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Ronnie Jones got the COVID-19 vaccine because it was convenient. He did not register through the D.C. government portal or call center to get the shot, nor did his health care provider offer him one. The vaccine came to him.
“It wouldn’t make sense for the shot to be right here and not take advantage of it,” Jones sais as he waited in line at the corner of G and 24th streets NE.
He stood in line with a few of his neighbors who live at Langston Terrace Dwellings, one of the country’s first public housing communities, located at 2101 G Street NE. Jones arrived early to his morning appointment on March 18 as it drizzled outside. He was scheduled to get vaccinated alongside his wife in the recreation room, where the tenant association often meets and the greater community gathers for holiday celebrations. Tables that were once adorned with silver and white tablecloths for the last big event, a senior dinner, just weeks ago were moved out to make space for a makeshift vaccination center.
When Jones and his neighbors entered the room, they were greeted by someone from United Medical Center, whose medical team would administer the Moderna vaccine that day. “I was excited when I got mine,” a UMC representative told a resident, as he inserted their information into a computer. About a dozen chairs were situated a few feet apart, so people could social distance as they waited to get vaccinated. A divider separated the chairs from the injection area.
“It was OK,” Jones assessed after getting the shot.
He says he would not have gotten vaccinated this early had the vaccine not come to him. While he qualifies to receive one based on the District’s current guidelines, the long lines he saw on the news discouraged him from searching for an appointment. “I ain’t in the mood to get a shot. But it is what it is,” he said before getting it. “I haven’t heard about anyone dying from it.”
Dozens of residents who live at the 274-unit complex got their first shot that day because one of D.C.’s equity efforts actually went according to plan. Information about a mobile clinic coming to Langston Terrace was disseminated through flyers and robocalls. The property manager and the tenant association pre-registered tenants, and United Medical Center visited the complex a week ahead of time to let tenants know they’d be administering shots. It helped that the tenants were familiar with the hospital because the UMC van had visited previously to offer COVID-19 testing.
The collaboration between the tenant association, government agencies, and hospital resulted in 50 D.C. residents who are at risk of serious illness from COVID-19, due to age or medical status, becoming vaccinated. United Medical Center even vaccinated one homebound senior with multiple health conditions inside their unit. The provider plans to return this week to vaccinate more tenants who wanted the shot but couldn’t get it due to capacity limitations. Langston Terrace is one of more than a dozen public housing properties where tenants have gotten vaccinated at home. In mid-February, the D.C. Housing Authority and DC Health partnered with United Medical Center and Johns Hopkins Healthcare Systems, and vaccinated over 1,100 tenants of 16 senior buildings. The program has since expanded and mobile clinics have been set up at more public housing properties in Wards 5 and 7, communities with some of the highest percentages of deaths related to COVID-19.
Ester Hardesty, the president of the Langston Community Resident Council, the complex’s tenant association, got DC Housing Authority to set up a mobile clinic at her home of over two decades. “I just called Housing and said ‘Could we get the medical van here?’ And they sent it,” she says. She made the request in February because her neighbors had trouble accessing the vaccine—many do not own computers. It took the city several weeks to meet the request because officials were initially only setting up clinics at dedicated senior properties, and Langston Terrace was not one.
Although Hardesty got vaccinated through the Department of Veterans Affairs, she worked to get a mobile clinic at her complex. When the clinic finally came to Langston Terrace, she monitored everything and greeted nearly everyone who walked in. The mobile clinic resolved lingering accessibility and vaccine hesitancy concerns.
“A lot of them are afraid. They hear this propaganda,” she says. “I tell them I would rather have a sore arm than I can’t breathe at all.” People who claimed to have gotten vaccinated showed up at the mobile clinic after all, Hardesty says. It’s hard to say whether it was her pitch or the vaccine being convenient that convinced them. Residents were also able to calm one another’s nerves at the mobile clinic. One elderly woman who is afraid of needles got comforted by a neighbor. After re-emerging from behind the divider, she gave Hardesty a thumbs up.
Mayor Muriel Bowser’s administration has been criticized for the inequitable vaccine roll-out, which some say leaned too heavily on an inaccessible portal and health care system concentrated in more affluent wards. Residents living in Whiter, wealthier neighborhoods are now vaccinated at higher rates. The mobile clinics at residential buildings, along with churches and recreational centers, are the administration’s more successful attempts at course correcting.
Some of these initiatives can vaccinate ten times more than that of Langston Terrace’s mobile clinic. Two sites at the Edgewood and Benning Stoddert recreation centers in Wards 5 and 7 vaccinated over 1,200 residents, according to DCHA. Residents that live in affordable housing or have housing vouchers were invited, and the Department of Parks and Recreation provided transportation. DC Health did invite some people who pre-registered through the portal to the Ward 5 site when they couldn’t fill appointments exclusively through door knocking and other outreach efforts. A majority of them live in priority zip codes, according to DC Health. DCHA is preparing another large-scale mobile clinic for Ward 8.
DC Health is allocating a small fraction of its shipment to these “special initiatives.” Last week, 7,130 of the D.C.’s 27,140 doses were dedicated to these efforts. (Nearly half of doses directed to special initiatives are actually going to CVS pharmacies, according to DC Health.) 14,400 were reserved for people who pre-register via the portal or call center, and the remaining 5,610 were sent to select hospitals and health centers. The portal continues to be criticized for being inaccessible to non-English speakers, and two private health systems, MedStar Health and Kaiser Permanente, have come under scrutiny for vaccinating their patients who aren’t eligible under existing D.C. standards. More than three months into vaccinations, just under a fifth of D.C. residents are at least partially vaccinated. 177,229 people have pre-registered through the government portal or call center.
What’s stopping D.C. from creating more of these targeted mobile clinics? Especially considering that residents living in less affluent wards still lag behind in coverage?
United Medical Center’s mobile clinics have logistical constraints, says Dr. Erin Athey, a UMC nurse practitioner and part-time faculty member at George Washington University. To start, she has a small team. She’s the only clinician on the UMC van, and has one medical assistant and a few nursing students helping her. Driving such a large van in D.C. means they can’t just pop around the city. Athey says the UMC van couldn’t visit homebound seniors across multiple properties in a day as DC Health had requested. Plans to vaccinate homebound seniors are in the works but have not been formally announced. She also says mobile clinics, broadly speaking, are expensive to run because they accrue extra costs, from gas to personnel. Grants usually have to supplement them.
For the last month, United Medical Center has been the vaccinator at sites across four different public or affordable housing properties. Johns Hopkins, which has more capacity, has been the vaccinator for larger sites. Athey says the van’s schedule is flexible, so she sees a lot of potential. Her team is focusing on seniors, but she could see them reaching residents with chronic medical conditions at affordable housing properties and even workers at restaurants. The focus would stay on Wards 7 and 8. “In addition to doing the COVID-related screenings and vaccines, we’re doing some surveys to collect data from the residents about what types of services they’d like to see in their community,” Athey says. “We’re really looking for a sustainable local community health effort.” The idea would be to offer, say, diabetes care from the van.
Hospitals can and have used doses DC Health sends them to vaccinate residents at mobile clinics. Providers just need to get the approval of DC Health. Beatrice Evans, 67, got her councilmember, Ward 7’s Vince Gray, to bring MedStar Health to her building. She lives at Triangle View, a 100-unit senior building on B Street SE owned, but not managed, by DCHA. She worked to bring vaccines to Triangle View because so many tenants struggled to access it. As the tenant association president, Evans is in constant conversation with her neighbors.
MedStar Health has vaccinated 116 patients across four residential properties in Wards 5 and 7. This week, the provider will be vaccinating another 150 to 200 people at Hubbard Place apartments in Ward 1.
The mobile clinic at Triangle View encountered more difficulties than the one at Langston Terrace. The elevators in the three-story building did not work the day MedStar Health visited to vaccinate tenants. They were not fixed until the afternoon, hours after vaccinations started, so seniors with mobility issues struggled to get the shot. The makeshift vaccination center was in a recreation room in the basement, so seniors had to leave the building and enter the mobile clinic through the parking lot to avoid any stairs. Some seniors living on the second and third floor could not come down when MedStar arrived. Evans thought they wouldn’t get vaccinated, but they were just the last to arrive.
According to the Fire and Emergency Medical Service Department, smoke was detected on the first floor elevator four hours before the vaccinator was scheduled to arrive. (A neighbor told Evans marijuana prompted the alarm.) It was a false alarm, according to the fire department, but it caused the elevators to shut off.
MedStar Health also arrived an hour late. A few tenants started to gather in the lobby around 9 a.m. Evans had her appointment scheduled for 9:45 a.m., but the two nurses did not arrive until just after 10 a.m. Vaccinations did not start until 11 a.m. because the nurses had to mix the Pfizer vaccine with diluent before administering. The late arrival meant that the staggered appointments became obsolete, so everyone ended up waiting together to get vaccinated, making it harder to adhere to social distancing guidelines.
“They don’t know what they are doing,” said one tenant under her breath. Another tenant couldn’t understand his neighbor’s frustrations. What else were they going to do? “You just got an aggressive crowd,” he said.
Testifying before the Council a week later, on March 19, Evans said Triangle View residents deserved better. “You gotta be mindful of your elders,” she told Gray. She hopes that the next time MedStar Health visits to administer the second shot, the process goes smoother.
“I feel like people didn’t put that effort in,” Evans tells City Paper. She says the property manager who coordinated with Gray’s office did not tell tenants when they’d be getting vaccinated until two days prior. She knows of at least three people who consequently could not get vaccinated. About 57 residents got vaccinated the day MedStar Health visited.
So what went right? “The people who wanted the shots really wanted them … and dealt with the problems that we had,” says Evans. “The man who I first signed up was patient enough to wait four hours to get his shot.” She believes the people who got vaccinated wouldn’t have otherwise.
The community came out to support the initiative, including members of the Ward 7 Democrats and the local ANC commissioner. The property manager, who’d never done anything like this before, supported the mobile clinic the entire time. Evans had to leave early to care for her 93-year-old mother.
“It was a blessing when I heard about this here, right at home,” said Byron Mansfield, a Triangle View tenant of 12 years. He wanted to get a shot but did not know how to access one. Mansfield, 76, does not have a computer. And his doctor did not tell him what to do.
Mansfield was nervous about the shot at first but being the religious man that he is, he had a conversation with “the man upstairs” who told him what to do. “I want to be safe. The only reason I come out is to go to the grocery store,” he said. “It’s been lonely, cooped up in my house.”