Building Confidence Around COVID-19 Vaccines and Expanding Health Equity for All

With our nation’s COVID-19 vaccine administration rollout underway, policy influencers and advocacy groups are focusing on communities of color that have been disproportionately impacted by the fluctuating pandemic.

Over the last year, COVID-19 has laid bare long-standing health disparities compounded by significant COVID-19 testing, treatment and vaccine distribution inequities. The narrative that members of historically underrepresented and underserved communities are hesitant to get vaccines minimizes the reality that for many who want to receive the vaccine, access issues are a real and growing barrier.

“The Biden-Harris Administration is committed 100% to a vaccine strategy that is fair and equitable,” said Dr. Marcella Nunez-Smith, Chair of the Administration’s COVID-19 Health Equity Task Force. At a Feb. 18 virtual workshop hosted by the Black Coalition Against COVID-19, Nunez-Smith shared some key critical success factors for vaccine equity, such as improving vaccine access to build public confidence and establishing partnerships with community-based organizations and faith-based organizations to ensure everyone has updated information about the vaccine and vaccination locations.

For hospitals and health care organizations that are working to promote vaccine equity in their communities, it’s a matter of connecting the dots – linking information with local partners to distribute accurate information and create easier ways for people to get a shot. More specifics about the vaccine itself and science-based information coming from trusted community partners can calm fears and encourage more people to roll up their sleeves.

“From the beginning we’ve come from a place of humility, it’s all about trust for us and relying on community members to guide us on how to proceed,” said Kinneil Coltman, senior vice president and chief community and social impact officer for Atrium Health, a 42-hospital integrated health system based in North Carolina.

Coltman cited Atrium’s “Community Immunity For All” collaborative, designed to ensure equity in access to vaccines while acknowledging the history of health injustice in communities of color. Atrium’s collaborative also works with partner organizations to support individuals in making informed decisions.

Some of the ways Atrium has helped eliminate barriers to receiving vaccines is through a geographic information map based on collected data to see which areas served have the greatest disparities in vaccinations. Atrium then reaches those communities through its roving vaccination model, which works with faith-based organizations to set up on-site vaccinations and provide patient transportation if needed. No appointments are necessary. “We have to be operationally savvy, nimble and fast,” Coltman added. “Our primary focus has been speed.”

Dr. Alisahah Cole, who leads innovation and policy in population health at CommonSpirit Health, described how their initiative leverages community partnerships with faith-based organizations and conducts home visits as a part of its vaccine equity strategy. CommonSpirit Health is a system of 137 hospitals and more than 1,000 care centers in 21 states.

“We know the patients who have barriers; we actually created an outreach stratification pool,” Dr. Cole said. “We’ve been doing home visits and focusing on our senior populations, also going to senior communities.” In California, CommonSpirit tackles language barriers by partnering with trusted community-based organizations to conduct webinars in Spanish.  

Both hospital leaders addressed what one speaker called “the excuse of vaccine hesitancy.” Coltman noted that research suggesting that African Americans are hesitant to take the vaccine is dated – December 2020. More recent research shows African Americans have an increased desire to take the vaccine and other speakers, including Ambrose Lane Jr., Chair of the Health Alliance Network of Washington, D.C., suggested that the data are more nuanced with generational differences noted around vaccine hesitancy in communities of color. Moreover, he stated older people are more willing to get the vaccine – going against previous assumptions. Others noted that if accurate vaccine information isn’t delivered in ways that can reach people of all ages, the hesitancy may continue.

Overcoming pitfalls of misinformation, simplifying vaccine access while emphasizing community partnerships, communication and collaborations are a few ways to mitigate the inequitable COVID-19 vaccine administration rollout, and potentially offer lessons to address broader inequities in health care.

The AHA has launched a new webpage dedicated to disseminating accessible information focused on addressing the equity issues in COVID-19 testing, treatment and vaccine administration efforts. The page hosts a wealth of tools and content that link back to resources developed by our strategic partners and other organizations to equip hospitals and health systems with culturally appropriate ways to engage patient populations and communities who are disproportionately impacted by the pandemic.

Joy Lewis is AHA’s senior vice president of health equity strategies. She also is the executive director of the AHA’s Institute for Diversity and Health Equity.