On Wednesday, February 3, staff at EMPath’s largest shelter received their first doses of the Moderna COVID-19 vaccine at a clinic run by Boston Health Care for the Homeless Program (BHCHP).

Staff and residents at congregate (dormitory-style) settings were eligible for the vaccine toward the end of Massachusetts’ Phase 1 of the vaccine distribution. Hastings House, EMPath’s largest shelter for women and children, accommodates 58 families in non-COVID times but has been at less than half that capacity during the pandemic.

BHCHP provides health care services to individuals and families experiencing homelessness. The organization has been running vaccine clinics for staff and residents at shelters around the city.

“Having staff and residents be able to get the vaccine is huge,” says Amanda Kwok, Hastings House’s Director of Residential and Program Mentoring. “We’re of course going to continue taking all safety measures, but this will give many of us a peace of mind.”

Lingering Hesitancies

While most Hastings staff are thrilled, many residents – and some staff – remain hesitant about getting the vaccine. This reluctance is due in part to language barriers, skepticism around how quickly the vaccine was developed, and misunderstandings that it could spread the virus (the Moderna and Pfizer vaccines are mRNA vaccines, which do not use a live virus and cannot give someone the disease).

Racism also plays a large role in vaccine hesitancy. For Black and Latine communities in particular, a racist health care system has justifiably ingrained deep-rooted distrust in medical providers, health care institutions, and the government. In a country with systemic racism baked into its DNA, structural inequities, ongoing everyday interpersonal racism by individual clinicians, and historical traumas like government-backed medical experiments mean many Black and Latine people are skeptical of the doses.

“Thinking about the residents who are and are not getting the vaccine, it’s disproportionate based on race,” Amanda says. “There’s a lot of talk around, ‘How can I trust that I’m actually getting the same vaccine that everybody else is getting?’ We have to assure people that there’s no tracking system tied to the vaccine, that there’s not a chip. I think it stems from distrust of the government and a deep-rooted history.”

“I also think there’s just a lot of misinformation,” Amanda adds. “And a lot of information about the vaccine is really complicated. It needs to be explained in a way that’s digestible.”

Education to Combat Misinformation

To address these hesitations, BHCHP has been doing a lot of education and outreach to explain how the vaccine was developed and reassure patients that it’s safe.

“A lot of the hesitation around the vaccine is from the novelty of it too,” Amanda says. “Even for myself, in the beginning I was like, how did they turn this around so quickly? But going to BHCHP’s info session, it was really good to hear that a lot of the science behind how the vaccine was made had already been in the works. It wasn’t just working on a vaccine from square one; the science was already there and they could build off of it.”

“BHCHP has been great. They’ve held info sessions in both English and Spanish, and they’re more than willing to talk to residents one-on-one.”

EMPath mentors have been having conversations with the families they work with to assuage their anxieties, providing literature and sharing that they’re planning on getting the shot themselves. “If they have a mentor they’ve been working with for a long time and they trust them, they’re able to really dissect the questions,” Amanda explains.

Ellen Conner, a Program Mentor at Hastings, says when she told one resident that she was getting the vaccine, it seemed to make her a little less worried. “I hope that when she and others who are hesitant see more and more people getting it, they’ll feel better about getting it themselves,” Ellen says.

That was a big reason Hastings staff got vaccinated the week before residents – the hope is that in seeing the success of the first shots, those who are wary will decide to opt into a future clinic. Staff also made signs with the reasons they got the vaccine, and plan to wear their “I Got My COVID-19 Vaccine” stickers around the shelter to celebrate the milestone.

Leaving the door open for people who are hesitant is also critical. “I think that’s the biggest key – you don’t shut people off and give them an ultimatum of now or never,” Amanda explains. “We want to let them know that they have the agency at any point in time to change their mind; it’s their own bodies and the decision is up to them.”

“BHCHP has been really great about continuing the education and the messaging that the vaccine is going to be available,” she adds.

A Glimmer of Hope for the Future

Of course, until many more people have immunity to the virus – scientists estimate between 70% and 85% of the population will need to be immune in order to reach herd immunity – mask-wearing and social distancing will continue. For now, day-to-day pandemic life at Hastings will stay the same: meetings with residents will be virtual or distanced, common areas will remain closed, deep-cleaning and sanitizing will continue, new residents will quarantine upon arrival, and community gatherings will be put on hold until warmer weather.

Still, the vaccine is a huge step. And staff who are getting it are grateful.

“We’re all very passionate about the work we do, and that’s why we continue to come in and do it,” Amanda says. “Right now, it sometimes feels like it’s either your job or the health and safety of your family. The vaccine means you don’t feel like you have to pick one or the other.”

Looking ahead, while some safety precautions will stay in place after the pandemic is over, Amanda says she looks forward to the eventual return of “that communal sense, that warm and fuzzy feeling that Hastings used to have.”

Until then, staff and residents march forward. Residents who have opted in, along with the next group of staff, will be vaccinated at BHCHP’s next clinic at Hastings this Wednesday. Second doses of the vaccine will be administered 28 days after the first.

A huge thank you to Boston Health Care for the Homeless for bringing vaccine outreach, education, and DOSES to Hastings House!