PAHOKEE, Fla. — The winds blew southwest the day of Pahokee’s Covid-19 vaccination drive, which meant the sugarcane fields were ablaze. Growers are banned from burning excess leaves when there’s an eastward breeze, to keep fumes away from the gated communities of Florida’s Gold Coast 40 miles away. Pahokee is in the same county but, with a median personal income of $13,674, its residents live in a different world.
A single highway connects the billionaire’s club of Mar-a-Lago to the working-class western edge of Palm Beach County, the vast shopping malls and mimosa-drenched restaurants giving way to acres of endless, flat fields. There are no buildings to break the horizon, only the desolate, empty beauty of farmlands reaching to meet the sky, with distant spirals of black smoke rising up to the gathering clouds.
Many of those here and in neighboring Belle Glade work in Big Sugar fields and factories: planting, harvesting, and packing sucrose to feed Florida’s $3 billion industry. Yet more than a third of the population lives in poverty. Around 60% of the inhabitants are Black, while Hispanic people make up a quarter of the population in Pahokee and almost a third in Belle Glade.
For the Feb. 13 vaccination event, a slow stream of cars arrived all morning and early afternoon at the Pahokee High School football stadium, down a quiet road flanked by dark fields and mostly empty school parking lots. There were never more than six vehicles in the observation area where people waited for 15 minutes after they’d had their vaccine. Typically, at least five of the cars were filled with white occupants.
They came from Stuart and West Palm Beach and Miami, even from Port Charlotte on the Gulf coast, many arriving in Pahokee for the first time. Plenty of locals were vaccinated too, but they were outnumbered by the out-of-towners. They drove with hearts in their mouths, anxious at the possibility of finally getting Covid-19 protection after weeks of rising at 5:45 a.m. to unsuccessfully enter the online lottery for vaccines that had been outsourced to the Publix supermarket chain.
“I’m so grateful. I feel I’m going to have another chance to live,” said Nancy Gerace, a 73-year-old, white retired teacher from West Palm Beach with type 2 diabetes. She wiped away tears of relief and shakily thanked everyone in sight. “I’ve been so scared of this virus, I’ve seen so many people around me who’ve died,” she said. “I have too many other things I want to do before I die.”
Individually, each person who arrived was desperate for a life-protecting injection. Collectively, their demographics reflected a pattern that has played out within Florida and across the United States, where the Black and Hispanic populations disproportionately affected by Covid-19 have been left behind in the vaccine rollout. In Palm Beach County, while Black people make up 18% of residents and Hispanic people 21.7%, these communities had received just 4.1% and 4.7% of vaccines respectively, as of March 1.
“I’ve been so scared of this virus, I’ve seen so many people around me who’ve died. … I have too many other things I want to do before I die.”
Nancy Gerace, retired teacher
At first, the same communities overlooked by the sugarcane-burning ordinance were forgotten entirely in vaccine distribution. Gov. Ron DeSantis handed responsibility for vaccine appointments in the county to Publix supermarkets in January, though the nearest store is more than 25 miles from Pahokee and Belle Glade. He denied the decision was tied to the chain’s recent $100,000 donation to the DeSantis campaign.
After grassroots organizers and local politicians pushed back, the state’s Division of Emergency Management agreed to set aside vaccines for local distribution, creating the first of several Pahokee vaccination events on Feb. 3. But they were planned on short notice, with few resources to help spread the word, and no way to reserve appointments for those who live here.
Vaccine events intended for underserved communities became destinations for those accustomed to getting their way, people who know whom to call and how to advocate for themselves. Nearby elders could drive up for their shot, but so could anyone else. They simply had to head west on Route 98.
The vaccination drive was easy to miss if you didn’t know to look for it. There were no signs along the chain-link fence, nothing to flag that precious doses of Moderna vaccine were available inside. Some 250 shots were available to over-65-year-olds and health care workers on Feb. 13. By the end of the day, only around half had been used.
This was the fourth vaccine drive held in the area, each one a scramble to organize. For the first event, Palm Beach County Commissioner Melissa McKinlay and Tammy Jackson-Moore, co-founder of the Guardians of the Glades nonprofit, learned the details only the evening before. They stayed up until midnight, calling around to turn local people out, and managed to rally a crowd for both that event and one later that week. A few days later, Jackson-Moore found out via Twitter that more shots would be distributed on Feb. 12 and 13.
A registration system would have helped to prioritize Glades area residents, said McKinlay. “It’s frustrating. But it’s the state’s decision not to allow us to do an appointment system at this location. It was their decision to make this first come, first serve,” she said.
Without a registry of potential recipients to call, news largely spread by word of mouth. Several people who showed up had learned of the event from a personal connection — a relative working in health care, or an old colleague working at the high school.
Two snowbirds from Quebec, Levis Bouffard and Mario Bureau, heard about the vaccine drive from a friend, who warned them not to tell anyone else for fear of vaccines running out. They drove the hour to Pahokee from their homes in Boynton Beach, and wanted to know if they’d soon be able to buy a vaccine for their wives, who are under 65.
Others heard from politicians. John Brown, 73, who lives in Stuart, a wealthy seaside town, called his state senator, Gayle Harrell, to ask about vaccine access a few weeks ago, and received a call from her secretary the day before they drove the Pahokee — “And we’re not even Republican!” said his wife, Jeanne Brown. He was shocked at the predominantly white demographics of vaccine recipients. “I would like to see 98% Black and brown people here,” said John Brown. “Those should be the first people in line.”
Stuart’s state senator sent her constituents to Pahokee at the request of the local county commissioner, she said. But McKinlay said she sent event details to Harrell because she also represents Pahokee. “At no point did I say, ‘Send Stuart residents to Pahokee,’” said McKinlay. “If she chose to share it with Stuart constituents, that’s her prerogative of course.”
Several of those who arrived for their vaccine started to spread the word themselves. “I don’t think there was much promotion,” said Michael Assam, from Pahokee, texting his friends to hurry down.
There were more locals at the vaccine drive on Feb. 12, said Jackson-Moore, when city buses drove people to the site. “We had to let them [the Florida Division of Emergency Management] know, one of the issues is lack of transportation, so you need to have a walk-up option,” said McKinlay. “You can’t just be doing drive-throughs.” But there were no buses available on Saturday.
One Pahokee resident, 70-year-old Shellie Myers, got a ride with her friend. She hasn’t seen her sister in months for fear of contagion, she said. Her driver, Ernest Fields, 70, said he would have liked to get the vaccine earlier, but couldn’t figure out the Publix online booking system. “I would have taken it as soon as I could have,” he said. “But I’m computer illiterate. A lot of people don’t have a computer and don’t have someone who can do that for them.”
On top of a haphazard rollout, local organizers said they have had to contend with a lack of information from state officials. “I’d like to know how many are getting the vaccine from our community,” said Jackson-Moore. She’s put in a request to the Division of Emergency Management, but hasn’t heard back. “If you knew how many in the Glades had been vaccinated, we would know what our job looks like moving forward,” said McKinlay. “It’s very hard to determine anything right now, because nobody is telling us the data that we need.”
The Florida health department did not respond to questions about how many vaccines were dispensed at the drive, or the demographics of those who received shots. “[W]hen a vaccination site initially opens up in an underserved community, the state makes every effort to ensure those individuals living in that area have priority access to the site and to the vaccine. That is why the site was not widely advertised statewide before opening,” said a spokesperson. The Division of Emergency Management did not respond to requests for comment about the rollout.
At the beginning of the pandemic, there was a notion that the coronavirus was a great equalizer. The rich couldn’t call in their private staff or escape to exotic locations; their savings couldn’t protect them from fear or death. That refrain quickly became farcical. Wealth padded pandemics with private gardens, high-quality health care, Zoom-enabled home offices, and copious food deliveries.
Two days after the vaccination event, both Shellie Myers and John Brown had doctors’ appointments. Myers, a Black woman who is two years into recovery from a car accident, saw a physician to check on her gradual progress, while Brown, who is white, got a cutting-edge injection to treat asthma, arranged through his concierge doctor. Afterward, both returned home, where they have been sheltering for months.
Myers lives in a one-bedroom apartment on the ground floor of a beige apartment block in Pahokee. The street was quiet, with little activity. A bulldozer down the block graded an empty plot of land, and some neighbors sat on chairs by the road, waiting for the day to pass. Myers stayed indoors. “I won’t go nowhere, I’m scared,” she said.
Bulk produce was neatly stacked around her home, to help reduce her trips to the grocery store. Dozens of bottles of peppers were piled up next to the doorway, and a huge freezer sat in the corner next to the TV. Her home had the feel of a dark, protective bunker.
Myers heard about the vaccine drive from her sister. The notion of calling her state senator — as Brown did — never occurred to her, she said, pursing her lips and shaking her head. “I see them all on the news.”
At 70, Myers knows she’s vulnerable to Covid-19: “I’m up there in that age.” Her cousins, uncles, nieces, and nephews live nearby and, pre-Covid, they all gathered regularly. Now she can’t remember the last time she saw them. Her sister lives down the street, less than a five-minute walk away, but they haven’t met for three months. Myers swings her feet as she sits on the sofa, looking upwards. Weighing less than 100 pounds, she has all the skinny earnestness of a young girl.
She’s lived in this apartment for 13 years and in Pahokee her whole life. The daughter of a tractor driver, Myers worked packing corn and sugar on nearby farms. She survived the AIDS epidemic, which ravaged the local community in the 1980s, killing two of Myers’ cousins and several friends. And yet the fear, for Myers, wasn’t as bad as today. “I think this virus is worse than AIDS,” she said.
As she spoke, the battery alarm on her smoke detector beeped every 30 seconds. Over the months, it has become imperceptible background noise. “It do that all the time, it don’t bother me,” she said. She didn’t need help fixing it, she added; someone would come and look at it soon. Myers is content to wait out the pandemic with the same unquestioning patience. Only once she’s had her second dose of the vaccine will she see her sister again.
The drive from Myers’ home in Pahokee to John and Jeanne Brown’s home in Stuart takes less than an hour, yet the colors seem to grow more vivid along the way, the sun-bleached grass of Pahokee giving way to rich, dark green foliage.
The Browns live in a gated community of neat, detached houses and decorative fountains. Private roads leading to their house wind through an 18-hole golf course with “The Champions Club” emblazoned on the entrance gates.
Their garage, roughly the size of Myers’ living room, is filled with the kayaks and bikes that have kept John active through months of lockdown. Inside, two poodles prance around the living room.
Like Myers, the couple have spent much of their time at home during the pandemic. They haven’t been to any restaurants, or seen their daughter who lives in Hawaii. “Our real response has been to hunker down, separate ourselves,” said Brown. “It’s our human responsibility not to make another person sick.” He’s been drinking more, he said, and has found lockdown emotionally debilitating.
Were it not for Covid-19, they’d have gone traveling through New Zealand and Australia last year. Instead, they donated the money they would have spent traveling — around $12,000 — to a local food bank, House of Hope. The couple are worth millions, and can easily afford the donations as their savings have grown more this past year than ever before. “I’ve suffered emotionally and psychologically but not financially,” said Brown.
Pahokee’s drive wasn’t the first time the couple were offered a vaccine. John has severe asthma, and reached out to politicians and health departments to ask about his shot. “A lot of people don’t avail themselves to their local politicians, even though that’s their job to do,” he said. “At least try it, at least make a phone call.”
A few weeks ago, after calling around to health departments, he was told about a vaccine clinic in Indiantown, a poor area of the same county. But he decided not to go.
“We said that’s not kosher, that’s not fair. Other people need it more,” said Brown. “These people, these minorities, should get it before we get it. We can afford the best of all medical care and they can’t.”
He made a different decision for the Pahokee event, said Brown, because his state senator’s secretary said few people were showing up and the vaccines were at risk of going to waste. Though he’s relieved to get the vaccine, Brown was upset to see how few people were there, and how many had come from far away. “I felt so bad that they weren’t there in force,” he said.
Brown is aware his fortune is unattainable for others. He made his money through blue-collar work, fixing washing machines and refrigerators for Sears before setting up his own repair company in his 50s.
“Do you know how many other people worked their butts off and were never able to save the kind of money I could save?” he said. “The couple down the street with three kids, her husband works in a minimum-wage job, she was a waitress. She’s out of work, and how terrible their lives are now. And it makes me feel guilty.”
Many of the vaccine priority guidelines are ambiguous and open to interpretation. Even within the first stage of rollout, there were different definitions of “health care worker” in various states and regions.
This setup rewards those who self-advocate the loudest. People who are confident they qualify to get the vaccine, and push for it, are more likely to be inoculated. The racial disparity in vaccine access partly reflects this gap in expectations. At the Pahokee drive, unvaccinated Black health care workers waited to be offered a shot, while others argued with site administrators to claim what was theirs.
By 2 p.m., around 120 vaccines had been given out, said Ed Ingrao from CDR Maguire, the company managing consent and registration for the event. The rest of the afternoon was especially slow. No more than a dozen cars arrived during the last two hours, and the parking lot was often empty.
Three lay community health workers who had been there since 10 a.m. approached each person after they were vaccinated, to give them hand sanitizer, two masks, and information on social distancing and hand-washing. They made sure their own masks were fitted properly; all three live nearby and have been repeatedly exposed to Covid-19 for months.
“We’re on the frontlines,” said one of the workers, Sharon Clark. They would take the vaccine if they could get it, but said they hadn’t been offered the chance. Another worker, who wanted to be identified only as Lavette, paused when asked whether they should be eligible as health care workers. Her eyes flickered briefly with hurt and betrayal as she considered the notion that vaccines weren’t simply unavailable, but had been arbitrarily denied. Then she blinked the emotion away and shrugged. She was too tired to be angry.
“I would love them to be deemed as health care workers,” said Jaime-Lee Bradshaw, chief strategic initiatives officer at Community Partners of South Florida, a nonprofit that employs the health workers. The organization received federal emergency funding to combat the coronavirus, such as by performing contact tracing — including going to people’s houses — and working at food banks and vaccination drives.
Bradshaw lamented the tremendous inequity in the vaccination rollout, and how it’s exacerbated by a divide in self-advocacy. “With privilege comes the ability to question your elected official because you’ve put them in office and they should respond to you,” she said. “There’s a lot of history, there’s a lot of trauma. That is the reason why a segment of our population does not believe that they have the same privilege and access.”
A Florida health department spokesperson later told STAT that community health care workers who have direct contact with patients are eligible to receive the vaccine.
The Moderna vaccines handed out at the Pahokee event come in 10- or 11-dose vials. Once a vial is opened, all the doses have to be used in six hours. Jackson-Moore received her vaccine earlier in February, after nurses told her there was one dose to spare that risked going to waste. “I didn’t want it to spoil and I wanted to be an example,” she said.
“There’s a lot of history, there’s a lot of trauma. That is the reason why a segment of our population does not believe that they have the same privilege and access.”
Jaime-Lee Bradshaw, Community Partners of South Florida
At 3 p.m., an hour before closing, the health department official overseeing the event told the community health care workers to leave, meaning they wouldn’t be nearby if there were spare doses that needed to be used. She never asked if they were vaccinated.
The last car to arrive pulled in moments before the gates closed at 4 p.m. The driver, who looked decades younger than all the other vaccine recipients that day, quickly received his shot. But the nurses wouldn’t vaccinate his passenger. Eventually, after protesting the refusal to the health department official, the passenger got out of the car, rolled up her sleeve, and received her injection.
When they drove to the observation area, both were giddy. Shane Hodson and Andrea Prieto, both 32, had driven from Miami, where he is an orthodontist and she works as an orthodontist’s assistant. “Oh, my God, it feels awesome,” said Hodson, laughing with relief. They’d had two scares recently, when patients had tested positive for Covid. As health care workers, they’d been trying to get an appointment since December.
Hodson heard about the Pahokee drive-thru from his mom at noon. They skipped lunch and, as soon as their shifts ended, raced up to Pahokee. In Florida, orthodontist’s assistants aren’t formally licensed. But the nurses were reluctant to vaccinate Prieto — who came to the U.S. three years ago as an asylum seeker from Venezuela, where she worked as a dentist — because she couldn’t show a health care license, they explained. Eventually, the health official accepted her pay slips as evidence.
Like so many others, Hodson and Prieto have faced risks from their health care work throughout the pandemic. Unlike Lavette and her colleagues, they were adamant they deserved this protection. “It took a bit of begging,” said Hodson. “But we weren’t going to leave until we got it.”
Bethany Mollenkof, a visiting Nieman Fellow for STAT, contributed reporting.