Inside Camden’s fight to vaccinate the most vulnerable

On a recent morning in Camden, it took hours to vaccinate just 25 people in a makeshift clinic on the ground floor of an apartment building. To Kevin Emmons of Rutgers University-Camden School of Nursing, who organized the clinic in Mickle Towers, that session was a success.

Emmons and his team started hosting pop-up vaccine clinics with the Camden County health department in housing complexes last month. Planning begins long before shots go into arms.

Armed with lunch for residents, they offer information about vaccines in the community room, then go door-to-door asking if there’s anyone who is elderly, homebound, or without internet access who would like to get the vaccine. They return on another day to administer one-shot doses of Johnson & Johnson to those who signed up.

Vaccinating hard-to-reach people is a crucial part of the region’s – and the nation’s – path to conquering the coronavirus, Emmons said. But spend some time doing it, and it’s not hard to see why large-scale vaccination sites often get priority over the resource-intensive process of meeting people where they live.

“I may be working with a dozen people in the community on these days,” said Emmons, an associate dean and professor in the Rutgers-Camden School of Nursing. “In that time, if I was working at a mass site, I could have vaccinated 2,000 people.”

» READ MORE: New Jersey’s vaccine rollout is mostly working. In Pennsylvania, it’s more complicated.

In one of the nation’s poorest cities, Camden’s mostly Black and Latino residents have suffered from a disproportionate number of coronavirus cases over the last year, a disparity reflected in national data that have shown people of color are far more likely to contract and die from the virus. The Camden County health department set up testing sites in the city last year, went door-to-door with information about staying safe, and provided buses to take seniors to vaccine sites.

For Emmons, 39, pop-up clinics are a natural step in a career spent forging connections with his community’s most vulnerable residents. A native of Woodlynne, Emmons grew up outside of Camden and went into nursing and the military, where he served overseas in the U.S. Army Reserves Nurse Corps. In Camden, he founded a clinic focused on treating wound and foot problems among people experiencing homelessness. At Rutgers, he teaches undergraduate and graduate students about the needs of underserved populations.

Emmons has been part of New Jersey’s pandemic response since last year, when he was chosen to run the field hospital for overflow patients in Atlantic City. There, he saw that the only patients diverted to the temporary hospital were people of color, mostly those without insurance. Some patients were migrant workers, he said – the same people who kept food and other supply chains operating when much of the country retreated indoors last spring.

While other hospitals were overwhelmed and the staff overworked, those at the field hospital -- which never approached full capacity -- were able treat patients for health issues unrelated to COVID-19, and get some on track for continued care.

“It enabled us to get them into the health-care system,” Emmons said.

Now Emmons is focused on vaccinating those same people. While Camden has the benefit of two major health systems that can help with contacting existing patients and those who have had hospital visits, there remain many transient residents who can’t be easily found.

Emmons is working with shelters and other centers that are hubs for the city’s homeless population, arranging clinics as well as setting up temporary accommodations for those who might suffer from flulike side effects after a shot. Some shelters don’t allow residents to sleep there during the day, which Emmons fears could lead to vaccine hesitancy among those who don’t have places to go when they feel sick.

“You’d think it would be easy, just stand on a corner and hand out vaccines,” he said. “But there’s a lot that goes into every step of this.”

As of last month, more than 12,000 vaccines had been administered to Camden’s adult population of 54,000, according to a Camden County spokesperson.

Equitable distribution remains a struggle for New Jersey and the region. Less than 6% of the Garden State’s vaccines have gone to Black residents, and mass vaccination sites and online appointment systems have funneled doses to those who have the benefit of flexible schedules, as well as reliable transportation and internet access.

When appointments opened at the Salvation Army Kroc community center in East Camden, Emmons and others saw the slots filled by residents of wealthier towns like Cherry Hill and Haddonfield. They moved some appointments to the nearby county site in Blackwood and began requiring proof that recipients lived or worked in Camden. They allowed residents to schedule appointments in person, by walk-up.

“We were in such a rush to get people vaccinated at the mass sites, but a big enough percentage of people of color just wasn’t getting there,” he said. “Could those sites have been set up quicker in those vulnerable areas? Maybe, but even then there’s no guarantee that those people will be the ones who go.”

For Emmons, the pandemic better illuminated the needs of those who have few people to advocate for them. But removing barriers to vaccines takes time, and in the months since the rollout began, highly infectious variants have spread through the state. Some of those who remain most at risk of getting sick may still be weeks or months away from being vaccinated – which Emmons said makes it all the more important that thousands of other New Jerseyans keep getting shots in arms each day.

“It makes you realize the vaccine isn’t just about you. It’s about protecting other people,” he said. “And some of the people who need protecting are these vulnerable populations.”