Flint, MI— Local leaders and health officials are criticizing the State of Michigan’s new “hyper-local” campaign to deploy “Street Teams” into Flint’s underserved neighborhoods to increase COVID vaccination rates in Flint and Genesee County.
Health officials said they were not included in conversations with the state and disagree with the messaging surrounding the effort.
The campaign is spearheaded by the Protect Michigan Commission, which advises Governor Gretchen Whitmer and the Michigan Department of Health and Human Services on strategies to overcome vaccine hesitancy. The goal is for every street team member to sign up 50 new people each day over the next two-weeks.
During a press conference on May 19, PMC organizers said the effort was in partnership with faith leaders, health officials, the Mass Transportation Authority of Flint, and built upon ongoing work within the Flint Community to increase COVID vaccine access.
“This new effort in Flint aligns with what we are seeing nationally. Public health authorities across the country are responding to the challenge of getting COVID-19 shots in arms by shifting efforts away from mass vaccination sites and focusing on communities with low vaccination rates,” Eli Isaguirre of the PMC said at the press conference.
But faith leaders and health officials said they were unaware of the campaign, including Health Advisor to Mayor Sheldon Neeley Dr. Lawrence Reynolds, who was appointed to the PMC by Whitmer in Jan. 2021.
“It’s been mischaracterized as a new initiative. What it really is, is an addition to existing initiatives that have been organized by the Flint Community for several months. … There was some misunderstanding on the part of the state about what the Flint Community with the Health Department and the City of Flint has already organized, plus a host of other nonprofits,” Reynolds said.
Monica Villarreal, who co-chairs the Faith Subcommittee of Flint’s COVID-19 Taskforce on Racial Inequities and is a lead organizer for Michigan United, has led several on-the-ground efforts in Flint to meet the needs underserved residents during the pandemic.
The Faith Subcommittee developed a door-to-door model to educate Flint residents on COVID-19, to coordinate vaccine distribution and access, and to develop vaccine clinics, Villarreal said.
Michigan United also launched a grassroots public health navigator program in June 2020. Trained individuals use a list that was developed during the Water Crisis to target residents most in need. They make cold calls and visit neighborhoods to educate residents and address transportation struggles in partnership with the MTA.
“I felt that the state was coming in to bring a program to take credit for work that others have been doing,” Villarreal said, adding that they’ve received very little funding for their efforts.
Officials at the Genesee County Health Department said they were also initially unaware of PMC’s campaign.
Deputy Health Officer for the GCHD Kayleigh Blaney said confusion set in after the PMC held a separate press conference on May 17 concerning the success of the mass vaccination clinic at Ford Field.
During the press conference, PMC Director Kerry Ebersole Singh announced they would be shifting efforts from large-scale vaccine sites to “focus on communities that have the lowest vaccination rates” by using a “hyper-local,” census-style approach.
Singh cited a survey conducted by the PMC between May 5 through May 9 which showed the strongest “resistance” to the vaccine occurred in Flint, Saginaw, and the Thumb Region. She said they would be making an announcement about how the commission plans to address vaccine hesitancy in Flint but revealed no further details at the time.
“I found out from the press that this was announced at a press conference, because obviously, we weren’t notified. So, we spent the majority of (May 17) trying to figure out, ‘Okay, what is this? What’s happening?’” Blaney said.
After a few phone calls, Blaney said they were able connect with PMC organizers.
“They weren’t very aware of what we actually had been doing as a Health Department or the Flint Community in general,” she said. “This was billed as a new thing, which obviously was very upsetting to us.”
Blaney also said that health officials disagreed with the “vaccine hesitant narrative” pushed on Flint.
“We don’t agree that relative low vaccine rates are always because of vaccine hesitancy. … Vaccine hesitancy is an issue everywhere. I mean, there’s going to be vaccine-hesitant folks in rural areas, urban areas, in suburban areas. But that’s only part of the narrative when you’re talking about access to vaccines,” Blaney said.
Based on reports from the public health navigators, Flint residents aren’t vaccine hesitant and are eager for more information, Villarreal said.
“Our navigators have held thousands of conversations. We are not seeing or hearing a sense of vaccine hesitancy in the proportion in which these reports are suggesting. What we have really found through the conversations is a lot of questions. (People) still want information about the vaccine and the accessibility pieces around it,” Villarreal said.
The GCHD alongside Villarreal and Reynolds were able to address this messaging before the press conference on May 19, but news outlets had already reported on the survey.
“The messaging suggests that the State of Michigan is needed to swoop in and ‘save Flint.’ This community has seen what happens when the State Government thinks they know what is best for the community. We deal everyday with the mistrust in Government, and I am not convinced this new program won’t leave our own health department and community struggling to support the capacity needed,” Villarreal wrote in an email to PMC organizers.
Vaccine hesitancy as an easy ‘narrative’
Reynolds said vaccine hesitancy is a “convenient narrative” for cities like Flint where over 50% of the population is Black.
While there is a sense of medical distrust among Black and Brown populations due to a history of abuse and unethical human experiments, hesitancy and access are two separate but often conflated issues, Blaney said.
Since the onset of the pandemic, Black Communities have been overrepresented in confirmed COVID-19 cases and COVID-19 related deaths. While the reasons are nuanced, one is socioeconomic status and exposure to the virus due to holding more “frontline” or “essential” roles, according to the Centers for Disease Control and Prevention.
These roles also affect vaccine access, Blaney said.
“If you’re working from 6 in the morning until 10 o’clock at night, when are you supposed to go get your vaccine? So, that’s not necessarily that that person isn’t being vaccinated because they don’t want to be. They’re not vaccinated because they don’t have the access because they’re working,” she said.
Reynolds echoed Blaney’s sentiments.
“Don’t talk to me about hesitancy until you can assure access,” he said. “Yes, (Black people) do have a history of mistrust, distrust over 400 years in our relationship to healthcare. But that can be overcome if you use credible people and put the resources behind it consistently.”
Nationally, Black people are no more resistant to get vaccinated than White people, according to data by the Kaiser Family Foundation, a nonprofit organization that reports on national health issues.
According to a KFF survey, 13% of White people and 13% Black people who responded said they would “definitely not” get a COVID vaccine.
However, a higher percentage of young Black people (19%) said they would “wait and see” compared to their White peers (16%).
KFF cites lack of information as the biggest barrier to getting vaccinated for people of color.
“While side effects and safety top the list of concerns for those who haven’t gotten vaccinated for COVID-19, we continue to find that lack of information and access are barriers for some individuals, particularly people of color,” the report said.
Will the state’s efforts help inform Flint residents?
The PMC plans on sending 60 individuals, all Flint residents, to “high social vulnerability index areas” located mainly on Flint’s north side.
“Our Flint Street Team is a pilot program that developed from our work in Detroit. …Through our door-to-door engagement we have connected with thousands of residents. We know good things are already being done in Flint,” Singh said.
Residents will receive materials focused on the “safety and effectiveness of the vaccine information approved by the Michigan Department of Health and Human Services,” Singh said.
However, Villarreal said the materials, which include a door hanger and a pamphlet, are state branded and do not include local vaccine information, phone numbers, or websites.
“In the press conference, they talked about different vaccine sites locally that they said these street teams would be helping funnel people to and guiding people to. But none of that’s on those door hangers. My fear is that this is an effort by the state that’s ultimately going to result in undermining our very own efforts in this county and by our health department,” Villarreal said.
Singh said the PMC is meeting with local organizers to ensure all programs are aligned.
“We believe this is a team effort to vaccinate our state and we need all hands on deck,” Singh said.
Debra Furr-Holden, director of the Flint Center for Health Equity Solutions and associate dean for Public Health Integration at Michigan State University, who has also been instrumental in leading COVID efforts in the Flint Community, said she hopes the state’s interest in Flint isn’t short-lived.
“We’ve already got a tremendous amount of partnership around outreach to address COVID vaccine access in some of our most underserved communities … and we’re happy that the Governor’s office and the Protect Michigan Commission is joining the fight and our ongoing effort. And we hope that the Governor’s Office will avail funds to us because our work to date in this area has been very underfunded. It’s mostly been led on grit and goodwill,” she said.