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Multiple Interventions Being Investigated Or Proposed To Achieve
Equity In COVID-19 Vaccination
According to the
Centers for Disease Control and Prevention (CDC), monitoring community
level characteristics of COVID-19 vaccinations is going to be
essential in tailoring specific interventions which can reduce
inequities. Among possible causes for the inequities cited by CDC are
access problems such as vaccine supply, vaccination clinic
availability, and lack of prioritization. Other challenges relate to
vaccine hesitancy among different subpopulations for a variety of
reasons which are not well understood.
Guide
In a new guide
prepared by CDC entitled “COVID-19 Vaccine Confidence Rapid Community
Assessment Guide” CDC proposes three strategies for building vaccine
confidence:
• Building trust
through credible, clear communications.
• Empowering
healthcare personnel to be confident in their own decision to be
vaccinated and to successfully recommend the vaccine to their patients
• Engaging communities
and individuals in a sustainable, equitable, and inclusive way, using
two-way communication to reinforce trust in health authorities and
build confidence in COVID-19 vaccines.
Interventions
Among the
interventions CDC described in states with high equity vaccination
results are the following:
1) prioritizing
persons in racial/ethnic minority groups early on,
2) actively monitoring
and addressing barriers to vaccination in vulnerable communities,
3) directing vaccines
to vulnerable communities,
4) offering free
transportation to vaccination sites, and
5) collaborating with
community partners, tribal health organizations and the Indian Health
Service.
According to CDC, “more investigation is needed to
understand these differences to identify best practices to achieve
COVID-19 vaccination equity.”
Hopkins Project
One investigation currently underway at the Johns
Hopkins University sponsored by the Robert Wood Johnson Foundation is
entitled “Understanding Diverse Communities and Supporting Equitable
and Informed COVID-19 Vaccination Decision Making.” [Disclosure: The
Epi Monitor is a consultant to Hopkins].
The
framework for the Hopkins project identifies the usual factors
considered important to address in vaccination programs such as
filling information gaps people have around COVID-19 vaccines and
removing obvious barriers to vaccination such as lack of
transportation and language differences. Both of these can impact
decisions to get vaccinated or not, but the Hopkins framework also
highlights the need to interact with members of the public in genuine
two-way communication as recommended in the CDC guide. The Hopkins
project conducted neutrally facilitated “community conversations”
which acknowledged and respected the different values and experiences
individuals brought to the discussions and impacted their decision
making about COVID-19 vaccination.
Respect
As stated in 2013 by
Kathleen Hall Jamieson, Professor of Communication and Director
of the Annenberg Public Policy Center at the University of
Pennsylvania at a Science of Science Communication Colloquium at the
National Academy of Sciences, “You can’t persuade someone you don’t
respect.” (Epi Monitor, October 2013)
Public
Engagement
Other
experts are also making the case for the importance of genuine public
engagement with members of the public on vaccine related topics. A
recent op-ed in the New York Times by Heidi Larson, an expert
on vaccine confidence, states that “In our scientific rush to develop,
manufacture, and deliver vaccines more rapidly than ever in history,
countries around the world have failed to engage the public.” Also,
“Few countries have coherent national strategies, but they are
necessary. These strategies need to involve the public, not only as
vaccine recipients, but as actors in the process.
COVID
vaccines cannot be seen as something taken because the government says
so, but because they have meaning in people's lives.”
White
House View
Local or
community dialogues have been identified as important to carry out by
Andy Slavitt,
White House Senior Advisor for the COVID Response Team. He
noted in a recent CNN interview that as the US vaccine supply
increases and demand for vaccination possibly fails to keep up, local
dialogues will be needed to interact directly with people. Slavitt
also pointed out that some members of the public, especially
conservatives, don’t want an authority to try to convince them to take
the vaccine. They don’t want to feel like they’re being manipulated
but rather feel like they’re getting straight answers from trustworthy
sources, said Slavitt. These observations highlight the importance of
neutral facilitation and respectful dialogue in genuine public
engagement processes.
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