Starting this week, mobile vaccine clinics that have been trying to reach unvaccinated residents will begin pulling out of New Bedford, the city with the lowest vaccination rate in Massachusetts.

The move is part of the state government’s broader strategy to shift resources so it can ramp up delivery of booster shots for those already vaccinated against Covid-19, as well as first doses for children under 12. 

The decision leaves leaders in New Bedford searching for another way to catch up with the vaccination rate in the rest of Massachusetts, which is among the highest of any state in the U.S. New Bedford’s own vaccination rate — just under 50 percent — is closer to the rates in Georgia, Mississippi and Alabama, some of the nation’s least vaccinated states. 

What exactly set this diverse port city of 100,000 people on such a different course from the rest of Massachusetts has been difficult for the city’s leaders to pin down. New Bedford has slipped behind numerous cities with similar demographics and economic hardships.

“Are people in New Bedford more fearful than the rest of the state or the region?” Damon Chaplin, the city’s top public health official, asked during a recent interview. “I wouldn't say that, but there have been situations that have caused us to become delayed in our response.”


Early problems in New Bedford with vaccine distribution

Chaplin, who leads a municipal health department with roughly two dozen employees, was an early critic of the vaccine plan adopted by the Massachusetts Department of Public Health last winter.

The largest share of the state’s limited vaccine supply went to mass vaccination sites located in sports stadiums, empty big box stores and convention halls. For the first month of public vaccinations, the closest site to New Bedford was located at Gillette Stadium in Foxborough, almost an hour’s drive away. Appointments had to be booked online, through websites that frequently crashed or ran out of appointments within minutes. 

"The system is broken for hard to reach communities," Chaplin said in March. "We've got a large group that responds well to mobile clinics, but the state's distribution plan is not set up for what that population needs."

At the time, Chaplin was asking for more vaccines to go to the city’s health department, which used its weekly shipments of a few hundred doses to go door-to-door in public housing, vaccinating people who didn’t have the computer skills or the transportation to access mass vaccination sites. 

“We had a small window of opportunity early on last year to really go into neighborhoods and communities when everyone was really interested in getting the vaccine,” Chaplin said. “We missed that window prior to when the Johnson & Johnson incident happened. ”

The Centers for Disease Control briefly paused vaccinations with the Johnson & Johnson vaccine to investigate a rare type of blood clots in women. Ten days later, the CDC determined the J&J vaccine was safe, but Chaplin and several other public health experts interviewed for this story said it was enough time for hesitancy about the vaccine to harden into fear in some neighborhoods. 

Allison Vigna, who helps run a party rental business in New Bedford, was one of the people who reacted strongly to the CDC’s pause. She has not received any form of Covid vaccination, and said she gets most of her information about vaccines from friends or right-wing news channels. 

“I think, just, people are talking,” Vigna said. “And people don't trust this government.”

That sentiment unites a diverse cohort of people in New Bedford, from Trump supporters like Vigna, who form one of the largest Republican voting blocks in any Massachusetts city, to growing immigrant communities from Central America.

“Some of the immigrant community, I think, is always a little bit hesitant of things that come out from our government, because our government periodically doesn't protect them very well,” said Cheryl Bartlett, the CEO of the Greater New Bedford Community Health Center.

Faced with stubbornly low vaccination rates in several cities, the Massachusetts Department of Public Health shifted gears with its vaccine outreach this summer. Mass vaccination sites closed, and the ambulance companies that staffed them were redeployed to municipal health departments, along with much larger quantities of the Covid vaccine.

Chaplin used those resources to create more than 250 mobile clinics in New Bedford, enlisting community organizations to help with administration and outreach. In two months, the city’s vaccination rate rose seven percent.

But the Massachusetts Department of Public Health is now winding down those mobile clinics and reopening the mass vaccination sites. A department spokesperson said the clinics were initially successful but turnout in New Bedford has since dipped to new lows. Some mobile clinics are vaccinating as few as three people a day.


Are vaccine mandates the answer?

Increasingly, leaders on the front lines of New Bedford’s fight against Covid are looking to vaccine mandates as their last hope to boost vaccinations to a level where Covid outbreaks begin to disappear. 

In Massachusetts, vaccine mandates took effect across most branches of state government last month without triggering the mass resignations that some feared. Ninety-five percent of state employees who work under Governor Charlie Baker reported for work in compliance with the mandate. Even the Massachusetts State Police, whose union is suing Baker over the vaccine mandate, report 85 percent of troopers are now vaccinated.

National polling suggests the earliest mandates have had significant sway outside of Massachusetts too. 

“We know not just from our polling, which suggests that at least a third of unvaccinated people say they would get vaccinated if required,” said Jen Kates, the director of health policy research at the Kaiser Family Foundation. “There's evidence out there from these large companies that have instituted mandates — United Airlines, I think Tyson's — where they have 95% to 98% compliance.”

But vaccine mandates aren’t on the immediate horizon for most of the private sector in New Bedford. 

“It has to be, you know, maybe taking off the kid gloves a little bit with the employer community,” said Corinn Williams, an organizer brought in to coordinate some of New Bedford’s mobile vaccine clinics in the city’s Central American neighborhoods. 

Williams directs the Community Economic Development Center, which now requires proof of vaccination for anyone showing up for the English classes or free tax prep that the center offers. Williams wants employers to start asking the same of their workers, provided they offer time off to make appointments and recover from side effects.

“A lot of our outreach did happen one person at a time, in trusting relationships, and that kind of relational organizing model is definitely effective,” Williams said, “but it's got to be bigger than that.”

Dr. Dani Hackner, the chief clinical officer at Southcoast Health, the region’s largest hospital network, said the impact is clear in workplaces that have already started vaccine mandates.

“There is no doubt,” Hackner said, “when folks see this affecting their pocketbook, when they see it affecting their jobs, that they think again about hardened positions not based on science.”

Tony Sapienza, the chairman of the city’s Economic Development Council, is a personal supporter of vaccine mandates. Nevertheless, he said it’s been hard for small to mid-sized employers to require vaccinations when their competitors don’t have to.

“In this period of time when many jobs are unfilled,” Sapienza said, “the thought that they might lose a number of employees because of the mandate has been a problem for a number of employers.”

New Bedford’s own attempt to require vaccination for city employees is an example of a mandate that’s buckled under pressure. 

On August 6, Mayor Jon Mitchell announced that city employees would have to get vaccinated or submit to frequent testing. But three months later, a city spokesperson said departments aren’t tracking which employees get vaccinated. The spokesperson said tracking won’t happen until the city’s finished negotiating the mandate with its employee unions.

Ben Berke is the South Coast Bureau Reporter for The Public’s Radio. He can be reached at bberke@thepublicsradio.org.