Mary’s Center nurses share stories from the vaccine rollout—and hopes for the future
As COVID-19 vaccination continues worldwide, Teresa Hundertmark and Eva Sweeney spoke with Hola Cultura about the most rewarding and challenging aspects of vaccinating the community over the past few months at Mary’s Center, a D.C.-based health clinic that caters to a large Latinx population. Hundertmark, who holds two university degrees including a Bachelor of Science in Nursing (BSN) from Georgetown University, is a nurse manager of telephone triage and employee health. Sweeney, who has a BSN from Johns Hopkins University and Master of Public Administration from American University, works as a nurse manager at Mary’s Center’s Silver Spring location.
Since nearly everything—including providing medicine—over the past year has required social distancing, the nurses spoke to us about how the staff at Mary’s Center has had to constantly pivot to ensure proper patient care, whether it be scheduling COVID tests and vaccination appointments, educating patients on COVID vaccine doses and side effects, or coordinating vaccine storage.
“We had to work under a different [type of] stress and help our patients deal with a different stress. As I reflect a year later, I’m really pleased and happy with how we were able to do that,” Sweeney says.
Eva Sweeney Teresa Hundertmark
Can you tell us a little bit about yourselves and your work? And how has it changed because of the pandemic?
Hundertmark: I have a dual role at Mary’s Center. In managing the telephone triage team, there have been a lot of changes during the pandemic. It used to be that someone could walk up to the clinic or site. Now that’s done on the phone; people call and want those refills and lab results. A lot of our visits are now virtual visits. So there’s a lot of follow up and the telephone triage team helps support that. [My responsibilities regarding] employee health really changed because of the pandemic. Now, we have to incorporate COVID into workplace injuries or workplace exposures [for Mary’s Center staff].
There has also been much more emphasis on education, answering questions, and guiding those who have symptoms or exposures. When are they cleared to come back to work? Do they need to be tested? Do their families need to be tested? It just totally upended the type of work I was doing. It also involved updating what we screen for at the door with our staff, and our PPE. PPE is “personal protection equipment.” Because of the pandemic, we had to make time to fit-test people for their special masks. Gowns and gloves also are required, so it was a huge change for me.
Sweeney: I managed one of the Mary’s Center clinical sites. We currently have five sites that provide care for Mary’s Center patients, with two in Maryland and three in D.C. Prior to the pandemic, we had moved into a newer location. This was a really great thing, because we’ve had a lot more space to serve our patients and grow, especially during the pandemic. My general responsibilities are management of the team at [the] Silver Spring [location] and how we care for our patients.
We see patients across the spectrum from pediatric newborns to adults. During the pandemic, we’ve had to pivot and change how we served our patients by thinking about where and how we can serve them. With the move that I mentioned before, we were lucky in that we had a whole bottom floor to use as our respiratory clinic, where we saw patients who had COVID symptoms. At the same time, we were able to still serve our patients for primary care upstairs. We also started offering COVID testing in conjunction with [Montgomery] County in our parking lot. Now we’ve had to pivot and provide COVID vaccine clinics. Things really changed, but we had the space, resources and support to make it work. We had to work under a different stress and help our patients deal with different stress. As I reflect a year later, I’m really pleased and happy with how we were able to do that.
What was it like for Mary’s Center to work on the vaccine rollout?
Sweeney: It is a complicated and confusing thing, because each vaccine has different requirements for storage and handling. We also had to do it really quickly. There were also a lot of different jurisdictions involved because we operate in D.C. and Maryland. There’s a lot of communication that goes on between the D.C. Department of Health and the Maryland Department of Health. Each state has different eligibility requirements for the vaccine. Having to figure out who is eligible for the vaccine and other logistics had to fall into place pretty quickly. We started in D.C. Two or three weeks later, we received access to vaccines through the Health Resources and Services Administration. The federal government created a program to give vaccines to community health centers, which was wonderful.
Coordinating is a big piece of what I do in order to make sure the vaccines are being stored appropriately, as well as understanding how to use each vaccine and how fast you have to use the vaccine once you pull it out of the fridge. We’ve all collaborated pretty well to create vaccine clinics at each of our sites that incorporate those guidelines. We want to ensure that we’re able to get as many vaccines into arms as we can and to not waste any doses. That’s another important piece. A really cool thing that Mary’s Center did was to create a standby list of staff’s family members who we could contact in case we had an extra dose at the end of the day. If we couldn’t find a patient, we were able to call someone off the list and get it to someone, which has really been a great thing.
.@MarysCenter has been a critical bridge to reach community members who need accessible COVID testing and vaccinations. While visiting, @RepRaskin and I heard about their direct outreach efforts to engage patients and get them vaccinated. pic.twitter.com/xgHByUzXnJ
— Douglas Emhoff (@SecondGentleman) March 30, 2021
Above: Top left photo of Sweeney vaccinating a community member, while First Gentleman Douglas Emhoff arrives for a visit to Mary’s Center earlier this year. All photos courtesy of Mary’s Center.
Can you tell us more about the extraordinary effort it is taking to vaccinate as much of the population as possible?
Sweeney: It’s been a pretty big lift. We had to scale up to not only provide routine primary care, but also care for COVID patients who were experiencing symptoms. When it came time for testing, we had to pivot again while simultaneously vaccinating our participants. It does require understanding of the different eligibility requirements for each city and each state’s jurisdiction and scheduling.
Another big lift has been figuring out the scheduling of the second dose and making sure patients understand that for full protection against the virus, two doses are required. It has required a lot of time, planning and education to ensure patients receive both doses and understand the side effects. Almost everyone in the clinic—from nurses, doctors and administrative employees—had to really step up and help. Everyone’s been really engaged in that process.
When it comes to the vaccine, in general, what has it been like for Spanish-speaking populations in the area?
Hundertmark: The COVID virus has disproportionately affected those who identify as part of the Latino and Hispanic community, as well as communities of color. We’re finding that the vaccination rates are also disproportionate. As of June 3, the Centers for Disease Control and Prevention reports that there is ethnicity data on only about 56 percent of the vaccinations. If you look at the federal data, only about 13 percent of those who’ve been vaccinated identify as Hispanic or Latino, but the population nationwide is 18 percent. That’s a disproportionate number that seems reflected at every jurisdiction, or at least most. In Montgomery County, where about 20 percent of the county is Hispanic or Latino and only 17 percent of those who have been vaccinated identify that way. DC looks better, but only about 50 percent of vaccine clinics have been reporting ethnicity data, or we only have data for about 50 percent. Of those reporting demographics, 10 percent of those fully vaccinated identify as Hispanic or Latino, and 11 percent of the city is Hispanic or Latino. Here at Mary’s Center, we serve a population that is about 70 percent Hispanic or Latino. Our vaccination rates show that of those who we’ve met, those who are vaccinated are about 69 percent Hispanic or Latino. We are continuing to reach out to everyone who is eligible.
Do you feel you have to convince Latinos to get vaccinated? Is it the same with other groups, or is access to information, insurance or trusting institutions a bigger issue in the Latino community, for example?
Hundertmark: Some of the vaccine hesitancy is sort of universal, regardless of your ethnic background. There are concerns about the fact that it’s a new vaccine. What are the side effects? What’s it made from? Those in the Black, Indigenous and people of color community—we want to take into account the historical abuse of distrust inflicted on the community. That’s a real fear or issue that people might have. Especially if English isn’t your first language, where do you get your information? Is it reliable? Do you have to register or pre-register on a website? Is that even offered in Spanish? Are vaccines offered at a time when you’re not at work? Can you take time off work to go get the vaccine? Is this putting your job in jeopardy? What if you have side effects? Can you take off the next couple of days from work? Does it cost money? Does my immigration status matter?’ All of these are obstacles that pertain especially to the Latino community.
If someone is undocumented, what can they do to get vaccinated?
Hundertmark: Your documentation status should not affect your ability to get a COVID vaccine. You shouldn’t be asked to present any type of proof of documentation status to receive your COVID vaccine. One of Mary’s Center missions is to serve everyone, regardless of the language you speak, ethnicity or immigration status. We take that to heart here at Mary’s Center.
Can health insurance influence if a person can receive the vaccination?
Sweeney: It should not influence whether you can get the vaccine. There is no out-of-pocket cost to the patient for getting the COVID vaccine. The CARES Act includes federal funding to cover the cost of vaccines for uninsured individuals. Documentation of citizenship or having insurance shouldn’t be a requirement. You shouldn’t have to provide a health insurance card or a document that shows you have health insurance. At Mary’s Center, we serve anyone regardless of their ability to pay or if a person has health insurance. Our team is trying to make sure all of our patients understand and are educated on their rights.
There are some misconceptions regarding how the vaccine works. What can you tell people who have concerns about the vaccines to ease their concerns?
Hundertmark: First and foremost, the vaccine works. I’m actually an example of it working. I had one dose of a vaccine. My whole household ended up with COVID and I did not. So it works. It does not change your DNA. Each of the different vaccines has been tested in clinical trials. In order to reach herd immunity—to protect as many people as possible—we need to vaccinate as many people as possible. You’re not only thinking about vaccinating yourself, you’re thinking about protecting children and those who can’t get the vaccine—your abuelos (grandparents) and your church (members). Possibly, you’re just protecting your community if you get the vaccine yourself. Do your research and know it works. It’s safe. We really need as many people as possible to be vaccinated.
What are you looking forward to once everything calms down with the pandemic and we can return to “normalcy?”
Sweeney: I started at Mary’s Center right before the pandemic. I’ve really never seen my staff without masks on, which is so funny to think about. I’m really excited to just be able to connect with my staff or co-workers and with the patients on a closer level. It’s been tough because when you’re interacting with someone, with a patient, you want to do things quickly to make sure you’re not exposed to each other for too long. There’s this barrier. I’m excited for that to go away. I’m really looking forward to that.
Hundertmark: Personally, just like everyone else, I want to see my parents again. I want to travel. These are all things that we have not been able to do this past year. Professionally, being able to engage with my team in person again would be great. Just to have those forms of teamwork and lunch breaks is what I am looking forward to. I look forward to seeing how we pivot again, because that’s what we’ve been doing—going with the flow.
—Story by Melissa Perez-Carrillo
—Interview by Mariángel Villalobos, Melissa Perez-Carrillo, Sarah Patsell and Vanessa Romero Gutierrez
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As a nurse, I am proud of the contribution these two nurses are making to care for an underserved population. Their responses to the questions were well spoken and thorough.