Editor’s note: This story has been updated to clarify information about New Hampshire’s equity allocation.
New Hampshire is falling short of its goal of using 10 percent of its COVID-19 vaccine doses to reach vulnerable populations, but officials say they're taking some steps to close the gap.
As outlined in New Hampshire’s statewide COVID-19 vaccine plan, the state said it would “allocate 10% of the available state vaccine supply to geographic areas that are highly vulnerable to COVID-19.” The goal was to reach a range of marginalized populations: racial and ethnic minorities, people experiencing homelessness and those with “other access barriers that prevent someone from being vaccinated through routine state mechanisms.”
According to data provided to NHPR through a right to know request, 21,801 doses were used at equity-focused clinics between February and early April. If New Hampshire were keeping pace with its original vaccine equity goal, more than twice as many doses would have been used during the same time frame, according to calculations by NHPR.
In an email to NHPR after this story was published, Department of Health and Human Services Communications Director Jake Leon clarified that the state is not including federally managed vaccine doses — such as those administered to long-term care facilities through a federal pharmacy partnership — in its equity allocation.
While the state has not made full use of its equity supply, Leon said the state set aside 55,617 of 572,300 doses received between February and early April, or about 9.7 percent. The 21,801 doses used at equity clinics only account for about 3.8 percent of the state-level vaccine supply during the same time period.
Initially, state health leaders said they weren't planning to significantly adjust their strategy to bridge the gap in vaccine equity outreach.
“It doesn’t really require any type of change of strategy,” New Hampshire Bureau of Infectious Disease Control Chief Dr. Beth Daly said during a Thursday press conference. “We’ve realized this is going to be our hardest populations to meet, which is why we’ve dedicated resources to this work.”
On Friday, however, state health officials clarified via email that they have launched new efforts designed to get more of the vaccine into at-risk communities. Their plans include adding more clinics at food distribution sites, churches, homeless shelters and companies that employ predominantly low-wage, frontline workers or people of color.
State data shows persistent racial disparities in New Hampshire’s vaccine rollout and the impact of the pandemic. Black and Latino residents in New Hampshire have faced higher rates of COVID-19 infection and death, but they have been vaccinated at roughly half the rate of white residents, according to state data.
State health officials have placed most of the responsibility for running equity-focused clinics on New Hampshire’s 13 regional public health networks. Public health officials in each region have partnered with community groups to organize clinics focused on reaching a range of people at heightened risk for the coronavirus or who would otherwise face barriers to the vaccine.
As of Thursday, Daly said about 280 of those equity-focused clinics had been scheduled, with plans to reach about 26,000 people.
“Yes, this is less than the 10 percent that we have set aside and have wanted them to vaccinate,” Daly said Thursday, during one of the state’s regular coronavirus press briefings. “However, we have always understood that these populations are going to be harder to reach.”
Equity-focused clinics are often much smaller than those run by the state, Daly said: They might be held at a soup kitchen or shelter, for example, instead of a mall or motor speedway. These clinics are harder to set up than the other fixed vaccine sites, she said, and often reach fewer people at a time.
And Daly said the doses set aside for equity clinics aren’t going to waste, even if they aren’t being used for their original purpose.
“When they aren’t using the full vaccine each week, we’ll go ahead and make sure that vaccine gets used in other settings,” Daly said. “But we still make that vaccine available to them in future weeks — if, for example, they did have a big opportunity to do a low income housing unit or something really large.”
The focus of the clinics vary from region to region. In the Greater Nashua region, about three-quarters of equity doses have been set aside for racial or ethnic minorities, with the remaining doses focused on people experiencing homelessness, low-income residents and other at-risk populations. In the North Country, more than half of the region’s equity doses have been targeted to homebound residents or people with transportation barriers.
Alice Ely, Executive Director Public Health Council of the Upper Valley, said her organization partnered with local groups serving low-income residents to vaccinate about 65 people at a downtown Lebanon clinic earlier this week. They’re also working on an upcoming clinic focused on people with limited English proficiency.
“It's really designed to make it easier for folks who are concerned about their language skills to come and get a vaccine,” she said.
These clinics are often small, Ely said, but they’re “exactly what we need” — especially as the state broadens vaccine access to the general population. And the Public Health Council of the Upper Valley, too, is trying to make sure no doses are being wasted: After one recent clinic, they brought leftover doses to a nearby restaurant and offered the shots to staff.