Covid testing in Bayview
A Covid-19 Testing Site at Mendell Plaza in the Bayview Hunters Point neighborhood on Nov. 29, 2020. Photo by Annika Hom.

The tall woman kept a brisk pace down 3rd street in the Bayview. Double-masked and in sensible walking shoes, she was not about to put up with any funny business.

The 62-year-old was making a beeline for a reason. “I live in the neighborhood, but that’s it,” she said, meaning she kept her activities to a minimum to avoid exposure to Covid-19.

“Folks aren’t thinking straight,” she said, referring to why some other residents aren’t getting vaccinated or boosted. “All these folks think they’re invincible.” 

The woman, who asked not to be named, seemed to know something the data does, too: Despite a high rate of primary vaccination series, greater than 90 percent, the Bayview now lags behind almost every other neighborhood in San Francisco in terms of getting boosters.

The San Francisco Department of Public Health estimates that 49 percent of Bayview’s residents with a complete vaccine series have received a booster, which is on par with the Tenderloin, at 49 percent, and ahead of only Treasure Island, at 42 percent. Citywide, 61 percent of eligible residents received a booster, with rates increasing up to 80 percent in older age groups.

It’s not certain why booster uptake has been low in Bayview Hunters Point, and rates differ across demographics like age, income, race/ethnicity and neighborhood. The San Francisco Department of Public Health’s public primary vaccination and booster data does not cross-reference more than one category at a time; booster rates by age and neighborhood, for example.

The San Francisco Department of Public Health did not respond by press time to Mission Local’s requests for specific data summaries, or to clarify how the estimates are calculated. Are recommended wait times figured into who is eligible for a booster, for example?

In short, the data may not tell the whole story.

Other insights have been offered by leaders and health professionals working in the community.

Drew Jenkins, a community leader from Sunnyvale who works for Mercy Housing, said people can get the wrong information, or feel like they’re not at risk. “Now they’re hearing about people having a booster and still getting the virus,” he said.

He also mentioned trust. “It’s just difficult, because the community has been so neglected and lied to over the years,” he said, referring to a history of enslavement and discrimination of Black and African American residents. This group makes up around 27 percent of the Bayview Hunters Point population.

Recent events during the pandemic brought this history into focus, such as the Johnson & Johnson vaccine, whose single-shot regimen and easier storage needs were marketed as ideal for reaching populations traditionally located at the geographic and cultural periphery of mainstream health services, including urban Black communities.

Public health officials eventually recommended a supplemental dose for J&J recipients, a “follow-up” dose of Pfizer or Moderna, because the single dose vaccine’s ability to fight off infection dissipated more quickly than mRNA vaccines. In December, the CDC recommended mRNA vaccines over J&J, due to rare but life-threatening blood clots linked to J&J.

By early August, some seven percent of San Franciscans had received the J&J booster. The San Francisco Department of Public Health did not respond to Mission Local’s request for an updated number, or to specify how many of these recipients were Bayview residents and how many were Black.

“It just turns everybody off again. And then you’re starting back at square one, you know?,” said Jenkins. “‘Johnson Johnson is going to be the best one.’ Then all of a sudden … they pull it off the shelf,” he said. On top of a history of exclusion, he said, “it is really difficult to believe in something that’s going to help you.”

Dr. Monique LeSarre, executive director of the Rafiki Coalition, which offers vaccination and testing in the community, including wellness services for those who test positive, referenced viral misinformation on social media as a detriment to vaccine and booster uptake.

She also cited disenfranchisement, particularly among specific groups, like unemployed teens, who don’t have a requirement nor feel they will benefit from getting vaccinated or boosted.

LeSarre said her team is thinking about ways to reach groups like this. “I think we’re trying to be creative about it. And I think that the creativity is also about relationships,” she said, like “supporting the people that are related [who are already vaccinated] to them to talk them through it.”

Neighborhood residents also weighed in about their decisions to get boosters, some addressing trust and risk.

The briskly walking woman introduced earlier has had her primary Modena series already, but she said she is waiting the recommended five months to get her booster. She said she’ll get Moderna, because she doesn’t want to mix the brand of her primary series and booster despite official recommendations to get whatever booster is available.

“You don’t mix beer and milk,” she said, then shrugged. “I don’t know. I don’t like being a guinea pig. They wanna see if it will work.”

A graying man taking a smoke break on 3rd Street near Kirkwood Court, who declined to give his name and exact age, said he was “forced” to get the Moderna booster to take an international flight to see his father, who had suffered a stroke. 

“I think if your immune system can take [covid], it doesn’t need [the vaccine],” he said. 

Arturo Ramos, 22, a security guard waiting outside an apartment building at 3rd and La Salle streets, had also received the Moderna booster. It hadn’t been his idea, either. “My mom told me if I don’t get it, I can’t come in the house,” he said, smiling. 

Laura, 17, and Edwardo, 17, were waiting for a bus nearby. Laura completed her primary series and Edwardo will get his second jab later this month; they aren’t boosted yet, but say they plan to be.

Laura, who got her vaccines at a community clinic, said she just needs to make the booster appointment. 

She said most of their peers at their high school aren’t vaccinated. “Some are against it. They think it’s not going to help them,” she said, adding there aren’t that many people at her school right now, due to many having covid. 

Edwardo wasn’t sure about the vaccine initially. “At first, I thought it would kill me,” he said. But then his family went to get vaccinated, he said, and he went, too. Like his parents, he plans to get boosted. 

“I feel like it’s the parents,” Laura said about her unvaccinated peers. “They think what [their parents] think. But if you look at the research … you can still get covid, but it can help you from getting as sick.”

That’s one message Jenkins hopes other residents will also take to heart. Working with the San Francisco Department of Public Health and community partners, his team has expanded from satellite sites to provide testing and vaccinations clinics four days a week in Sunnydale and the Excelsior via a “roving bus.”

“I can’t lie, it is really hard to try to persuade,” said Jenkins, adding it might come down to “extremes” for people before they feel the need to get boosted. “As people keep catching the virus [or] they get ready to shut the city down, some people are going to start getting their booster,” he said. “We wish we wouldn’t have to go to that, but you know.” 

He compared it to the first round of vaccinations and seemed hopeful. “Everybody wasn’t getting the vaccination right away,” he said. “So we got to play in the same way that we did … [The] booster is slowly going to happen.”

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"Annie" is originally from Nebraska, where she found her calling to journalism as editor of her high school newsletter. Before returning to the field, she studied peace and political science in the Balkans, taught elementary and middle school, and worked as an epidemiologist during the COVID-19 pandemic. Follow her on Twitter @anlancheney.

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