The Vaccine Gap
Trymaine Lee: By now, we've all heard the story, that Black people aren't getting vaccinated for COVID-19 at the same rates as white folks because of deep and historic mistrust. But that's not the whole story.
Janice Phillips: We were sitting and waiting, waiting and waiting to get called. You know, we had been waiting probably a couple of months.
Lee: Janice Phillips wants the vaccine for her and her mother. Just a few months into the rollout, and it's already pretty clear that gaps are emerging between who gets the vaccine and who doesn't. And we're seeing old, typical patterns. Fewer than 7% of vaccine doses have gone to Black Americans nationwide.
In New Jersey, where Janice lives, that number drops to 4%, even though the state is about 15% Black. Janice is from Trenton, the state capital, and I know Trenton well. I actually worked for one of the local papers there years ago, The Trentonian.
And there are some things you should know about this city. First off, it's almost 50% Black, while the surrounding towns in Mercer County are mostly white. The city is poorer and has a higher unemployment rate than the county and the state. It's dense and segregated, and struggles with many of the typical racial disparities you see in other urban centers across the country.
All of this means its residents are more vulnerable during this pandemic. And it means many Trentonians are also being denied proper access to the vaccine. Black people in Trenton have gotten about one third of the doses. Considering the odds, it's all right, but remember the city is half Black.
With data coming in from across the state showing that white people are getting the vaccine at far higher rates than communities of color, and the state's outreach efforts so far clearly not working, New Jersey decided to turn to a different kind of healthcare partner, the Black church.
Reverend Darrell Armstrong: Pastors are naturally thought leaders, as well as influencers.
Lee: The idea, a community-government partnership that relies on faith leaders to get the vaccine to the people, to meet them where they are.
Armstrong: If we want to reach the Black community in America, we need to reach them through their Black faith communities.
Lee: I'm Trymaine Lee, and this is Into America. Today we go to Trenton, New Jersey to get a clear sense of why vaccine doses aren't reaching Black people, and how a group of faith leaders are stepping in to help close the gap.
Phillips: I was born and raised here in Trenton, New Jersey.
Lee: Janice Phillips is 63. She's a retired speech therapist and special ed teacher, and she's got a really close-knit family.
Phillips: My mother is 103, hundred and three.
Lee: Wow, congratulations to her, that's amazing.
Phillips: Yes, yes. She lives with my sister. There's just two of us, and I live about five minutes away. I generally go over a couple days a week in the evening to help care for her for her meals. We did not want to put her in a nursing facility, so we're caring for her ourselves.
Lee: Janice's 103-year-old mother, Carrie Raymore, requires near constant care. She uses a wheelchair and has dementia.
Phillips: She knows who we are. She knows her granddaughters, but she doesn't remember faces and things like that. The thing that she does remember is hymns.
Phillips: And we have a hymnal, and I'll start singing, and she remembers all the verses.
Lee: Never lose that.
Phillips: Lift Every Voice and Sing. She's just singing it out, and I'm, like, "Wow, she remembers that."
Lee: That must be a source of comfort, I mean, that your mother is still holdin' onto those hymns.
Phillips: It is. (MUSIC)
Lee: What was life like for the family before COVID?
Phillips: Well, we got together more frequently. Before, we took her out. She came over here at my house. We always did holidays here, Christmas dinner, Thanksgiving dinner, you know, out in the backyard. I mean, she was out with us. So, you know, when COVID hit, we had to stop all of that. Gradually we became a little less fearful, but still very protective of, you know, masks, six-feet distance. But, you know, you gotta go in the grocery stores, and so we were doing that. But we basically were staying home.
Lee: On January 14th, New Jersey opened up the vaccine to residents over 65. As Mrs. Raymore's caretaker, Janice is also eligible. She wanted it, but she hesitated for her mom. Mrs. Raymore is frail, and Janice was worried about possible side effects.
Phillips: Then we started thinking, that's not smart to think that way, because if she contracts this, it's gonna be deadly for her. So we contacted her physician. She said, "Sure, go ahead. Make sure she gets a vaccination," and so we put her on the NewJersey.gov list.
Lee: States right now are managing their own vaccine distribution plans, which include websites like the one Janice described where you can find out how to get tested or try to make a vaccine appointment. Janice looked for other options too.
Phillips: We were on several lists. We were told to get on the Henry J. Austin list, which we went on the website and signed up on that list.
Lee: Henry J. Austin. It's another place to get vaccinated in Trenton. It's a federally subsidized health clinic that has its own supply from the state.
Phillips: Then some information came out about Walgreen's and CVS having the vaccine, so we ran and got on their websites and signed up on their lists. And then we have a neighbor who works as a social worker with the City of Trenton. We kind of talked to her to see if she knew of any other lists. You know, so it was just like we were running around trying to get the vaccine. We were sitting and waiting, waiting and waiting to get called. You know, we had been waiting probably a couple of months.
Lee: How frustrating was that? I mean, were you starting to say, you know what, what do we have to do?
Phillips: We started seeing where, as we're watching television and seeing a lot of white folks lining up getting shots, we're thinking, okay, well how come they're all getting shots? Why isn't it available to us? You know, why are we hearing on the radio that West Caldwell, New Jersey just got a big batch? They're all lined up in some beautiful facility getting their shots, and they're not people of color. So that's when, you know, we started thinking, wait a minute, you know, something's not right about that.
Lee: Janice was seeing those gaps I mentioned earlier in action. In Mercer County where she lives, 8% of vaccines have gone to Black residents, even though they represent nearly a quarter of the county's population. More than half of the doses have gone to white residents.
There was nothing Janice could do but wait. One of the biggest reasons Janice couldn't get the vaccine for her mom is supply. It's a problem Trenton Mayor Reed Gusciora has been dealing with for weeks. How many doses of the vaccine is Trenton guaranteed each week?
Mayor Reed Gusciora: We get 235. This last week--
Lee: I don't mean to put the brakes on you, but two hundred and thirty five?
Gusciora: Yes, 235 is absolutely guaranteed.
Lee: Two hundred and thirty five vaccines each week for a population of 85,000. It sounds crazy, but let me break it down for you. The federal government allocates vaccines to the states based on population. In New Jersey, counties get their allotment based on population as well.
So in Mercer County, where Trenton sits, 2,000 doses arrive every week. Half of those go to the municipalities. Trenton, as we mentioned, gets 235 doses from that pool. If you live in Mercer County, you can also sign up for a chance to get one of the other 1,000 doses. Two of the biggest vaccination sites are the sports arena in Trenton and the Mercer County Community College just outside of the city. But there's a catch.
Gusciora: It's the luck of the draw, and the first come first serve out of those thousand.
Lee: And then there are other sites that have their own allocations, which leads to the multiple lists and signups Janice Phillips described earlier. The whole thing is a tangle, it's a mess.
Gusciora: Henry J. Austin's Health Center, which is a free health center, they distribute vaccines as well, and the two other hospitals, and then the drugstores.
Lee: Just this week, Mayor Gusciora learned that Mercer County will soon get 3,000 vaccines a week. But his office hasn't learned when that increase will happen or how that will change the calculations for his city.
Gusciora: Where in the suburban areas you could walk, you know, a quarter mile to the next door neighbor, we have literally people living in ten-story tower senior towers and the like. So the real danger of an epidemic flow is in the high-density housing areas, the Trenton Housing Authorities. And that's why we need to have more vaccinations, and that there should be a greater recognition that it shouldn't just be based on population, but it should be based on population density.
Lee: Supply aside, there are other barriers to access in the city.
Gusciora: This is a city that people lose their housing, people move, people move around, so it's a challenge. We had people who signed up, and by the time we called them, their phone had been disconnected, or they were no longer at that address. A lot of people have challenges getting internet access.
Lee: And the mayor has tried to address the transportation barrier.
Gusciora: And we'll pick you up too. We offer rides to the vaccine sites, so we have a host of volunteers from the churches and from the city to make sure you can get to the vaccine site on time.
Lee: You know, I heard you mention the drugstores, and I came across this list of CVSs that, you know, have the vaccine. But they all seem to be in white communities.
Gusciora: White neighborhoods, Robbinsville, Princeton, and it's disappointing. And I want to contact CVS and/or the state to find out why they left Trenton CVSs behind. But it should not be just the suburban drugstores, but it should be everyone, and we have at least two CVSs and other independent pharmacies that we could reach a lot more people.
Lee: A spokesman for CVS didn't directly answer our questions about why Trenton's two locations do not have the vaccine. She told us that supply is limited, and they chose the locations based on a number of factors, including population density, community need, and the layout of the store. She said, "CVS expects to add greater access as supply becomes available." In the face of these glaring disparities, the state announced a plan to close the access gap.
Phil Murphy: We are always striving to ensure equitable access to appointments and vaccinations. It is among our very highest priorities.
Lee: And they will be looking to the communities for help. That's coming up after the break.
Lee: New Jersey has watched over the past year as COVID-19 hit Black Americans hardest. State officials told us they knew it would be a challenge to get the vaccine to Black people in vulnerable, densely populated cities like Trenton. But remember, just 4% of the state's vaccines have gone to Black people, proof they hadn't done nearly enough. So on February 12th, at one of his regular coronavirus briefings, New Jersey Governor Phil Murphy made an announcement.
Murphy: We are preparing to launch the first of our community-based vaccination sites. These locations are being strategically placed in communities that had been disproportionately impacted by COVID-19, and some of our most diverse and socioeconomically challenged communities.
Lee: A community partnership that would center around houses of worship. The next day, Trenton Mayor Reed Gusciora got the call.
Gusciora: Somebody reached out from the state department of health. There was an offer to reach out into communities of color, and the best way that they felt was to go through the Black churches and Spanish churches and the like.
Lee: The state dedicated enough doses to vaccinate 15,000 people through the program by the end of March. Working with FEMA and local governments, ten vaccination sites were chosen around the state, all centered in lower income communities of color. Trenton got two of them, an Hispanic church in a local high school with enough doses for 3,000 people. That's more than six times what the city alone could administer with their guaranteed allotment.
Gusciora: We immediately took them up on the offer.
Lee: But in order to make this partnership work, Mayor Gusciora had to act fast.
Gusciora: We were told on a Saturday that we had to have 1,500 people's lists by the following Wednesday. We called every church in Trenton to see if they would sign on. We got the pastors collectively together. Some were skeptical, but most of 'em had the opportunity.
We gave the churches an independent portal where they could plug in their congregants. And then FEMA came in with the National Guard, set up two vaccine sites, and quickly filled up. For two weeks we were distributing 3,000 vaccines, 1,500 a week.
Lee: In a few weeks, the sites were reopened, so folks can get their second doses.
Gusciora: And so I think that it was a really good idea to do it through the churches, 'cause you have, you know, a standing community. But we have to get to the people that don't necessarily belong to a church and don't have access to the communication system that the church has.
Lee: But so the 3,000 additional, I mean, that seems to be a step in the right direction, right?
Gusciora: Was a spark, and it was manna from heaven. And we need more of those opportunities that will continue to distribute vaccines, as the supply increases.
Armstrong: The medical establishment was absolutely correct to say, "If we want to reach the Black community in the United States of America, we need to reach them through their Black faith communities."
Lee: Reverend Darrell Armstrong is the pastor of Shiloh Baptist Church in Trenton. It's over a century old and has a large congregation of about 800 members.
Armstrong: Listen, I talked to more than a few members that said, "Pastor, when I heard about the state registry, I signed up, but it's been weeks and I've not heard anything."
Lee: Reverend Armstrong was one of the faith leaders who heard from the mayor a few weeks back. When he found out that he could secure vaccine appointments for around 50 of his congregants, he knew exactly where to start.
Armstrong: I have six 100-plus-year-old members of my church. Four of them had not been vaccinated. Three of them were waitin' on the list. Listen, these are the shoulders upon which we stand. They paved roads and opened doors for me to walk through.
Because of that generation who fought the integration fight, I was able to get opportunities that they only dreamt of, and so payin' it forward, right? When you are blessed, you've got to be a blessing. And you have to always remember from when you've come.
Lee: The oldest member is Janice Phillips' mom, Mrs. Carrie Raymore.
Armstrong: When I first came there in our church in 1997, Mother Carrie Raymore was already in her 80s. And to watch her over the last 20 years grow into a state of now dependency, right? As 103, she can't do everything she used to do, but anytime she hears the word "church," or even when she hears "Pastor Armstrong," the smile that comes on her face is absolutely invaluable.
Lee: So on February 17th, Reverend Armstrong texted Janice Phillips.
Phillips: So when I got this text, at first I thought, "Oh my gosh, this is unreal. The vaccines are coming to churches in Trenton?" It was just like a breakthrough. It was like somebody woke up and realized that they gotta get these vaccines to the people.
Lee: Reverend Armstrong remembers that moment too.
Armstrong: I was overwhelmed. I was joyful when I was able to contact her two daughters, and I could almost hear tears welling up, "Thank you, thank you, thank you for gettin' my mom vaccinated."
Lee: The Reverend laid out the details.
Phillips: He decided to go through the age, start with the centenarians, which did not surprise me at all. He loves his centenarians. So then he said, "The centenarians and their caregivers." So then we thought, "Oh gosh, that means there's, like, four or five of us. Is he gonna be able to get us all vaccinated?" And so he put us on the list.
Lee: Janice's sister had already gotten the vaccine through her work by this time, so Janice, her husband, her mother and her god-sister, all got on the Reverend's list. And on February 23rd, with a mini caravan in tow, they brought Mrs. Raymore to the Iglesia Pentecostal Assemblies Church in Trenton to get their first shot. And it's one thing, I mean, obviously it's a big breakthrough to get your mother protected, but then also for you all to get the shot to make sure there's also a buffer of protection there, that must have felt incredible.
Phillips: Yes, it did. It did. We were all pumped up, we were excited. We were just happy, ecstatic, that we were going to finally get the vaccine. My mother did well. My sister has since told me that she's a little drowsy. She's not as alert as she normally is. She was born in 1917, so she was here for the first plague, I'm calling it a plague, but, you know, pandemic. She was a baby. She made it through that, so she's gonna make it through this.
Lee: They done been through some things.
Phillips: Yes, yes.
Lee: They've been through.
Phillips: Yes, exactly.
Lee: Do you think you would have gotten a vaccine without this partnership between the church and the city and the state?
Phillips: I think we would have still been waiting, especially if you don't have any secondary health conditions. I would've still been waiting, definitely would have still been waiting.
Lee: Janice and her family are scheduled to receive their second dose on March 23rd. By most accounts, this community partnership program is on track for success. Three thousand people in Trenton gained access to the vaccine, and 15,000 people in underserved communities stand to benefit from the effort. But let's call it what it is, just a Band-Aid. It's barely covering up just how unequal access to quality healthcare is in this country. The fact that there is a gap in access wasn't a shock to Janice.
Phillips: It didn't surprise me, especially with what's happening during this current time with the inequities that we're seeing. It kind of fell in line with that unfortunately. I thought we were past that more than we are, but we're not. That's unfortunate.
Lee: I asked the Reverend about what more can be done to help close the gap.
Armstrong: Well, listen, I mean, it's clear that this is a supply and demand issue. We are reaping unfortunately the negative results of a prior administration that did not act proactively. And so this new administration had to step in and expedite what should have been expedited all of last year. We as moral leaders need to understand that this is a moral question. This is a moral question of life and death, and that government is created to ensure that life is extended and prolonged and not truncated and aborted.
Lee: The newly approved Johnson & Johnson vaccine has given him some hope on that front, and there are promises from the Biden administration that there will be enough vaccines for every adult American by May. In New Jersey, the state says they're working on other ways to reach vulnerable Black communities, like mobile vaccination clinics.
And Mayor Gusciora says he'll continue to fight for more supply in Trenton, going door to door to find people who aren't connected to churches. For now, Janice Phillips is trying to focus on life after the pandemic. Do you imagine a day in the near future where, you know, your family including your mother will be back in church singing her favorite hymns? Can you see that day?
Phillips: I can't see that day yet. I know it will happen. I know it will get here.
Lee: Our episode this week is part of a network-wide effort called COVID One Year Later, Life After Lockdown. So be sure to check out coverage on NBC, MSNBC, and NBC News NOW as we approach March 11. That's when the COVID-19 outbreak was declared a pandemic.
I know it's so wild that it's already been a year. And as we continue to have these conversations around access and equity and the COVID-19 vaccine, we wanted to let you know about a new resource that could help you and your family.
You can visit PlanYourVaccine.com. It's an interactive, personalized, state-by-state guide from our parent company, Comcast NBC Universal, that has everything you need to help you figure out when and where to receive the COVID-19 vaccine.
You can sign up for customizable alerts that let you know when you're eligible to receive the shot in your state and find the vaccine locations closest to you. So if you're one of the millions of Americans trying to get vaccinated right now, check it out. PlanYourVaccine.com.
Into America is produced by Isabel Angell, Allison Bailey, Aaron Dalton, Max Jacobs, Barbara Raab, Claire Tighe, Aisha Turner, and Preeti Varathan. Original music by Hannis Brown. Our executive producer is Ellen Frankman. I'm Trymaine Lee. We'll be back next Thursday.