hard-to-access registration system to thousands more wealthy residents.

And while the District has ramped up efforts to target the vaccine to underserved areas, the initial rollout prioritized downtown locations and mass vaccination sites. Frustrated D.C. lawmakers say the disparity reflects a historic lack of investment in public health care for low-income communities of color, an injustice they say the city could have done far more to correct.

“As a government, you have to center your work around racial equity from the outset — if you don’t, you will be playing catch-up,” said Kenyan R. McDuffie (D-Ward 5), who was among the first council members to criticize the city’s vaccine distribution. “And the District of Columbia, as is the case with many cities, has been playing catch-up.”

The Biden administration on Thursday pledged $10 billion to address racial disparities in vaccine distribution — including $6 billion for community health centers, which primarily serve low-income communities of color. President Biden said the funding would help reach “the hardest-hit and most vulnerable communities.”

Those are the people Lisa Fitzpatrick focuses on through Grapevine Health, the health literacy organization she founded. Fitzpatrick spends several days a month handing out literature and promoting the vaccine on the streets of Ward 7 and Ward 8. She hears from some people who don’t trust the vaccine, and from others who say they want it because they know Black people are disproportionately dying from the virus.

Many have struggled to access the shots, Fitzpatrick said, losing out to people who are more plugged in and on top of the latest developments.

“If you think about who’s getting the vaccine, it’s because convenience is not really a factor for them,” Fitzpatrick said. “They’re able to get online in a timely fashion and get the slots. They’re able to drive to wherever [appointments] are.”

The D.C. government must find more effective ways to address that issue, she and other advocates said, but at the same time it needs to get ahead of a deeper problem: As supply of the vaccine expands, and all those who want a shot can get one, health officials must convince those who are wary of vaccinations to accept them too.

Wayne Turnage, deputy mayor for health and human services, said officials want their equity efforts to bear fruit faster. But he also called hesitancy, fueled by misinformation, among the most crucial obstacles remaining.

“That’s what we have to overcome,” Turnage said. “I think we will, but it will be slower than we otherwise would have accomplished. And unfortunately, some people are going to die.”

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Health-care workers in Washington, D.C., are trying to make the coronavirus vaccine more accessible in Black communities and combat lingering skepticism. (Video: Whitney Shefte/The Washington Post)

Early missteps

When the city first offered the vaccine to senior citizens in mid-January, they deliberately included people ages 65 and older, while neighboring states prioritized only those 75 and older.

Officials said they were aiming to include more African Americans in poorer parts of the city, where the life expectancy is substantially lower and many people battle chronic medical conditions that increase the chance of complications from covid-19.

But the decision made a flood of seniors across the city eligible for the vaccine, and residents of wealthier neighborhoods — who generally have better access to information and the Internet — booked a disproportionate share of appointments. Nearly 2,500 seniors in Ward 3 found slots in mid-January, compared with just 94 seniors in Ward 8.

The city also launched a call center, in addition to an online portal, so people without Internet access could sign up for an appointment. Then word spread that the call center was sometimes easier to access than the website, and some people who had Internet access began using it too.

“I think you have to ask the question of whether we have effectively reached out far enough into populations where the disparities are evident,” said Council member Vincent C. Gray (D-Ward 7). “And I’m not sure we have, and we need to continue to do more.”

Lynda Mosley, 72, of Ward 8, saw the disparities firsthand. After a neighbor who has two computers helped her snag an appointment, she and her 95-year-old mother went to the Giant supermarket on Alabama Avenue SE in Ward 8 to get their shots.

“We looked around and the whole line was non-Black people,” Mosley said, adding that Black customers shopping for food seemed surprised as well. “They looked and they said, ‘What is this? What’s going on? How do we get this?’ ”

On another day, a young White couple trekked from Northeast Washington to the Safeway on Alabama Avenue SE in Ward 8, seeking leftover doses.

“A colleague of mine heard that quite a few friends were able to get the vaccine at this Safeway, so since we lived so close we thought we’d just come down and see if they had any extra,” said the 32-year-old woman, who spoke on the condition of anonymity to protect her privacy.

Few states are accurately tracking vaccinations by race. Some aren’t at all.

Council member Christina Henderson (I-At Large) said the government should focus more on getting information to people who don’t tune into online news briefings or monitor virus developments on Twitter.

“Go to any person of color on the street who is not a millennial and ask them if they know how to get a covid vaccine. Most of them would say, ‘Not really’ or ‘Maybe,’” Henderson said. “I think there’s this belief that there is a lot of information out there. And in fact, it may not be as much information as we think, for people who are not consumed by this in our daily lives.”

Similar disparities have been reported in other cities, including Los Angeles and New York, where Zip code data showed vaccination rates in wealthy, Whiter neighborhoods were eight times those in low-income communities of color in February. The situation reflects stark racial differences nationwide in who has been inoculated.

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In the District, just nine of the initial 45 vaccination sites were in Wards 7 and 8, according to a report from the D.C. Council’s Office of Racial Equity. Most were clustered at hospitals and major supermarkets, which are scarcer east of the Anacostia River, the city’s historical dividing line.

Health officials said they first focused on larger locations in these neighborhoods that could process a high volume of people.

An effort to conduct special vaccination clinics for residents of low-income senior apartments also was concentrated west of the river at first. 

And when the city began reserving a portion of its vaccination appointments for areas hit hardest by the virus, or “priority” Zip codes, officials included multiple mixed-income neighborhoods in Wards 1, 4 and 5, again boosting competition for the slots. The city is now focusing mostly — though not exclusively — on Zip codes in Wards 5, 7, and 8 that have low vaccination rates.

“Black residents are on the lower end of every indicator of success: education, health, employment. Policies and programs have to account for that,” McDuffie said. “That means you don’t allow people from the poorest communities to have to compete on a level playing field with communities that historically have had significantly more resources.”

Hopeful signs

While the data on fully vaccinated residents still shows enormous gaps between wards, the latest reports on people getting their first shots is more encouraging, said Ankoor Shah, the city’s vaccine czar.

As of March 15, he said, about 71 percent of Ward 3 seniors had received at least one dose of the vaccine, compared with 58 percent in early February — an increase of 13 percentage points. In Ward 8, 43 percent of seniors had received one vaccine dose — a jump of 27 percentage points since early February. The city is not publishing the data because of the challenge of differentiating between the two-dose Pfizer and Moderna vaccines and the one-dose Johnson & Johnson vaccine that has more recently become available, Shah said.

He posited that without the city's outreach efforts, the disparities would be worse — noting that other health indicators, like pediatric asthma and emergency room visits, are 20 times more common in Ward 8 than in Ward 3.

“Those specific decisions we’ve made, we’re thinking about how do we make sure it’s easy access,” Shah said.

One key change was the March 10 switch from a free-for-all sign-up system to a preregistration portal, where people sign up anytime and the city doles out appointments to priority groups as they become available. No longer do residents need to log on to multiple computers, hoping to find an appointment before the site crashes or all the spots are taken.

City officials would not provide ward-level breakdowns for how many people got appointments during the first weeks of the new system. But Shah said health officials will use the preregistration data to locate areas with the fewest sign-ups, and target door-knocking efforts there.

The city has also partnered with churches and community health centers east of the river, which say they are well-suited to offer the vaccine to their congregants and patients, respectively.

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Janice Jones, 73, a day-care teacher who lives in Ward 8, has been a patient at the Community of Hope health clinic near her home since 2014. Soon after the vaccine became available, she began getting calls from clinic staffers asking her to come in.

“They were concerned about my health” said Jones, who has diabetes and high blood pressure and whose son was also urging her to get vaccinated. “They called me about three times. ‘Ms. Jones, we are calling about the vaccine.’ ”

She said the health center called her before she had a chance to seek the vaccine out another way.

Jones, who was furloughed from her job in October, said she was both relieved to get the vaccine and pleased with her experience at the center. But she doesn’t plan to talk with her friends about it.

“I don’t want to hear nothing negative,” she said. “If you get it, you get it. If you don’t, you don’t. Don’t worry about me.”

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More than 1,880 people had gotten at least a first dose at church clinics in Wards 5, 7, and 8 as of March 21, officials said. The Rev. Kendrick Curry of the Pennsylvania Avenue Baptist Church, where about 330 people have received shots, said congregants expressed relief at being able to get vaccinated after failing to secure appointments through the city portal.

“It is comfortable when folks can go in their own neighborhood, in their own safe space, knowing that there are people that they already know and they trust, and in many cases, that look like them that are actually doing the vaccinations,” Curry said.

“Just imagine being able to come to a work service of some sort, or a meeting of some sort, and oh by the way you show up a few minutes early and you can get vaccinated, then go right to your meeting. That sort of ecosystem is the thing that makes the difference.”

The city has stepped up its efforts to offer pop-up clinics for low-income seniors east of the river, with hundreds vaccinated on March 13 at Benning Stoddert Recreation Center in Ward 7 and a clinic scheduled this weekend in Ward 8. Two of the three CVS vaccine clinics announced by the city on Wednesday will be located in Ward 7, with the other in Ward 5. And volunteers have secured vaccine appointments for more than 870 people living east of the river through a program known as Vaccine Buddies.

Jarvis Clark, 62, is one of them. One recent afternoon he and Trina Hayman, 50, were rushing home after a quick trip to the corner store. They were approached by two strangers holding clipboards and wearing masks, who quickly determined Clark was eligible for the vaccine and signed him up for an appointment he could reach by bus.

“I feel much better. I was just waiting until it became available,” said Clark, who has heart problems.

He hadn’t tried to sign up on his own, he said, because “I didn’t know where I could sign up at.”

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Wary of getting the shot

As access increases, city officials and advocates say, the issue of hesitancy will become even more urgent. Many polls show Black adults are slightly less likely to say they will get a coronavirus vaccination than the public overall, though interest in getting vaccinated has been rising since late last year.

For many African Americans, the wariness is rooted in generations of mistreatment by the medical establishment, from the Tuskegee Syphilis Study to modern research showing doctors are more likely to turn away or misdiagnose Black patients.

D.C. Council member Trayon White Sr. (D-Ward 8) was not available to comment for this article, his office said. But Gray, who represents Ward 7, said he hears frequently from constituents who simply don’t believe the vaccine is safe — which he called a primary driver for continuing disparities.

“I think we need more African Americans who are willing to stand up and say you’ve got to protect your future by getting a shot — you’re not walking into another Tuskegee experiment,” Gray said.

Md. governor said Black residents don’t want the vaccine. But thousands are seeking shots.

Turnage, the deputy mayor, said the city must respect residents’ freedom of choice but is also trying to counter hesitancy through one-on-one outreach where people can ask questions and have their concerns addressed.

“We won’t have definitive information on how resistant a particular community is to receive this vaccine until we have a supply that exceeds demand,” Turnage said. “If you still see these persistent differences, then you will clearly come to the conclusion that we’re dealing with an issue of vaccine hesitancy, and really nothing else.”

He said his hope is that hesitancy rates — along with ward-level disparities — will be “minuscule” by fall.

In the meantime, those who want and are able to secure the vaccine are trudging forward.

Vanessa Pone, 66, got her first shot at Community of Hope. She has friends who have died of covid-19 and said she wants to live.

“A chick told me on my way over here, ‘Don’t take it, girl — you know they’re killing up the seniors,’ ” Pone recalled.

She responded: “Girl, hush, I’m doing what I got to do to stay aboveground.”

Julie Zauzmer contributed to this report.

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