Community health centers filling gaps in health care deserts are ground zero for getting COVID vaccine to underserved areas

Dr. Mina Hwang and Dr. Edwin Mangram conduct COVID-19 testing at Lawndale Christian Health Center on the West Side, one of 390 federally qualified health centers in Illinois that have long filled the gap in hospital health care deserts. The centers are next in line to receive COVID vaccines for their staff, as Moderna’s vaccine hits states this week. | Provided

With a second coronavirus vaccine arriving in states Monday, community health centers that have long filled the gap in hospital health care deserts nationwide are prepping for their turn at vaccinating clinical and other staff amid challenges of trust and prioritization. With a second coronavirus vaccine arriving in states Monday, community health centers that have long filled the gap in hospital health care deserts nationwide are prepping for their turn at vaccinating clinical and other staff amid challenges of trust and prioritization.
In Illinois, an initial 109,000 doses of the first vaccine, Pfizer-BioNTech’s, was rolled out last week — 17,000 doses were distributed to hospitals by Friday, the remainder to be given out over the weekend.
But federally qualified health centers (FQHC), which replaced hospitals as they disappeared from rural and inner city communities, will be the real ground zero in the task of vaccinating disadvantaged communities.

In Illinois, 390 such centers serve 1.4 million Illinoisans, those centers expected to receive the newest COVID-19 vaccine, by Moderna, Inc., over the course of the next two weeks.
“Most of the Pfizer vaccine, harder to store at minus 70 degrees Celsius, are going to hospitals,” said Dr. Wayne Detmer, chief clinical officer at Lawndale Christian Health Center, one of those FQHC’s, serving 60,000 Chicagoans in West Side North Lawndale.
“Community health centers will get the Moderna vaccine, which can be stored at minus 20 degrees Celsius, with a longer shelf life — 30 days, as opposed to Pfizer’s five days,” he said.
Once the rationed doses are received, Lawndale Christian Health Center, 3860 W. Ogden, like other FQHC’s, will face an equity dilemma that goes beyond race.
“One of the challenges is to try and figure out an equitable way to distribute the vaccine among staff, so we don’t make some mistakes we’ve made in the past, prioritizing only physicians and nurses,” Detmer said.

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Lawndale Christian Health Center in West Side North Lawndale was contracted by the city of Chicago to provide care for high-risk homeless during the pandemic. Standing outside Hotel 166, where the homeless were housed downtown, are Dr. Thomas Huggett and Dr. Wayne Detmer (L-R, Rear); support staff William Knox and nurse practitioner Heather Duncan (L-R, Middle), and three clients.

“Lab technicians, staff who clean the rooms, respiratory therapists, reps signing people in — all of these folks are potentially exposed to the coronavirus,” he said.
“We need to be sure we’re treating people fairly. You’re given a limited dose of vaccine. You have to find out who in your organization is at highest risk and in most need of the vaccine.”
Nationwide, the vaccines will be given first to health care workers and nursing home residents, then essential workers, older adults and those at high risk, before the general population, by spring.
“COVID has been quite a challenge for federally qualified health centers. We’re very sensitive to the challenges it has posed within the communities we serve, and hopefully, we can be part of the solution,” Bruce Miller, CEO of Lawndale Christian Health Center, said.
“It really will come down to the place where people are going to feel comfortable going to get their vaccine. Our role, as a primary health care provider, is to be a trusted agent, and the phases of this really will start with vaccination of our staff.”

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Contracted by the city of Chicago to provide care for high-risk homeless there during the pandemic, Lawndale Christian Health Center set up a makeshift clinic at the Downtown Hotel 166. (L-R) Manager Tawana Freeman, medical assistant De’Angel Groves and manager Sandra Alvarado work inside the hotel.

After clinicians, an FQHC could prioritize remaining staff based on risk of exposure from their role at the clinic, and/or compassionately based on the risk for severe COVID-19 consequences due to a staffer’s underlying conditions.
Its vaccine allotment unknown, Lawndale Christian Health Center is writing plans for both scenarios.
“This really is a Christmas gift to our country, to have this vaccine in such a short time,” said Detmer. “But it does make distribution algorithms challenging. There’s no blueprint for this.”
And there’s no blueprint for getting past lack of trust among communities of color — needed if America is to achieve herd immunity by vaccinating at least 75 percent of the population.
At Lawndale Christian Health Center, half the patients and 40 percent of staff are Black — a population with historic distrust of a health system marked by racism and inequity.

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Dr. Edwin Mangram gives a COVID-19 test at Lawndale Christian Health Center’s drive-up site at 3860 W. Ogden on the West Side. The center is among 390 federally qualified health centers in Illinois that have long filled the gap in hospital health care deserts. After hospitals, the centers are next in line to receive vaccines for their staffs.

“I don’t think it’s unreasonable for our patients to wonder about safety when this vaccine, from start to finish, happened in less than a year; and in our country, there is no question people of color have been experimented upon and abused,” said Detmer.
“It will be important to listen to people’s concerns, and then just tell the truth. And the truth is that all of the evidence shows that this is a safe and effective vaccine.”
The FQHC will face that trust barrier not only with its patients, then, but with its Black staff.
“It will be necessary to create communication with our staff, and trust, so that our staff members are all willing, because I think they’re going to be hesitant too,” noted Miller.
“That’s what we’re hearing in our initial dialogues. People are a little bit worried. They’re concerned about, ‘Should I do this or shouldn’t I do this?’ And so we have to first educate our own staff,” he said.
“It starts there, before we can move on to our patients. It’s an incredible challenge. I think we’re going to be learning every day, moving from plan A to plan B, and so on.”

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