President Biden has set a nationwide goal to vaccinate 70% of our adult population with at least one COVID-19 (Covid) shot by July-just over one month away. About 10 states have met this goal at the current time. Many other states are lagging behind and the majority of under-vaccinated areas are within zip codes where poverty is prevalent, and/or many residents are immigrants, migrants or other minority populations. The federal Covid Max Vaccination Centers have been very successful in increasing vaccination rates which has in turn produced a significant corresponding drop in Covid infections. But many residents who have not yet been vaccinated face a myriad of barriers to doing so. The most common barriers cited by residents of neighborhoods with a high level of poverty, and/or neighborhoods made up of ethnic minorities, immigrants, migrants and some indigenous populations, include the following as reasons preventing them from getting vaccinated:
1. a lack of Identification/proof of residency/documentation and a concern that those without legal status will be reported to federal authorities for deportation proceedings;
2. a lack of transportation or childcare to be able to get to vaccination sites;
3. language barriers preventing them from understanding the vaccination process;
4. misinformation producing mistrust of the government/fear of government services and concern over the safety of the vaccines;
5. jobs or multiple jobs with no paid time off to get vaccinated and an inability to afford to take time off.
In order to meet President Biden's stated goal that will enable our country to get closer to being able to fully open up again, new strategies and innovative ideas that are currently being used need to be emphasized and funded by the federal dollars issued to, and allotted for, states and communities as part of the Covid vaccination program. The money that FEMA has been allotting to mass vaccination sites that are now closing, can be shifted to local community, targeted mobile vaccination programs. It is time to fund many more mobile vaccination vehicles and staff so they can go meet people who have been unable or hesitant to get vaccinated, where they are. These mobile units need to be organized and assembled into a large-scale national effort to "Roll for the Goal."
People who live in these disproportionately under-vaccinated neighborhoods often have bonds with and trust their local leaders such as neighborhood doctors and nurses, local health department workers, social organization leaders, faith-based leaders, and other local community trusted stakeholders. FEMA should fund and collaborate with these groups in zip code areas identified by the CDC and other health data as being the most under-vaccinated, to produce targeted Covid vaccination messaging campaigns in culturally and linguistically appropriate personalized formats. FEMA and HHS staff need to partner in this targeted educational health messaging campaign. HHS already has a "We Can Do This" Covid education campaign and the CDC additionally has many tool kits available to help local communities do community outreach with pre-written key messages, answers to frequently asked questions, posters, flyers, social media and newsletter content samples, and more. A unified nationwide effort now needs to be organized to make sure all the least vaccinated areas of the nation have this information disseminated and distributed to them in their neighborhoods by local trusted stakeholders who volunteer, or locals who get paid through FEMA or HHS funds to go to homes, restaurants, and other business and community-based organizations. This funding needs to include money to hire local employees who are bilingual and bi-cultural to ensure the educational Covid messaging is delivered in an efficient, effective, and organized manner. Also, such targeted health messaging should emphasize that immigration status is not being reported to any government authority and that information on their status is protected under the HIPPA act, along with relaying that healthcare providers are not legally required to report immigration status.
Many churches and transportation companies have buses that can be converted into mobile vaccination centers, along with other mobile units funded by FEMA to go to small neighborhood businesses, fields where agricultural workers are located, day labor daily check-in sites, church parking lots, food pantries, homeless shelters, homeless encampments, Salvation Army locations, social service organizations, and other community-based organizations in order to customize delivery of the vaccines on a neighborhood by neighborhood grass roots basis. Many such efforts are now being done on an ad hoc basis by communities across the nation. What is needed is for the same large-scale, fully-funded, comprehensive national effort that the federal government organized through FEMA and HHS to put into Max Vaccination Centers, to now be redirected to the least vaccinated neighborhoods. This national initiative of "Takin' it to the Streets and Beyond Vaccine Transition" should be a collaborative effort between FEMA, HHS, and local governments and community-based businesses and organizations, including all the appropriate cultural organizations in each targeted under-vaccinated neighborhood. The use of trusted local messengers and trusted local healthcare vaccinators going door-to-door, workplace location to workplace location, community gathering spot by community gathering spot, neighborhood by neighborhood, will significantly increase the vaccination rate and allow our nation to reach a level of Covid immunity that will enable a safe reopening of America.