By Liam Bohen-Meissner
Medill Reports

The city of Evanston refocused its coronavirus vaccination efforts on people living in group settings such as homeless shelters beginning the week of Feb. 22, according to the city ‘s website.

After Evanston moved into phase 1b of its vaccination plan in late January, the city prioritized administering doses to those who are 65 and older and essential workers. But 1b includes a multitude of settings for group living, according to Ikenga Ogbo, director of Evanston’s Health and Human Services Department.

With limited vaccine supplies in Evanston and elsewhere, the city is prioritizing immunizations of older residents who are among the most vulnerable should they contract COVID-19, said Evanston Mayor Stephen Hagerty in the Evanston “Coronavirus Q&A” on Feb. 4.

“75% of the people that we serve are people of color, 65% of our front-line workers are people of color, and we feel very strongly that we should be vaccinated at the very front end of the 1b’s,” – Betty Bogg, executive director of Connections for the Homeless

The 1b group also includes essential workers such as those working in public transit, grocery stores, shelters and day care centers, manufacturing, food and agriculture, first responders, U.S. Postal Service workers, K-12 education workers, and corrections workers and inmates.

However, this prioritization worries Betty Bogg, executive director of Connections for the Homeless, an Evanston-based organization providing programs and services to support the homeless community in the northern suburbs of Chicago. She is concerned about the equity impact of the city’s plan.

Some “75% of the people that we serve are people of color, 65% of our front-line workers are people of color, and we feel very strongly that we should be vaccinated at the very front end of the 1b’s,” she said.

But Ogbo emphasized that the city’s vaccination strategy follows guidelines from the Centers for Disease Control and Prevention (CDC) and the Illinois Department of Public Health. The CDC is calling for prioritizing people 75 and older within 1b, however Illinois broadened the phase to include those 65 and older.

“The end goal is for everyone to get vaccinated,” Ogbo said. “Everything that we are doing is based on science, based on logic, based on rationale and protocol. So once we are done with the elderly population, then we will venture into vaccinating other population groups, and the homeless population will be included in our next round of vaccinations.”

The Evanston Health and Human Services Department developed a comprehensive plan to immunize people experiencing homelessness. Members of the department have toured homeless shelters to assess how and where they can set up a vaccination clinic within the shelter, Ogbo explained. The department also worked with administrators of shelters to determine the number of residents willing to receive the vaccine.

The city also developed a plan for reaching those who choose not to reside in a shelter. If individuals have access to a phone or the internet, the city recommends they call 311 to speak with a staff member who can help them fill out the vaccine contact form. The form serves as the department’s means for reaching those interested in receiving the vaccine. It can also be completed on the city’s website.

For those who do not have access to a phone or the internet, the department has an alternative strategy. It is working with community leaders and anyone in a position to help to get in contact with people experiencing homelessness and who do not reside in a shelter.

“This is an all-hands-on-deck affair,” Ogbo said. “There are community members who are in touch with these individuals, who know them intimately and who can talk to them, educate them, convince them of the importance of the vaccines. So of course we’ll be relying on these individuals to help us out here to disseminate the information.”

In order to ensure people return for their second dose, the department plans to use a similar method for reaching out to sheltered individuals. They will call them and, for those living in shelters, the city will likely work with shelter administrators to coordinate this, Ogbo explained. The department also has staff trained to answer phones and provide the necessary information for individuals about their follow-up doses.

Hesitancy about receiving the vaccine is still widespread across the world. A study published in Nature Human Behaviour showed that, as of September, fewer people in the United Kingdom and the U.S. would be willing to be immunized than is required for herd immunity. Vaccination of 75%-85% of the public is needed to achieve herd immunity, according to Dr. Anthony Fauci, the leading government infectious diseases expert in the U.S. Researchers also found misinformation accounted for about a 6% decline in willingness to get vaccinated in the U.K. and the U.S.

“We have already started connecting the dots and talking to those who are in the medical field, having the coronavirus sessions where we debunk misinformation about the safety of the vaccines,” – Ikenga Ogbo, director of Evanston’s Health and Human Services Department.

Distrust is also prevalent in communities of color as these communities have faced historic medical discrimination and abuse. One of the most infamous cases of this abuse is the Tuskegee Syphilis Study of 1932. The study, which sought to document the progression of the disease if it was left untreated, lied to Black patients. Researchers told them they were receiving treatment for their disease but purposely did not provide any treatment and instead observed them to document progression of the disease, according to the CDC.

A paper in 2015 in the Journal of Health Care for the Poor and Underserved also found the primary barrier to participation in medical research among African American adults was mistrust in the health care system that stems from historical mistreatment, including receiving lower quality care and denial of treatment.

To tackle this challenge of earning back trust, Bogg said Connections for the Homeless is working on building people’s trust while providing accurate information and supporting them.

“We’re having one-on-one conversations with them,” she said. “We have a nurse on staff who is really great at engaging with folks who have mistrust of the medical establishment about all kinds of things, not just about the vaccine. And so we feel like just kind of setting good examples, getting vaccinated ourselves, talking about it, let people need time to kind of think it through.”

On a city level, the department is working with the community and hosting numerous events to spread awareness, debunk misinformation and assure people the vaccine is safe. Ogbo stated this is a community effort in which everyone can do their part to spread accurate information and encourage others.

“We have already started connecting the dots and talking to those who are in the medical field, having the coronavirus sessions where we debunk misinformation about the safety of the vaccines,” he said. “We have information on our website, on our social media, and we are trying to disseminate information the best way we can.”

According to the city of Evanston e-newsletter, the city has distributed over 13,000 vaccine doses as of Feb. 25. The city recently sent an update that all Illinois residents under 1b can begin making vaccination appointments at the United Center in Chicago beginning on March 7. Those 65 and older can begin making appointments on March 4.

For more information on vaccinations or filling out the vaccination contact forms, call the Evanston 311 number at 847-448-4311 or go to the city of Evanston’s website.

Liam Bohen-Meissner is a health and politics reporter at Medill. You can follow him on Twitter at @lbmeissner.