Regional Health Collaboratives Targeting Vaccine Hesitancy Among Key Communities

June 14, 2021
The Network for Regional Healthcare Improvement recently convened state and regional leaders to share practical insight about addressing barriers to vaccination and enhancing trust at the community level

According to the Centers for Disease Control (CDC), more than 170 million Americans have received one vaccine, representing over 52 percent of the total population. More than 143 million are fully vaccinated, representing over 43 percent of the population. 

While these numbers are cause for celebration, there are growing concerns that vaccinations are declining. The average daily count for vaccinations is now below one million, down from a high of 3.4 million daily shots in April. Health experts worry that vaccine hesitancy is a major reason for the downturn. 

COVID-19 rates are dropping in the U.S., however, concerns remain about the potential for vaccine hesitancy to slow our progress. Health experts have warned that we must vaccinate between 70-85 percent of the U.S. population in order to reach herd immunity, a target that remains elusive. 

“Vaccine hesitancy is emerging as a key barrier to ending the COVID-19 pandemic,” noted Wendy King, associate professor of epidemiology at the University of Pittsburgh Graduate School of Public Health, and lead author of a study on vaccine hesitancy. “Identifying occupations with a high rate of COVID-19 vaccine hesitancy and understanding the reasons for hesitancy can help public health practitioners and the health care community target interventions and address concerns to hopefully increase vaccination rates. Our study indicates that messaging about COVID-19 vaccine safety and addressing trust are paramount."

Some states are resorting to creative strategies to encourage vaccinations. Ohio is offering $1 million each to five people through a state lottery of those who have received at least one vaccine dose. New Jersey residents who are 21 and older are eligible for a free beer after their first vaccine shot. Maine just announced that residents who get a vaccine before the end of the month will qualify to receive L.L. Bean gift cards and other perks.

In a push to address vaccine hesitancy, the Biden Administration just announced a national campaign featuring celebrities and athletes promoting vaccinations through social media and public service announcements.

A growing cadre of nonprofit health organizations are joining in partnership with the Administration to ensure wide and equitable COVID-19 vaccine uptake, especially in places where vaccine hesitancy is a growing concern.  

The Network for Regional Healthcare Improvement (NRHI), a national organization of Regional Health Improvement Collaboratives (RHICs) and affiliate partners, recently convened state and regional leaders to share practical insight about addressing barriers to vaccination and enhancing trust at the community  level to support equitable solutions to overcome hesitancy and to help with readiness.

Some of the common themes and lessons that emerged among participants include:

·      Data. We must use data to identify highest risk populations and inform allocation of the still limited supply of vaccines. To do this most effectively we need to improve data capture by race, ethnicity, and language. The Duke-Margolis Center for Health Policy reported that some states are making progress by encouraging, incenting, and even requiring providers to capture this data during each patient encounter.

·       Partnerships. For maximum success, we must leverage existing partnerships and continue to build new, trusted partnerships with and across communities.

·       Community Engagement and education. We must engage at the community level with residents to better understand what they know about the vaccine, where they are getting information from, and who their trusted sources are.

·       Leveraging lessons learned from COVID testing. We must apply the knowledge gained and the partnerships developed early in the pandemic to support COVID-19 testing and expand that knowledge beyond testing to vaccinations and distribution of health, safety, and education, and food distribution kits with a focus on minority and low-income populations.  

One example of promising practices can be found among Ohio’s Somali American community. Kawther Musa, an HIV program coordinator and community health worker with the Heart of Ohio Family Health Center said that initially, many among the Somali community thought that COVID-19 would not affect Muslims. Governmental public health messaging targeting this community had been limited, leaving the population vulnerable to misconceptions about COVID-19 and limited responsiveness to recommended prevention measures among segments of society: “The community didn’t believe the risks of this pandemic disease.” When family members began to get sick, the stigma was such that they didn’t seek treatment out of fear of how their neighbors would react. Misinformation was rampant. “Many thought it was just a cough. They thought if they ate fruit, they would be okay. They didn’t believe facemasks would provide protection,” noted Musa. The Heart of Ohio FQHC created a Somali COVID-19 taskforce made up of doctors, health professionals, and religious leaders with a goal of better understanding barriers to vaccinations among vulnerable populations. “The Imans played an important role. COVID was spread easily if people came together to pray and eat. The Iman had to tell people to stay away from the Mosque and not to pray together to control community spread.”

In Rochester, New York, Common Ground Health utilized barbershops and beauty salons to target at-risk populations. Owners and operators of barbershops and beauty salons were trained and empowered as community health educators, becoming subject matter experts and a trusted resource in the community about COVID-19, vaccines and testing. Common Ground Health recruited these COVID ambassadors with stipends and the resources they needed to reach the community with vital health messages. Through table talks and empathy interviews, they were able to better understand vaccine hesitancy among key constituencies and combat misinformation with science, research and facts.

Wayne State University in Detroit, Michigan is piloting a program with Wayne Health to bring COVID-19 testing and vaccinations to harder-to-reach populations via mobile units. Known as the Goa, they have been able to reach more than 200 community locations with vital information, COVID-19 vaccinations, flu shots, blood pressure and other health screenings.

By finding creative ways to meet people where they live, work, play and worship, and getting the facts out about COVID-19 and the protection vaccines offer, regional health collaboratives are playing an essential role in helping communities navigate their way toward achieving higher rates of vaccinations. Through this work, they are supporting not only healthier communities but ultimately, a post-pandemic America that can get back to our daily lives.

Jolie Ritzo is director of partnerships and programs for the Network for Regional Healthcare Improvement (NRHI). Tanikka Price is the education director for the Healthcare Collaborative of Greater Columbus (HCGC). NRHI is a membership organization representing HCGC and other regional health collaboratives nationwide.

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