PROVIDENCE — Rhode Island public health officials are trying to determine why certain areas of the state are taking fewer vaccinations than their population would suggest, and what can be done to change that.
The term “cold spots” has been applied to these areas by the R.I. Department of Health where residents are taking much fewer first doses than the population and vaccine distribution would indicate should be happening.
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The areas include all of Woonsocket, the Darlington neighborhood in Pawtucket and seven neighborhoods in Providence: Elmhurst, Washington Park, West End, Smith Hill, Wanskuck, Silver Lake and Elmwood.
What does it mean to be cold? Overall, adult residents in the nine areas have received 26% fewer doses than would otherwise be expected. The areas of the high-density communities studied by health officials have 82,064 adult residents who have received at least a first dose of a vaccine, about 48.2% of the population.
The R.I. Department of Health did not immediately respond to requests by Providence Business News for comment and additional information.
The state, meanwhile, has begun to shift its vaccination and testing strategy away from mass centers and into more-focused geographic areas. Gov. Daniel J. McKee announced on Monday that 19 state-run test sites would close by the end of June. The larger-volume sites will be consolidated, although 25 sites would remain open, including at localized shopping centers and in senior centers.
In a meeting of the COVID-19 vaccine advisory committee last week, when the “cold spot” issue was introduced, health officials said they’re looking into the pattern of under-vaccination.
In the case of Woonsocket, health officials wondered if people were getting vaccinated in Massachusetts instead, and examined the health data provided by the Bay State. But this was not the case, said Alysia Mihalakos, chief of the center for emergency preparedness and response. Westerly also did not have much cross-state traffic for vaccine.
In Woonsocket, the state purposefully placed a mass-vaccination center in the city in the hopes of increasing access to the vaccine, but “it did not have the uptake we thought it would,” she said.
The state partnered with Thundermist Health Center and Landmark Medical Center, for vaccine clinics. And Thundermist had one of the highest vaccination rates among all the R.I. Department of Health’s partners, but it still wasn’t enough, health officials said.
What the state is now examining is likely barriers to vaccination and what can be done to eradicate them, said Tricia Washburn, the department’s vaccination director.
“What are the barriers? What are the challenges? Why is vaccination not occurring and really thinking strategically about how to increase vaccination in that area,” Washburn said.
Dr. Michael Fine, the former R.I. Department of Health director, and the COVID-19 response coordinator for Central Falls and Pawtucket, said demographics could explain some of the hesitancy. But also, he said, many residents of working class areas of the cities have multiple jobs. In many of these areas, residents had access to the vaccine supply first, as part of high density communities.
There is vaccine hesitancy among the Latino and Black resident population, he said, which may be influencing the numbers. It could also be lack of access to primary care physicians, who are reminding people to get their shots.
In countries with coordinated health care systems, “The primary care doctor’s job is to call you and bug you to get vaccinated,” Fine said. “But we know in Pawtucket and Central Falls, only about 50% of the population has a primary care doctor.”
Mary MacDonald is a staff writer for PBN. Contact her at macdonald@pbn.com.
