The COVID-19 pandemic disproportionately impacted people of color, with Indigenous, Black & Pacific Islander Americans experiencing the highest death tolls from the virus.
Pacific Islander, Latino, Indigenous and Black Americans all have a COVID-19 death rate of double or more that of White and Asian Americans, who experience the lowest age-adjusted rates.
Underlying conditions, or social determinants of health, that predate the pandemic are contributing factors to racial and ethnic minority groups being disproportionately affected by COVID-19.
Social determinants of health increase risk of exposure to Covid-19, illness, hospitalization, long term health consequences and death. Barriers to physical and mental healthcare, testing, treatments and information compounded the effects of the pandemic for diverse communities.
And now, Covid vaccination rates are lagging for communities of color.
In May 2021, President Joe Biden set a goal for 70% of Americans over 18 to have had at least one Covid vaccine dose by July 4th. Pennsylvania is working toward that goal, but there is much work to be done to reach all eligible residents, particularly communities of color.
The Covid-19 pandemic has brought already existing inequities into sharp focus. OAK Street Initiative believes all communities should have health equity, or the highest possible standard of health for all people. That means providing additional resources and special attention to areas of greatest risk of poor health based on social determinants of health.
There are many barriers to reaching health equity particularly in under resourced communities, but in the particular case of Covid-19 vaccine distribution, these barriers must be overcome.
For the United States to reach the President’s 70% vaccination goal, every shot counts.
Questions remain amount how to overcome vaccine hesitancy as well as vaccine access, but a combination of the following approaches will go a long way to helping our nation reach herd immunity as quickly as possible. Not every idea is the right approach for area, but grassroots efforts will be the key in overcoming vaccine barriers in local communities across the nation.
Grassroots outreach efforts
Utilize Trusted Voices
Using trusted voices in local communities to serve as vaccine ambassadors will help to increase confidence in vaccinations and overcome vaccine hesitancy. Trusted voices can include faith leaders and community groups.
The voices of doctors and nurses are also critical in helping overcome vaccine hesitancy and more emphasis should be placed on the important role individual healthcare providers can play in helping their patients to understand the importance of vaccination. Pediatricians will be critical voices in getting adolescents vaccinated.
Utilize school buildings where students are already congregated and feel comfortable, as vaccination sites for both students and families. School nurses, teachers and other school personnel can be utilized as trusted voices to encourage adolescent vaccination now that the FDA has authorized the Pfizer-BioNTech vaccine for emergency use in adolescents.
Increase Access/Decrease Barriers
Allow for more time options to receive vaccines, including weekend and nighttime hours at vaccine sites.
Increase the use of vaccines in emergency departments so that those who tend to seek care only on an emergency basis would still have access to a vaccine. Johnson & Johnson’s single shot vaccine would be the most logical in this scenario as it would not require and additional follow up appointment by the patient or provider.
Utilize small scale, nimble, mobile vaccine teams rather than just mass vaccine sites to better reach those who live in low-income housing, mobile-home communities, those who are homebound and those who are homeless.
Have more walk-in vaccine sites, including in additional pharmacies, drugstores within superstores and supermarkets, to reduce the barrier of making and sticking to an appointment.
Think Outside the Box
A shot in the arm isn’t necessarily fun, but sports leagues offering exciting promotions to fans who get their shots is one way to increase vaccination rates. Alternatively, grocery stores and pharmacies can offer discounts or other incentives to shoppers who also get shots in arms.
States or other jurisdictions can partner with for-profit entities to increase vaccination rates, for example New Jersey’s “Shot and a Beer” program, a partnership between the Governor's Office, the Department of Health and the Brewer's Guild of New Jersey. Participating breweries provide a free beer to eligible New Jersey residents ages 21 and over who get vaccinated in May and show their vaccination card at the brewery.
No single approach will change all attitudes and behaviors. No single strategy will remove all healthcare barriers and lead to full health equity. But a grassroots approach using culturally competent interventions will lead to better health outcomes and increased vaccination rates.
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