BATON ROUGE, La – Flossie West was not at all interested in taking the coronavirus vaccine.
Carla Brown, the nurse who oversaw her care, was determined to change her mind.
Ms. West, 73, has ovarian cancer, heart failure and breathing difficulties – conditions that put her at serious risk if she contracts the virus. As it is, Covid-19 has killed far too many of its neighbors in Mid-City, a low, predominantly black community that is spreading east of the state capital of Louisiana.
But Ms. West’s skepticism about the new vaccines overshadowed her concerns about Covid-19. “I’m just not interested because everyone is telling me the virus is a joke,” Ms. West said. “And besides, this shot will make me sicker than I already am.”
On Thursday morning, Ms. Brown, 62, came to Ms. West’s apartment and gave a stern lecture: The virus is real, the vaccines are harmless, and Ms. West should get out of bed, take her oxygen tank and get into her car.
“I’ll be damned if I let this coronavirus take me away,” she said.
For the past few weeks, Ms. Brown has worked frenetically to get her patients to vaccinate, and her one-woman campaign provides insight into the barriers that have contributed to worryingly low vaccination rates in the black community.
Even if the vaccine supply continues to grow, African Americans will be vaccinated with half of whites, according to an analysis by the New York Times. The differences are particularly alarming given the disproportionate impact of the pandemic on color communities, who have died twice as often as whites.
The racial divide in vaccination rates is no less great in Louisiana, where African Americans make up 32 percent of the population but only 23 percent of those vaccinated.
Part of the problem is access. In Baton Rouge, most of the mass vaccination stations are located in white areas of the city, creating logistical challenges for older and poorer residents in black neighborhoods like Mid-City, who often have no access to transportation. Older residents have also been thwarted by online appointment systems, which can be daunting for those without computers, smartphones, or fast internet connections.
Experts say much of the racial differences in vaccination rates is due to African Americans’ longstanding distrust of medical facilities. Many Baton Rouge residents can easily quote the history of abuse: from the eugenics campaigns, in which black women were forcibly sterilized for almost half of the 20th century, to the infamous government-run Tuskegee experiments in Alabama that involved hundreds was withheld penicillin from black men with syphilis, some of whom later died of the disease.
“Suspicion among black Americans comes from a real place and pretending that it doesn’t exist or questioning whether it’s rational is a recipe for failure,” said Thomas A. LaVeist, health justice expert and dean of the school of Public Health and Tropical Medicine from Tulane University. Dr. LaVeist has advised officials in Louisiana on ways to increase vaccination rates.
Ms. Brown, 62, the hospice nurse, has a good idea how to change the minds of vaccine skeptics: Encouraging one-on-one meetings with distinguished black community figures who can address concerns and provide reliable information while acknowledging what you describe as the scars of inherited trauma. “If you look back on our history, we have been lied to and there has been a lot of racial pain so it’s about building trust,” she said.
March 6, 2021, 4:46 p.m. ET
It also helps if she tells people that she has already been vaccinated.
As a Covid survivor, Ms. Brown has become a whirling dervish cruiser against the hesitation of vaccines in Baton Rouge. Your sense of mission is fueled in part by personal loss. Last May, while working as a hospital psychiatric nurse, Ms. Brown unwittingly brought the coronavirus into her home. Her husband, son, and 90-year-old father all became seriously ill and ended up in the hospital. Her husband, a cancer survivor whom she referred to as “the love of my life,” ended up on a ventilator. He died in July.
With a newfound determination to care for the most vulnerable patients, she quit her job at the hospital and started working with terminally ill people in January last year.
“My husband couldn’t get the vaccine, but I’ll be damned if I don’t vaccinate everyone around me,” she said. “I don’t care if you’re homeless. When I come to you, you get in my car. “
She went into high gear on Thursday after learning that a pop-up vaccination center in East Baton Rouge had dozens of doses available.
Ms. Brown prefers to personalize her parking space, but less than three hours before the site was due to close, she pulled her cherry-red Toyota Scion into the Hi Nabor supermarket parking lot, took out her cell phone, and opened a thick folder with contact information for it the 40 patients she manages as Nursing Director at Canon Hospice, a palliative care provider in Baton Rouge.
“Is that Miss Georgia?” She asked. “Have you already got the Covid shot? No? Then get dressed because we’re coming to get you. “
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There were several refusals – “I’m still not convinced it’s safe,” said one woman – but in less than an hour she had five people persuaded to get vaccinated.
She then called the East Baton Rouge Council on Aging, the nonprofit group that runs the vaccination site, and asked them to ship some of their vans.
In addition to organizing the transport, Tasha Clark-Amar, the organization’s managing director, tries to overcome the logistical hurdles by making appointments by telephone and letting the employees fill out the necessary documents in advance. Next week she hopes to send teams of health workers to vaccinate 4,000 residents across the city who are bedridden.
Ms. Clark-Amar is also driven by a sense of urgency: In the past year, more than 140 of her customers died of Covid-19. Her strategy of winning over the hesitant is no different from Mrs. Brown’s, though she often seeks to appeal to the guidance and respect commanded by the elders in the black community. “I tell them, ‘You are the matriarch or patriarch in the family and you should lead by example,” she said. If that doesn’t work, she’s more dull, “At your age, it’s the vaccine or the grave.”
Less than 30 minutes after Ms. Brown spoke on the phone, a housekeeper, Dorothy Wells, rolled into the brightly lit cafeteria of the senior citizen center. Ms. Wells, 84, a stroke patient, had initially refused to be vaccinated but was overruled by her son.
Ms. Wells’ aide, Rashelle Green, 45, was also reluctant to get vaccinated. She shared stories she read on social media about people who got sick or died after receiving the gunshots, despite health officials saying side effects from the coronavirus vaccine are extremely rare.
But after Ms. Green saw people being vaccinated and walked out after 15 minutes of observation, she changed her mind. As she waited for her turn, she jumped nervously up and down. When it was time to roll up her sleeve, she winced but barely noticed the needle prick. “That wasn’t bad at all,” she said.
Then there was Ms. West, the cancer patient whose house Ms. Brown had visited earlier that day. For the past year, Ms. West, who lives alone and has no children, has been looking forward to twice-weekly checkups with Ms. Brown. Aside from the occasional appointment with her oncologist, her visits are roughly the only time that she has personal contact with another person. “I feel like Ms. Brown really cares about me,” she said.
Given the deep trust that had been cultivated over the past few months, it was not long before Mrs. Brown won her over.
Ms. West was sitting in the surveillance area of the vaccination center on Thursday and said she was glad she listened. “When I get home,” she said, “I’ll text all of my friends and tell them to get the shot.”