July 26, 2021

Dr. Bukhosi Dube warned of the Delta variant.
Multnomah County doctors urged people attending a farmers market in Gresham’s Rockwood neighborhood July 22 to bring them their questions or concerns about the COVID-19 vaccine.

Within minutes of the offer, one woman did.

She had come to The People’s Market to get a vaccine. But she was six months’ pregnant and hesitated. “I am wanting my baby to be safe,” she said through an interpreter. 

Dr. Bukhosi Dube, a Mid County Health Center provider, Oregon Health Authority adviser, and host of the radio show “Ask a Black Doctor,” assured the young mother both she and her baby would be safe. The COVID-19 vaccine would provide antibodies that would protect her and her child, Dube told her. The vaccines had been tested on people of all backgrounds and administered safely to millions of people. And with the new Delta variant spreading quickly, time was of the essence.

“You are truly in harm’s way if you are not vaccinated,” he said.

The woman listened carefully, then agreed to receive the shot. It was a scene that played out across the market as Multnomah County leaders, staff and partners doubled down on vaccinating more people in the Black, African American, African immigrant and refugee communities. They held a press conference at the market to highlight alarming disparities in vaccination rates and new efforts to boost the numbers, including incentives.

“A lot of people think that COVID is over because 74 percent of all people 18 years and older in our County have received at least one dose of a COVID-19 vaccine. But the reality is, in the Black, Latinx and Native communities, that number is much lower,” said Ebony Clarke, interim director of the Multnomah County Health Department. “Less than half of adults have gotten at least one dose of vaccine. Less than half. 

“And for me, that’s scary, because we know that we are also fighting a lot of chronic diseases, like diabetes and heart disease, that put people more at risk.”

Multnomah County leaders say they are committed to reducing barriers.
In fact, the Health Department reports, in the last three months since vaccines became widely available, the percentage of positive COVID-19 tests is more than double the number  for whites (6.3 percent vs. 2.7 percent) indicating more concentrated disease among members of the Black, African American, African immigrant and refugee communities.

Hospitalizations due to COVID-19 are still overwhelmingly among those who are unvaccinated. And Black and African Americans are being hospitalized at a rate five times that of white residents, the Health Department reports. That disparity is driven by everything from who had access to vaccines first (overwhelmingly white professionals) to the fact that Black and African Americans suffer disproportionately from underlying conditions that put them at higher risk of COVID-19 complications, including diabetes, kidney disease and heart problems.

“We know there are many reasons people have not yet been vaccinated,” said Clarke. “We are working to break down the barriers people face.”

That includes trying to answer questions and provide the information people need to make their vaccination decisions, while also fielding outreach teams and offering people incentives such as gift cards. 

Chair Deborah Kafoury said the County is also working with community-based partners to who already have deep connections in their communities.

Multnomah County’s REACH program, which stands for Racial and Ethnic Approaches to Community Health, joined with Play Grow Learn, Kaiser Permanente and Medical Teams International to run a vaccine clinic at The People’s Market. 

“The County is here. Because we know how important it is to work with the communities who face the steepest barriers,” Chair Kafoury said. “That’s why we co-created our approach to testing, vaccinations and other services.”

Desire Cage opted for a vaccine after becoming ill with COVID.

Toc Soneoulay-Gillespie, Health Share of Oregon’s director of community health, said the state’s largest coordinated care organization is also working to better connect with communities of color, by supporting vaccines at events like the weekly People’s Market that draw in neighbors with food and music. “Even if just two people show up to be vaccinated, we’re like, ‘Yes! Two people!’” she said. “We are making strides but we need to do more.”

Gift cards, offered at all County-sponsored vaccine clinics, are among the County’s new strategies. The cards can help with the financial burdens of paying for childcare, getting a ride to a vaccine clinic, or even taking a few hours off work to get the vaccine.

The gift cards, for people who receive vaccines, range from $50-$150 depending on the vaccine type and dose number. The County also offers a $50 gift card to anyone who is vaccinated who brings someone else in for a vaccine. 

Dr. Jennifer Vines, Health Officer for the County, acknowledged the racist history in medicine and public health that contributes to many of the barriers keeping people from seeking vaccines.

“I am not selling anything, I don’t make money off any off the vaccines, I just want you to know what I know: how well these vaccines work, and how important it is to get it as soon as you can,” she said.

But she also wants people to know she’s deeply concerned about COVID-19’s disproportionate and preventable spread among members of the Black, African American, African immigrant and refugee communities.

“There is more virus circulating in your community, more of you are being hospitalized compared to other groups, and fewer of you are vaccinated,” she said, “and that is not acceptable.”