'Building The Plane While We Fly It': BIPOC Community Organizers Shrink The Gap On Vaccine Equity
Vermont has one of the highest vaccination rates in the country. But in early April, the vaccination rate for BIPOC – people who identify as Black, Indigenous or people of color – lagged 13% behind white Vermonters.
Now, that gap has closed by half. And it appears to be shrinking even further, thanks to clinics across the state, led and designed by leaders who are people of color, with funding and support from the Vermont Department of Health.Organizers say this is an important step forward and could be a model for how to begin to dismantle the systemic racism in our healthcare system.
Early on a recent Saturday, Luis Calderin was laying down tape, answering questions and greeting people – ipad in hand – as they begin to line up outside a vaccine clinic in Burlington.
It was raining, but the mood felt vibrant, thanks to a playlist he had queued up, with hip hop, salsa, bachata funk and, as he put it, the sort of “classics you’d expect at a dope barbecue.”
"It's an incredible group of Vermonters coming together." - Luis Calderin, Vermont Professionals of Color Network
This clinic is being hosted by a group of partners, led by the Vermont Professionals of Color Network.
They’re not a healthcare organization; they’re a multi-generational network of leaders and BIPOC entrepreneurs who support other people of color across the state with mentorship and community.
Calderin, who was the director of arts, culture and youth vote for Bernie Sanders’ 2016 presidential campaign, is on the board. He says he got involved with the clinics because he saw the way that COVID-19 was disproportionately impacting communities of color – both nationally and here in Vermont.
According to data from the Vermont Department of health, Black Vermonters have contracted the virus at nearly three times the rate of white Vermonters.
Vermonters who self-identify as Black, Indigenous or People of Color can register to get vaccinated at a BIPOC clinic now through July 10 online, or by calling 802-755-7239.
Before I visited the clinic, Calderin described what the Vermont Professionals of Color Network is doing over a phone call:
“It’s an incredible group of Vermonters coming together,” he said. “And you know, so many people who have come through have said this is the most positive medical experience that they’ve had in their life, you know? It’s like a barbecue, almost.”
Belan Antensaye leads the vision and strategy for the Burlington clinics with Calderin. She said the Burlington BIPOC clinics offer something state-run clinics don’t:
“I think the unique thing about ours – and we talk about this in our group – is that our group brings the culture, the energy, the security, the safety of seeing people like you running the show,” Antensaye said.
All BIPOC and New American Vermonters became eligible for the vaccine on April 1 – a move that came after months of calls from activists. But, as the vaccination rate data showed, just because someone is eligible, doesn’t mean they can get vaccinated – or that they’ll jump at the opportunity.
And if some Vermonters who are BIPOC are wary of state- or pharmacy-run clinics, it’s for good reason.
Vermont has a storied, yet largely unacknowledged, history of institutionalized racism – especially in medicine.
Dr. Maria Mercedes Avila is a professor of pediatrics at the University of Vermont’s Larner College of Medicine, who studies racism in health care. She’s worked with the state to develop specific vaccine clinics for Vermonters who are BIPOC or linguistically isolated, and she says the science shows the silence around racism causes harm to people of color.
“We are also seeing that provider biases are connected to poor health outcomes, not only nationally, but also in our state,” Dr. Avila said.
Vermont has never formally apologized for its role in the eugenics movement. As recently as the 1950s, some of the state’s medical institutions targeted Black, Abenaki and French Canadian residents with forced sterilization, sometimes under the guise of offering medical care.
Still, that history looms over the state’s COVID vaccination efforts.
Don Stevens is chief of the Nulhegan Band of the Coosuk Abenaki Nation.
He told Vermont Edition it’s difficult for many Abenaki to trust a state-led vaccination process, because Indigenous people still lack representation in state agencies.
“Because they trust the people that are part of their community,” Chief Stevens said. “So the only way to get into that, to get into that structure and try to uplift it, is to be one of them.”
"We are also seeing that provider biases are connected to poor health outcomes, not only nationally, but also in our state." - Dr. Maria Mercedes Avila, University of Vermont Larner College of Medicine
In contrast, at the Burlington BIPOC clinics, the first face people see when they come to get their shot is a community member who looks like them.
Initially, the clinic locations weren’t advertised, to keep organizers and participants safe – though that’s changed, as the clinics now allow walk-in vaccine appointments. But a local security detail -- Chocolate Thunder -- was brought on, just in case.
Staff personalize care, and follow up with vaccine recipients. They also seek referrals and offer to drive neighbors.
Maroni Minter of Waterbury received his first dose of the Moderna vaccine at a Burlington BIPOC clinic in April. He has friends who are skeptical.
“Some of us don’t really want to share our personal information about our preexisting conditions, and all of this personal information that the Vermont Department of Health is asking on [its registration] form,” Minter said. “The form that the BIPOC clinic created kind of avoids asking all these personal questions that people don’t want to talk about.”
Dr. Avila at UVM says she hears stories almost weekly from BIPOC Vermonters who face racial bias in clinical settings.
In fact, her research shows that nationwide, as many as 75% of medical providers don’t know the history of racial disparities or systemic racism in health care.
And, she says, you can’t unpack your own bias if you don’t know the history.
“So that lack of knowledge is directly impacting the way providers are able to interact or not with historically underserved communities in our area,” Dr. Avila said.
Vermont Department of Health Deputy CommissionerTracy Dolan acknowledged the department has work to do when it comes to reaching and supporting many communities in Vermont – especially Abenaki and communities of color.
“We learned the importance, again, of the cultural broker type of idea – of working through existing organizations who know, and who are known and trusted,” Dolan said.
She credits the clinics, among other factors, with the state’s progress on vaccine equity.
The partnership between the health department and Vermont Professionals of Color Network hasn’t been without its ups and downs. For the first several weeks of vaccine clinics, organizers worked as volunteers – often around the clock and always on top of their other jobs, as business owners, researchers and public servants.
But they ultimately worked out a contract that feels equitable, Calderin says, with back pay.
“The analogy I always use is: this is really building the plane while we fly it, and then having to write the manual on how to fix the plane, which we are building whilst we fly it,” Calderin said.
"The analogy I always use is: this is really building the plane while we fly it, and then having to write the manual on how to fix the plane, which we are building whilst we fly it." - Luis Calderin, Vermont Professionals of Color Network
In Southern Vermont, the NAACP of Windham County has also been running vaccination clinics for BIPOC Vermonters. Vice president Wichie Artu says they’ve vaccinated more than 1,100 people.
They say the partnerships formed between community groups and the health department during the pandemic could present a roadmap for dismantling institutional racism in Vermont.
“By being able to have partnered with us and being able to actually pay us for this work, we were able to access those vulnerable populations,” Artu said. “And moving forward, it’s important that, because we’re on the ground, we know what the issues are. The department of health – and I think they realize this – the department of health needs to do the work in conjunction with those who know the people. And us as community organizations, we know the people.”
Vermont Department of Health recently received about $28 million from the CDC to improve health equity, Dolan says. More is expected, and a bill in the Legislature now – H.210 – would establish a new Vermont Office of Health Equity.
Back at the Burlington clinic, Vermont Professionals of color board member Belan Antensaye took a break from laying down cones and greeting people to reflect back to the first vaccine clinic.
“It was really the most community I had seen in over a year, in the BIPOC community, all coming together. And these were just people that came to get their vaccine, and now they’re able to see each other for the first time. And I think it clicked that, like, these clinics are more than just a vaccine. They’re like really a community event. And it just felt really worth it.”
There have been more than 60 New American and BIPOC vaccine clinics in Vermont since February and more are planned. More than 5,000 Vermonters have been vaccinated at the clinics.
For organizers, progress doesn’t stop with reaching vaccine equity. And they say that ultimately, it's not their responsibility to take this work on – it’s the state's responsibility to ensure health equity for all Vermonters. But it’s a place to start.
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