Minnesota bets big on State Fairgrounds in push to inoculate hard-hit communities

It was the text message that Michael Elder, a stay-at-home father of five, had been waiting months for — and it had the potential to save his life. A shot of the COVID-19 vaccine was available for him. All he needed to do was get to the Minnesota State Fairgrounds in Falcon Heights.

Before dawn on Wednesday, Elder woke and readied his children, ages 1 to 13, for school and day care before loading his backpack with water and asthma medication for his journey to the vaccine site.

And then, as the sun rose over his home in St. Paul's Dayton's Bluff neighborhood, Elder dropped to his knees on his front porch and prayed. "I thanked God for the vaccine and all his loving mercy," said Elder, 35. "I asked him to pray over me on my journey and to protect all [God's] children from the coronavirus."

Elder and his family are among thousands of Twin Cities metro-area residents benefiting from an aggressive and highly coordinated campaign to expand COVID-19 vaccinations to minority communities hardest hit by the pandemic. At the center of the initiative is the State Fairgrounds, a place better known for cheese curds and barbecue turkey legs than medical care.

Since opening two weeks ago, the familiar site has been transformed into a bustling hub of activity — with more than 2,000 Minnesotans a day descending in buses, cars and on foot, all seeking the potentially lifesaving shots.

Run by state and federal agencies, the State Fairgrounds site has quickly become the largest distributor of COVID-19 vaccine shots in Minnesota and has been widely hailed as a model of efficiency.

The massive site is a well-oiled machine, with U.S. Coast Guard personnel directing cars into separate lanes and checking in people into a tent the size of a football field. People with disabilities or parents with children can roll down their car windows and get vaccinated without stepping outside their vehicles. All told, the sprawling site has more than 130 staff, including U.S. Air Force personnel from 24 bases across the country and more than a dozen foreign language interpreters.

With military-like efficiency, the staff have administered nearly 40,000 shots, and they expect to reach 168,000 total doses by early June.

"I wish every vaccination site in the state was as smooth as this," said Ubah Nor, a COVID-19 response specialist with the nonprofit African Immigrants Community Services, as she escorted an elderly Somali woman through the drive-through tent last week.

The site, established in partnership with the Federal Emergency Management Agency (FEMA), has also become the cornerstone of the state's efforts to address persistent inequities in the state's rollout of the vaccines. State officials acknowledge that the coveted shots are disproportionately going to white people, and public service appeals are having limited effect. For instance, Black Minnesotans account for 6% of the population but represent only 4% of those vaccinated. By contrast, whites represent 81.6% of the population but account for nearly 87% of those vaccinated.

Community groups say people who live in underserved neighborhoods face a variety of obstacles to getting the vaccine. These include English-only registration systems, pharmacy websites that can take hours to navigate, a lack of transportation and difficulty getting time off from work. Some people in minority communities are also more hesitant to roll up their sleeves because of deep-rooted skepticism of vaccines and a mistrust of institutions that have subjected minority groups to unethical experiments and discrimination.

Recognizing these disparities, the state took a more aggressive approach with the State Fairgrounds site, targeting neighborhoods hit hard by the virus.

The state sent tens of thousands of text messages to people who live in targeted ZIP codes within five metro-area counties that rank highest on a social vulnerability index that accounts for poverty, minority status and other factors. The state also turned to dozens of nonprofits that serve the Hmong, Karen, Somali and other immigrant communities in the Twin Cities to spread the word about the vaccines available at the fairgrounds. Groups like the Hmong American Partnership in St. Paul scheduled dozens of appointments at the site and posted messages on social media.

"There is hope that ... we can take the lessons learned from this rollout [at the fairgrounds] to community vaccination sites across the state," said Dr. Nathan Chomilo, vaccine equity director for the state Department of Health.

Despite his wariness of needles, Elder said it took little to convince him of the urgent need to get vaccinated. Four close relatives, including three aunts and his wife's uncle, have died of the virus since the pandemic began, he said. And earlier last month, Elder was notified that a classmate of his 6-year-old son, Josiah, had tested positive for the coronavirus — prompting his entire family to get tested.

"We were scared," said Elder, who worked as a car salesman and mechanic before the pandemic hit. "It felt like the virus was closing in all around us and no one was taking it seriously."

His fears were compounded when he began scanning the internet for geographic data on COVID-19 infection rates. He discovered that his family lived in the ZIP code (55106) with the highest number of COVID-19 infections — more than 6,000 — in Ramsey County. He looked around his close-knit community and became increasingly troubled by the sight of maskless people gathering outside stores, bars and bus stops.

"Look, if I have to put a mask on my 1-year-old kid, then why can't a grown adult wear a mask?" he asked.

Yet Elder faced early obstacles in his pursuit of the vaccine.

In late February, he called his medical clinic in St. Paul and was told that he wasn't eligible for the shots because he was under age 65. A month later, he became hopeful when his wife received her first dose at the Mall of America. Elder tried a second time to secure an appointment — carefully explaining that his asthma was so severe that he had to carry an inhaler everywhere and would "probably die" if he ever became infected. Even so, he was rejected again for the vaccine — this time because he was not classified as an essential worker, he said.

"I was highly upset" by the denials, Elder said. "With five kids going to school, and no idea of who they are exposed to, it sometimes feels like we are playing a game of Russian roulette."

But at 9:04 a.m. on a rain-drenched morning, Elder's daily prayers for relief were finally answered. A text message arrived saying he qualified for the vaccine at the State Fairgrounds site. By the next morning, Elder was in a celebratory mood as he wove his GMC Yukon through the grassy parking lot at the fairgrounds. Within minutes, he was sitting across from an Air Force officer filling a syringe with the Pfizer vaccine.

"I'm representing Ramsey County right now!" Elder said as he rolled up his sleeve.

"That's it. Yay!" said Lydia Payne, a senior airman in the Air Force, after inserting the needle.

Twenty minutes later, Elder stepped out into the midmorning sun with his vaccination card. Grinning, he took one more look at the steady stream of people arriving at the site before calling his wife.

"You know," Elder said, "I think everything is going to be OK."