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Clinicians Concerned About Vaccine Hesitancy Among People Experiencing Homelessness In Boston

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When Boston Health Care for the Homeless Program started vaccinating adults staying in homeless shelters three weeks ago, they found excitement at each stop. Doctors, nurses and shelter staff members applauded dozens of shelter guests who got the shots.

Fifty-year-old Jeffrey Davis was one of them. The Pine Street Inn guest said he took the vaccine because COVID-19 scares him.

"I was afraid of dying from it, to tell you the truth," he said.

Jeffery Davis, who has been staying at Pine Street Inn for two and a half years, receives the COVID-19 vaccine in January. (Jesse Costa/WBUR)
Jeffery Davis, who has been staying at Pine Street Inn for two and a half years, receives the COVID-19 vaccine in January. (Jesse Costa/WBUR)

But that initial rush for the vaccines dropped off much more quickly than expected, according to registered nurse April Donahue. She's associate director of clinical operations at Health Care for the Homeless.

"Our first day at the [Southhampton Street] shelter, we were very excited to have 90 guests that were ready to be vaccinated that morning," Donahue said. "And we held the clinic the following Wednesday ... similar amount of folks in the building. And we were only able to find 14 guests to vaccinate."

The organization's clinicians report they've administered first doses to just over 500 people staying in Boston's shelters, including family shelters. That's 25% of those eligible. Among shelter staff, 56% have taken the vaccine. Second doses start next week.

Dennis Watkins got vaccinated without hesitation. He became infected with the coronavirus in the spring and was asymptomatic. But the 60-year-old says he knows he could still be at risk.

"You know, they're talking about these new [coronavirus] variants," Watkins said. "So I said to myself, 'I don't want to get re-infected.' "

Watkins is staying at a shelter run by Boston-based St. Francis House in a former Brighton hotel. It opened a couple of months ago as a temporary shelter, to help the large shelters manage their populations for the winter. Watkins was staying at one of those when he got the virus.

He says he's talked with some people at the shelter who are refusing the vaccine "because they think that it was too quick. You know, [the researchers] came up with it too quick," Watkins recounted. "And I said, 'No.' I said, 'I'm gonna trust the science, because if it was too quick and it was dangerous for us, they wouldn't be giving it to us, right?' "

Watkins, who is Black, says he's trusting despite the long history of injustices committed against the Black community by the medical field. Those include the Tuskegee Syphilis Experiment. Thinking about that tragic part of history, Watkins says, "That was back then."

Dennis Watkins, 60, pictured outside Boston's Southampton Street shelter in May. He has now received the first dose of the COVID-19 vaccine. (Jesse Costa/WBUR)
Dennis Watkins, 60, pictured outside Boston's Southampton Street shelter in May. He has now received the first dose of the COVID-19 vaccine. (Jesse Costa/WBUR)

Dr. Jessie Gaeta, chief medical officer of Boston Health Care for the Homeless Program, says while she and her colleagues are seeing vaccine hesitancy across the board — and they expected it — it's most pronounced among Black people in the shelters.

"I can think of a gentleman who said, like, 'Are you crazy? You think that I'm going to let you inject something into me that that you're telling me is this thing? Why would I believe you?' " Gaeta recalled. "He didn't actually talk specifically about so many examples of really unjust treatment of Black people by the medical establishment. But that was, like, underpinning ... and it sort of went unsaid. And that's happened in a lot of conversations."

Gaeta says she responds to people by saying she understands their mistrust, and she knows they just want to protect themselves.

Health Care for the Homeless is collecting information on the race and ethnicity of people in shelters who are getting the vaccine. As of now about 46% of the shelter guests vaccinated are white, 37% identify as Black, 16% identify as Hispanic, and 3% are Asian.

The organization is awaiting data from the city to see how those percentages compare to the shelter population as a whole.

"I'm going to take a step back and watch to see what happens."

Ron Humphries

Ron Humphries, 57, is one of the people staying in a Boston homeless shelter who has, to this point, said no to the COVID-19 vaccine.

"It's a series of events that led up to my apprehension or paranoia, or just being highly suspicious," Humphries reflected.

Those events that have led to his questioning a lot of people and institutions — such as the health care industry and government — include when he learned the accurate histories of colonialism and slavery. And his own experiences with racism: as a Black METCO student from Roxbury going to school in a wealthy South Shore town, and as a young man trying to get a break as a fashion designer in Boston.

"I would so desperately want to be an equal or to be able to walk into an establishment and be looked at [as] not different," Humphries said.

He adds to the list the pharmaceutical industry's role in fueling the opioid epidemic, and his belief that drug companies have in the past colluded with the Food and Drug Administration to make big profits.

So now, on the vaccine, he waits.

"I'm going to take a step back and watch to see what happens," he said. "And of course there's a lot of questions... Is this something that two or three years from now that they're going to discover that as a result of people taking the vaccine, you know, all these other health issues [arise]?"

But Humphries says he'll continue seeking out information and "words of wisdom" that will help him reevaluate his perspective and possibly change his thinking. His aunt asked him to keep an open mind about the vaccine.

Dr. Jessie Gaeta, chief medical officer of the Boston Health Care for the Homeless Program, in a file photo from 2014. (Jesse Costa/WBUR)
Dr. Jessie Gaeta, chief medical officer of Boston Health Care for the Homeless Program, in a file photo from 2014. (Jesse Costa/WBUR)

Dr. Jessie Gaeta asks people who are hesitant if there is someone like that — a person whose opinion on the vaccine they would respect and want to know before making a final decision. She worries reluctance — much of it stemming from systemic racism — will harm the patients she cares for.

"It's devastating to know that we've got this amazing tool, that it is probably going to offer a survival advantage to people that take it, and the sooner the better," Gaeta said.

She and her colleagues will keep returning to the shelters, along with going to people living on the streets. They say they hope they can get to a level of vaccination that can really protect the homeless community — and that they can administer the shots equitably.

This segment aired on February 10, 2021.

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Lynn Jolicoeur Producer/Reporter
Lynn Jolicoeur is the field producer for WBUR's All Things Considered. She also reports for the station's various local news broadcasts.

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