William West III, president of the Cincinnati African American Firefighters Association, wears his COVID-19 vaccination card laminated and hanging on a lanyard around his neck when he’s out with city health nurses to spread education about the vaccine.
“I tell people, 'Please do your part to avoid the spread and avoid more deaths. Ask your personal physician, or someone you have trust in (about the vaccine).' We need all the tools in the toolbox,” West said.
They’ve gone door to door, held community meetings, led focus groups, and visited churches and libraries in the last several months – all as a way of familiarizing uncertain neighbors with information about and access to the COVID-19 vaccine.
Despite these and other efforts, in several Cincinnati neighborhoods, primarily on the West Side and with significant populations of racial minorities, the vaccination rate is low – lower than 40%. The per capita rates of COVID-19 infections in them also are the highest in Hamilton County.
The problem areas lag the nation by 30 points or more in the percentage of people age 12 and older getting at least one shot of a COVID-19 vaccine.
According to U.S. Centers for Disease Control and Prevention data, 73.9% of eligible Americans had received at least one jab by Monday.
The hot spots also lag Hamilton County as a whole. The CDC data shows 66% of county residents age 12 and older have had at least one vaccine dose.
The poor results are not for a lack of trying, health officials say.
“Cincinnati Health Department has been actively involved with our community partners offering vaccines in all of the low-uptake neighborhoods,” said city Health Commissioner Melba Moore.
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Said Maryse Amin, assistant health commissioner: "Our health centers all have vaccine. People are able to walk in or make a vaccination appointment. I don’t think it’s about accessibility.”
Which Cincinnati neighborhoods have the lowest COVID-19 vaccination rates?
The problem areas are highlighted on a dashboard of the Health Collaborative, the region's hospital system coalition, which includes a regularly updated graph that identifies local ZIP codes with the highest per capita rates of cases of COVID-19 over the last 14 days and the lowest rates of vaccinations.
On Sept. 13, the five ZIPs with the highest case rates and the lowest vaccination rates (based on people with at least one shot) were:
- 45232 (Spring Grove Village and Winton Hills).
- 45225 (Camp Washington, Villages at Roll Hill, East Westwood, Millvale and part of North Fairmount).
- 45204 (Lower Price Hill, Sedamsville, Riverside and part of East Price Hill).
- 45205 (parts of East Price Hill and West Price Hill).
- 45205 (most of East Price Hill and West Price Hill).
- 45207 (Evanston).
The vaccination rates in each of those five ZIPs are below 40%. In 45225 and 45232, the vaccination rates are below 30%, according to the Health Collaborative's dashboard. All five were in roughly the same position two weeks ago.
Two other city ZIP codes had the next highest rates of cases and vaccination rates below 40%. They are 45214 (West End and part of South Fairmount) and 45219 (Corryville, Mount Auburn, University Heights, Clifton Heights and Fairview).
The suburban Hamilton County ZIP code with the highest rate of COVID-19 cases was 45001 (Addyston), where the vaccination rate was below 43%.
'Misinformation ... still is a problem'
Leaders of the Health Collaborative, which led a Get Out the Vax effort to spur inoculations in the region from April to July, say that strategies to get people vaccinated – from incentives to, more than ever, listening rather than just educating – continue in the low-vaccinated neighborhoods as well as elsewhere.
"Progress is definitely slower in some areas, but no one is giving up," said Kate Schroder, interim chief strategy officer for the Health Collaborative. "Efforts are specifically targeted on the highest-need neighborhoods."
Said Amin: “There’s still misinformation. I think that still is a problem. Some people still need to have that discussion with someone they trust.”
That’s what city health department Nursing Director Virginia "Jenny" Scott believes, too.
Scott has led COVID-19 abatement efforts for the last 20 months, “including 21 weeks straight of COVID testing in the beginning of the pandemic,” she said.
She has gone out and made herself a prominent face of the vaccine effort within the city. She has sent out nurses armed with facts and vaccines. She had a nurse go out with Cincinnati firefighters when they did an annual smoke-detector blitz, and as they tested the detectors, a nurse talked to neighbors about the COVID-19 vaccine.
Scott credits the fire department for efforts they’ve made together, in a partnership.
She said Black residents may be more hesitant to trust the government because of past inequities. She said she is Black – and she is trusted, which is part of why she was out in the public at vaccine clinics large and small.
“Do you know how many people came up to me? One woman said, ‘I was not gonna take it.' She said she took the vaccine after hearing my mother took it, my family took it.
“The trust factor is huge,” Scott said.
West said he has listened to many voices, most from residents who were positive about getting vaccinated, some who did get the vaccine and others who were not comfortable doing so.
“Those who were hesitant, a lot of them had different reasons.” Many worried about the vaccine being put out fast, he said.
“We tell them, all of the resources, of epidemiologists and the professionals, have to put this as their No. 1 effort,” West said. He encourages them to trust science.
The Cincinnati African American Firefighters Association's presence is common in the city, West said, and he hopes that their presence instills trust.
On Saturday, just as other days when FC Cincinnati has home games, the organization had its booth at TQL Stadium in West End, and firefighters encouraged folks to get vaccinated even as they promoted fire prevention.
"Our booth at the stadium was on the outside at the employees' entrance, which we do all the time try to encourage people to get vaccinated," West said.
They've made other appearances, including this summer at the Black Family Reunion.
No opinions, 'only give the facts'
West said he uses his own vaccination status as an incentive: showing he got vaccinated and he’s healthy and glad he did, because he is doing it for his community.
Scott said there is a lot of false information that's preventing people from getting vaccinated.
One common myth is that the vaccine can cause infertility.
Another common worry: “They believe the vaccine was (developed) just too quickly,” she said.
Amin said that there are plenty of vaccine locations throughout the city and county, from pharmacies to doctor's offices. The health department has had a running clinic from 2-4 p.m. Tuesdays through Sept. 28 at the Price Hill Branch Library, 970 Purcell Ave., East Price Hill.
“The vaccine is still the best way to protect an individual from COVID-19,” she said. “We’re always going to advocate for vaccine.”
Scott will be leaving the health department this week to be director of medical management for a managed care organization, but she says she’s left her staff in Cincinnati well-trained to handle the residents' questions about the COVID-19 vaccine, and she wants neighbors to know that.
“If they see any of my team, I educated the nurses, the nurse supervisors. Every one of my staff of 100 clinicians is well-equipped to answer questions,” Scott said. “I told them, ‘Please do not state your opinions. Only give the facts.’ "
It's these trusted, familiar faces, Scott said, who are likely to see residents who don't have primary care doctors and those who need medical help generally in the neighborhoods. Their knowledge is essential to help improve the vaccination rates, she said.
Scott said she thinks that more residents will get inoculated as they see others get the vaccine and as their questions are answered from trusted sources, especially the firefighters and public health nurses.
“I think," she said, "it’s going to take time."
Health leaders in the region say they remain eager to get people vaccinated, but there is recognition that to have that happen, people need to be heard and to be comfortable with the concept.
"Every individual deserves access and the chance to have their questions answered," Schroder said. "Every individual vaccinated is another potential life saved."