NEW YORK – Chandra Singh wanted a coronavirus vaccination.
A native of Guyana, the 71-year-old doesn’t own a computer, with which she might access information online. So when she saw a crowd of elected officials and community leaders gathered on a corner for a news conference, she asked them where she could get the shot.
They couldn’t answer but directed her to a nearby library, where she settled for getting a free coronavirus test. It wasn’t a vaccine, but the test gave her some peace of mind because her Queens neighborhood, South Richmond Hill, had soared to the highest coronavirus infection rate in the city.
“The area is badly disorganized – they never inform you of anything,” said Singh, who has lived here for 33 years.
New York City health officials released data on Jan. 31 that revealed vast racial disparities in vaccine distribution. Among those whose race was recorded, nearly half of city residents who have received a coronavirus vaccine are White. Fifteen percent of those vaccinated are Latino, 15 percent are Asian and 9 percent are Black.
The experience in New York is reflected across the nation, where communities of color, which have been hit particularly hard by the pandemic, have fallen behind first in testing and now in vaccinations.
“We cannot make the same approach that we made in responding to the pandemic, where we assumed the risk was the same for everybody,” said James Hildreth, an infectious-disease expert and president of Meharry Medical College. “With the vaccine, if the goal is to save as many lives as possible, we’ve got to be focused on the most vulnerable populations.”
A Feb. 1 report from the Centers for Disease Control and Prevention shows that of those whose race was known among the 13 million Americans vaccinated in the first month of the drive, Black people accounted for little more than 5 percent. Six percent were Asian and 11.5 percent Latino.
The CDC data are incomplete: While the sex and age of recipients was reported in almost every case, only about half reflected the race or ethnicity of vaccine recipients. Researchers are calling for more accurate reporting to ensure equitable vaccine distribution, even as some jurisdictions work to counter the worrisome trend, knowing that gaps in vaccination rates could widen existing health disparities.
Chicago officials are making concerted efforts to boost the number of vaccine doses delivered to at-risk neighborhoods, with “strike teams” encouraging residents to sign up for shots. In Philadelphia, an African American physician launched the Black Doctors Covid-19 Consortium in April. It has partnered with the city health department to provide testing and is now rapidly ramping up the number of vaccine doses it delivers in familiar neighborhood settings, such as churches. Maine health officials are encouraging older members of the Somali community to be vaccinated and have allocated vaccine doses to a clinic in Lewiston that serves that community.
“A mistake we make in public health is assuming we have the right way to message, and we parachute into the community to deliver that message,” said Sandra Albrecht, an assistant professor of epidemiology at the Columbia Mailman School of Public Health. “We’re learning that it’s important to work with key members of the community that are trusted.”
Officials in three adjoining Queens neighborhoods – Richmond Hill, South Richmond Hill and South Ozone Park – say they have long been left out of coronavirus outreach. For weeks, the virus positivity rate in the neighborhoods has hovered around 18 percent, more than double New York’s average.
They said it took weeks of news conferences and a social media blitz from outraged elected officials to get the city to add the neighborhoods to its equity task force’s priority list. There are now plans to accelerate educational outreach and add testing sites; a new neighborhood vaccination site is in the works but won’t be possible until supply increases.
A city-run vaccination site sits across a highway from the neighborhoods but has little vaccine supply. A state-run site at a nearby racetrack has had few, if any, appointments available since it opened last month.
“Make no mistake – this is a relief,” said Richard David, a Democratic state district leader. But he still has concerns.
“Knowing that we are always thought about last, I am so scared,” he said.
The three working-class neighborhoods have recorded 347 coronavirus deaths since the start of the pandemic. Tucked into a pocket near John F. Kennedy International Airport, they are home to more than 54,000 Caribbean and South Asian immigrants, primarily from Guyana, Trinidad, Bangladesh and India’s Punjab state. Many arrived in the 1970s and 1980s. Spanning 20 blocks of Liberty Avenue are Guyanese bakeries, Trinidadian roti shops, Indian grocery stores and Hindu boutiques selling bright garlands of plastic flowers that spell the word “welcome.”
“What’s clear is, the status quo does not make sense,” Mayor Bill de Blasio said last week of vaccine access. “We’ve got to have a more systematic approach to ensuring that we focus on the places where the danger is greatest.”
That effort, he said, demanded more of a grass-roots approach to help assure people that the vaccine is safe. “We’ve got a profound problem of distrust and hesitancy, particularly in communities of color,” he said.
Queens officials said the neighborhoods have been overlooked for vaccination and testing. The city opened a permanent testing site at a library in South Richmond Hill in November. Local officials said it came too late and residents were not adequately informed.
Queens Borough President Donovan Richards Jr. said the city’s approach to testing and vaccination has been profoundly inequitable because it did not sufficiently involve local organizations.
“It is imperative that we involve each and every trusted community-based organization in a truly all-hands-on-deck vaccination effort,” he said. “The deep disparities revealed in the city’s covid-19 vaccination database are not just unacceptable – they are potentially fatal.”
Local leaders said their community had been overlooked long before the pandemic.
“A lot of times, people don’t realize that so many of us are low-income and we are working-class – we’re not a ‘model minority,'” said Aminta Kilawan-Narine, founder of the South Queens Women’s March, which gives away masks at its weekly food pantries.
She and other leaders have been monitoring the rise in positivity rates since the Hindu festival of Diwali on Nov. 14 – the same day the testing site opened. But when the city did open it, neighborhood leaders said they were not notified in advance to spread the word.
There were other disconnects. Kilawan-Narine said she urged the city to print cards that offered information on area testing locations and hours, something the volunteer organizations could not afford. David said the city could have better reached the Indo-Caribbean community by placing ads in its newspaper. Some faith leaders say they do not have updated information to share with their congregations.
De Blasio spokeswoman Avery Cohen said 600 city staffers have partnered with organizations in the three neighborhoods to help hand out masks and hand sanitizer. The city will set aside vaccine appointments for residents of 33 priority neighborhoods, including Richmond Hill and South Ozone Park.
“Equity is and will continue to be the backbone of this effort,” she said.
There are no localized statistics to explain why the Indo-Caribbean neighborhoods in south Queens have struggled to contain the virus. Many residents work outside the home in jobs considered “essential,” including in security or maintenance at JFK. Others are home health-care aides or work in construction. Some are undocumented.
Many residents live in multigenerational households. One family recently complained to their Hindu priest, Anand Maharaj, that their son was putting others in their house at risk. They told Maharaj that the young man had tested positive for the coronavirus but was asymptomatic; he was still going to work and not isolating.
“It’s a lot of carelessness, especially people under the age of 30, because they think they are strong, they think they can fight the sickness,” Maharaj said.
Maharaj, who is president of an international council of priests, has urged his affiliated temples to observe social distancing and mask rules when gathering for worship. But the unaffiliated, he said, do not always follow the rules. Outside the temple, he and others are worried that people are still holding house parties.
“Covid fatigue is very much real. And folks want to gather,” said Mohamed Q. Amin, director of the Caribbean Equality Project, a nonprofit that works with the LGBTQ Indo-Caribbean community. “We have to cancel fete culture to save lives,” he said, using the Caribbean term for any celebration.
Kilawan-Narine, who said she’s disturbed by social media feeds showing maskless revelers, recorded a video with testimonials from covid-19 survivors for social media.
“I know our people love to get together, we love to socialize. I know we’re getting antsy and we want to get on with our lives, but it’s not over yet,” it said.
Some on social media told Kilawan-Narine she was stoking fear or said the coronavirus was a hoax. People were also reluctant to get vaccinated.
De Blasio said the city could handle up to 500,000 vaccinations a day once supply replenishes. The closest city site for those in South Richmond Hill and South Ozone Park now is at a high school on the other side of the Van Wyck Expressway. Supplies are limited. The state-run Aqueduct Racetrack in South Ozone Park has had limited to no appointments since it opened on Jan. 18. The city said Citi Field will open as a vaccination site for Queens residents within days. Signing up can be confusing, though, because the city and state are not coordinating their vaccination sites.
Jatinder Boparai, president of the Sikh Cultural Society, said a representative from the office of Gov. Andrew M. Cuomo toured its 84,000-square-foot gurdwara to potentially include it in the Vaccine Equity Task Force’s pop-up program.
Boparai said the city called him a day later. While it is unclear when vaccinations will start, he said he is thrilled because no matter “your skin color, how rich, how poor,” anyone will be able to receive a shot once the site opens.
“This is a big achievement for our gurdwara,” he said. “We know where we’re standing now.”