As mass vaccination centers take the lead in the COVID race, the push is on to reach the most vulnerable

Yehyun Kim :: ctmirror.org

Residents register for COVID-19 vaccinations at a Griffin Hospital facility in Shelton.

As the state pivots to a new age-based vaccination schedule, it will rely on mass vaccination centers across the state to solve a problem that has vexed the rollout — getting more shots to the state’s minority, mostly city-dwelling residents.

Gov. Ned Lamont’s administration announced Monday it was abandoning its previous vaccination plan, which prioritized essential workers and those with certain medical conditions, in favor of an age-based rollout because, state officials said, it would allow the state to rapidly vaccinate more people. The only group specifically prioritized under the new plan are school employees and child care workers.

While mass vaccination sites — such as the one built on an air strip at Rentschler Field in East Hartford — have helped the state’s overall vaccination numbers rank among the best in the country, they have not reached the state’s most vulnerable populations, who so far have been left behind.

State officials expect there to be a growing number of mass vaccination sites, with new ones opening in the coming weeks at both of the state’s tribal casinos and Sacred Heart University. Pharmacies are getting a separate influx of federal vaccine to handle the roughly 650,000 people in the next group of eligible residents in the 55-64 age group.

[State memo: COVID vaccine providers should emphasize vulnerable populations]

After studying their own vaccination numbers, the state’s hospitals — which are operating many of these mass vaccination sites — are also trying different techniques to reach the minority population they have so far missed.

Those techniques run the gamut, ranging from making reverse 911 calls in New Haven to sending out blast text messages to eligible populations in Hartford, and while those outreach efforts are time-consuming and expensive, hospital officials say the people getting the shots are the ones who most need them.

“We know we have hesitancy in the African American community, and we may only get 10 people to show up in the church basement for a clinic — but that’s 10 people that otherwise wouldn’t have gotten vaccinated, and if that’s what we have to do, then that’s what we will do,” said Griffin Hospital CEO Pat Charmel, whose hospital has partnered with religious leaders to hold clinics in Ansonia.

“You need a small army to do some of this work, but I think it’s a one-time thing, and if we do it and make the investment, then I think we can get it done.”

More vaccine on the way

To ensure that the mass vaccination clinics reach the vulnerable populations, the state is asking vaccinators to either schedule clinics for individuals or groups specifically invited through the federal VAMS system under what is called “third party VAMS,” or to carve out time for certain populations by reserving  appointments for people from certain ZIP codes at their mass vaccination sites.

Many hospitals said they have already started doing that by using ZIP codes to block out clinics.

Dr. James Cardon, Hartford HealthCare’s chief clinical integration officer, said when someone puts the ZIP code of their home address into the system, “it opens up a bunch of schedules that somebody from another ZIP code won’t see.”

“That really does allow us a very clear way to reserve appointments,” Cardon said. “If people call into our Access Center for those that can’t go into the digital front door, the folks that are answering the phone have access to schedules that the general public does not.”

Parsing out doses will become even more critical as more vaccines enter the system. On Thursday, Gov. Ned Lamont announced that the state could receive up to 30,000 doses of the Johnson & Johnson vaccine as early as next week.

That would bring the state up to around 100,000 doses weekly, not counting a high influx of vaccines going to CVS and Walgreens.

The two pharmacies, which have vaccinated all of the state’s nursing home residents, are now receiving a significant amount of vaccine from a new federal program. Those vaccines will be administered in the pharmacies inside their stores.

They will be receiving 23,000 doses next week, almost a quarter of the state’s total. There are 13 CVS locations from Putnam to Bridgeport currently approved to vaccinate people and 48 Walgreens, including three in Bridgeport and New Haven, two in Hartford and single stores in Meriden and New Britain on the state’s vaccinator list.

Mass vaccination sites reaching out in new ways

A number of hospitals have already started or are planning to roll out mobile clinics aimed at church halls, community centers and apartment complexes, and some have started directly calling people to try to get them appointments.

“There’s nothing worse than going into the community and convincing them that they really need to do this — then they can’t find the vaccination site or don’t have access to the vaccine,” Charmel said. “We need to meet these people where they are, not expect them to come to us.”

Yehyun Kim :: ctmirror.org

Anna Bellucci, of Hamden, gets COVID-19 vaccine at a Griffin Hospital facility in Shelton. Tom Bellucci, right, took his mother to the site and expects to become eligible for the vaccine in March.

Griffin Hospital, in Derby, started a call center from scratch on Jan. 18 and generated a list of more than 200,000 names by merging hospital records from visits to emergency rooms with hospital-employed doctors who serve patients in Ansonia and Derby, two towns on the CDC’s Socially Vulnerable Index of at-risk areas.

The call center has received 24,386 calls and made another 4,335 calls to residents to book appointments.

Charmel said there have been “amazing calls where people frustrated with trying to sign up online say they can’t believe we called them and are making an appointment for them.”

Griffin also has been hosting mobile clinics for several weeks using church leaders and social service organizations to recommend locations for the clinics.

Hartford HealthCare has held 10 mobile clinics and vaccinated nearly 1,000 people, and they have nine more scheduled for the coming weeks.

Yehyun Kim :: ctmirror.org

Patients wait in the observation area after getting the COVID-19 vaccine at a Griffin Hospital facility in Shelton.

Pounding the pavement

Last week Yale New Haven Hospital officials used the reverse 911 system to reach residents in the socially vulnerable communities they serve.

Yale officials got a list of phone numbers registered for the state’s reverse 911 system, which is in place to alert people in emergencies like hurricanes or blizzards. Yale then matched numbers to their internal medical records and pushed out robocalls.

“If they took the call, they heard they were eligible for COVID-19 vaccine in an expedited fashion, and all they had to do was call this number and we’ll prioritize them for a vaccine,” said Dr. Thomas Balcezak, Yale New Haven Hospital’s Chief Clinical Officer.

He said they signed up more than 500 people for appointments at the Floyd Little Athletic Center mass vaccination site through the reverse 911 system, and they are planning to do it again.

Balcezak said Yale also has been sending teams of community workers into the city to knock on doors.

“We’re sending community health care workers, literally pounding the pavement, getting people signed up for clinics, because it’s not easy,” Balcezak said. “Not everyone has a phone, or not everyone knows how to use the technology.”

Yale officials have studied how they are trying to reach the city’s minority communities. They have held town hall meetings and made clinical experts available to talk about the effectiveness of the vaccine, how it was tested and why it is safe.

Working with New Haven Health Director Maritza Bond, they have done a number of different public information campaigns. Balcezak said he talks with other hospital officials across the state to get new ideas.

“It’s going to be a challenge, and we’re all working on different ways … and collaborating on ways that we can get more people signed up,” he said.

Balcezak is already thinking ahead to the next age groups of younger people, many of whom do have cell phones but don’t necessarily use them for phone calls.

“I think it’s going to be harder with younger kids, because it’s well known that they don’t use their phones as much as phones. They use them as other technological devices,” Balcezak said. “We’re going to need to come up with another strategy via texting or something else that drives them.”

Unknown targets 

This week Hartford Hospital started a new program using text messages in an attempt to reach more than one million people.

A text message was sent Monday to about 1.2 million phone numbers informing them of vaccine schedules, providing links to information about the vaccines and offering them the opportunity to respond back to the hospital.

“It’s another way that allows us to communicate, get feedback and to engage with the communities that we’re serving,” Cardon said. “It’s all about reaching out, saying, ‘Are you interested in vaccine?’ If they say they ‘let me know when I’m eligible,’ we could then reach out and tell them to click on this to sign up.”

Cardon said the text message list was created from phone numbers of people who have logged into the hospital’s website requesting information on vaccines, or through people who got a COVID test done at one of Hartford HealthCare’s testing sites.

Hospital spokeswoman Rebecca Stewart said there was a 72 percent return rate on the text.

These efforts come as the state prepares to hold vaccinators accountable.

At a press conference earlier this week, acting Department of Public Health Commissioner Deidre Gifford said the department is working on “numeric targets” for vaccines for highly vulnerable populations.

“We will be setting a target and rolling that out with our vaccine providers and measuring against that on a week-by-week basis to see if they’re reaching their targets of administering vaccines to people who live in these high vulnerability areas,” Gifford said.

Gifford didn’t elaborate on what these targets will be, and none of the providers who have spoken to the CT Mirror this week said they had any additional information.

“Not only do we want to see you operating in those communities, we want to see the doses going to individuals who live in communities,” Gifford added. “And those are two different things.”