As Long Beach prepares to operate small-scale COVID-19 vaccination efforts within its deeply-impacted communities, city leaders and community organizations are facing a number of challenges, ranging from the lack of manpower and language barriers to a digital divide and logistical obstacles.

Dr. Elisa Nicholas, CEO of local clinic TCC Family Health, said her staff has conducted three pop-up vaccine events in Central and North Long Beach—areas with the highest infection rates per 100,000 people. The city was able to distribute 300 doses to the clinic, with 150 of those expected to be administered at its fourth pop-up clinic planned this Thursday at Hamilton Middle School, Nicholas said.

In preparation for Thursday’s clinic, the staff personally reached out to patients who are 65 years or older, do not primarily speak English and those who do not have stable access to the internet to sign them up. Most of the patients are Black, Latino, Cambodian and Filipino, Nicholas said.

“We are doing outreach to communities at the most at risk,” she said. “They do not have access to technology—no computers or broadband. It’s a logistical challenge.”

Nicholas said the work to get patients vaccinated is labor intensive since setting up appointments by phone is tedious but easier for seniors not particularly internet savvy.

Once the list of patients is complete, the lack of manpower proves to be another hurdle. The clinic’s vaccination team consists of doctors taking on extra hours to help out. Even the clinic’s dentists have been pulled in to assist with the inoculations.

“Nurses have been recruited away to hospitals,” Nicholas said. “We don’t have access to all the manpower like the national guard and paramedics.”

Language and cultural barriers have also slowed down efforts to get patients to registered for vaccines. The city conducted its first actual mobile vaccine clinic in West Long Beach on Feb. 6 where approximately 500 doses were administered. Through the help of nonprofits, such as Long Beach Ministers Alliance, the city was able to have Spanish-speaking volunteers onsite to help the elderly navigate the paperwork of getting the vaccine.

A second vaccine clinic focused on Black seniors took place Wednesday, Feb 10, at St. Mark Baptist Church in Central Long Beach. The Rev. Gregory Sanders, president of the alliance and leader of the ROCK Christian Fellowship, said the turnout was “beautiful.”

While official numbers were not yet available, Sanders said roughly 200 vaccines were given to seniors. The event not only helped vaccinate a vulnerable fraction of the population, but it also alleviated some logistical issues. Sanders said many came in wheelchairs and only had to travel less than a mile to get inoculated and applauded city officials for facilitating the event.

“This was critically important. Some people can’t drive out to these massive vaccination locations,” Sanders said. “Black seniors still have anxiety, but they see trusted faces, pastors and it reveals a bit of that anxiety.”

But communicating with community-based organizations to let them know when vaccines are available has proven to be complicated.

Laura Som, founder and director of the MAYE Center, a holistic healing nonprofit, understands the barriers Cambodian refugees like herself face. The trauma experienced during the Khmer Rouge genocide in the 1970s have left many seniors with PTSD, leaving them feeling cut off and distrustful of political institutions. Though the city’s health department has met for months to strategize vaccine efforts, Som said the group lacked Cambodian representation.

“My community has been scrambling for the past two, three weeks,” she said. “We looked at the process that the city rolled out, and it really created this inequity against our community.”

Data shows that North Long Beach, with the largest population of Black residents at 20%, has the highest disparity in cases-to-vaccinations. While 131 people per 1,000 are contracting the virus, only 47.1 people received the vaccine, data presented to the City Council on Feb. 2 shows. This mirrors national statistics that show the share of vaccinations among Black people is smaller than their share of cases in 16 of the 17 states collecting this form of data.

The issue of vaccine inequities has caught wind at the federal level. Reps. Nanette Barragan and Alan Lowenthal, who represent Long Beach and surrounding cities, submitted a letter to the California Health and Human Services secretary and the Los Angeles County Department of Public Health, to collect and make public data on the ZIP code, race, age and occupation of those receiving the vaccine so that corrections can be made, if necessary.

This week, the White House announced a plan to place more doses in the hands of community health centers. There are more than 1,300 community health centers serving almost 30 million people across the country. Two-thirds of the population that these centers serve are living at or below the federal poverty line and 60% are racial or ethnic minorities, a statement from the White House read. The initial phase of this roll out will include at least one community health center in each state, expanding to 250 centers in the coming weeks.

This federal-led pivot to small-scale vaccinations gives hope to Nicholas, although she doesn’t know if her clinic will be among the health centers chosen by this new vaccine roll out.

“Any increase in the supply of doses coming to community health centers is a reason for hope,” Nicholas said. “This would assure our ability to continue to personally reach out to the most affected by COVID-19.”

Reporter Kelly Puente contributed to this report.