The FDA approved the first COVID-19 vaccine in December 2020, yet as of August 16, 2021, only half of the United States is fully vaccinated. Children under 12 and others who are not eligible to receive the vaccine account for part of this gap, but vaccine access and hesitancy also play a major role. Hesitancy, access to vaccines and access to credible information about the vaccine especially affect medically underserved and vulnerable populations in the United States.
The Clinical and Translational Science Awards (CTSA) Program is vaccinating underserved and vulnerable communities across the United States and addressing vaccine hesitancy so that hospitalizations and deaths from COVID-19 decrease.
Studying vaccine hesitancy
Vaccine hesitancy “refers to delay in acceptance or refusal of vaccines despite availability of vaccine services,” according to the World Health Organization. It is caused by a variety of complex factors and is influenced by issues such as complacency, convenience and confidence. Vaccine hesitancy is higher in populations experiencing health disparities, according to the NIH.
Because the reasons behind choosing not to get vaccinated vary from person to person and community to community, studying vaccine hesitancy locally can help institutions better address it.
The University of California Los Angeles Clinical and Translational Science Institute (UCLA CTSI) conducted focus groups on vaccine hesitancy November 2020 – January 2021 in Los Angeles with participants who self-identified as American Indian, African American, Filipino, Latino or Pacific Islander.
Researchers published the results of these focus groups in the policy brief COVID-19 Vaccine Hesitancy and Acceptability in Multiethnic Communities: Implications for Public Health Policy, Messaging, and Community Outreach. The brief provides recommendations and insights around public health vaccine policy, messaging and outreach. Recommendations include acknowledging both medical mistrust and the “complicity of the medical profession in systemic racism.” It also discusses reducing barriers for access to credible information and vaccines.
The focus groups were part of the Share, Trust, Organize, Partner: The COVID-19 California Alliance (STOP COVID-19 CA), which is a coalition of 11 academic institutions, including all California CTSA Program hubs. STOP COVID-19 CA addresses “gaps in COVID-19 (mis)information, vaccine trial participation, and vaccination accessibility” and is funded through the National Institutes of Health (NIH) Community Engagement Alliance (CEAL).
Other CTSA Program hubs, including the University of Miami and University of Alabama Birmingham (UAB), also have CEAL-funded projects that are studying vaccine hesitancy in underserved populations. Miami’s CTSI also led focus groups to understand vaccine hesitancy in Black, Latino and elderly participants.
Distributing information in multiple languages
Part of addressing vaccine hesitancy and access is making sure accurate information is readily available to everyone.
The University at Buffalo CTSI and its community partners created downloadable infographics in 15 languages that detail how vaccines are made.
“Reaching community members who speak languages other than English with clear, understandable and reliable information will be enormously valuable in addressing vaccine hesitancy,” said University at Buffalo CTSI Director Dr. Timothy F. Murphy in a University at Buffalo article.
Similarly, the University of Kansas Medical Center used an NIH Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) grant to create the multimedia campaign “Community Health workers Beat the Virus” in seven languages. These videos feature community health workers encouraging testing and vaccination in underserved populations.
“As a community health worker, we can relate to our community and have their trust,” said Guadalupe Tredway, one of the featured workers, in a Kansas University Medical Center news article. “They know we can provide sites and resources where they can find reliable information in their own language so that they can make a decision based on knowledge.”
Improving access to vaccines for underserved and vulnerable populations
At the Integrated Translational Health Research Institute of Virginia (iTHRIV), Outreach Program Assistant Tina Nunez worked with the University of Virginia’s Latino Health Initiative and the Blue Ridge Health District to vaccinate Latinos in Central Virginia. When the vaccine was approved, Nunez helped schedule appointments for local community members. The team also distributed flyers, videos and engaged in direct discussions to promote vaccination and assuage concerns about vaccine safety and fears of deportation.
“It’s all about building trust and making it easy for the community to get their shot,” Nunez said in an iTHRIV article.
To ease the burden of access to vaccines, the team brought pop-up vaccine sites to neighborhoods. By July, 2,300 Latino residents had been fully vaccinated, thanks to the combined effort of Nunez, the Latino Health Initiative and the Blue Ridge Health District.
In California, the UC Davis MIND Institute is also helping to vaccinate vulnerable populations through a new clinic for people with neurodevelopmental disabilities and their families.
Because COVID-19 vaccination clinics can be large and noisy, people who experience sensory overload or anxiety can get overwhelmed. The MIND Institute provides a controlled sensory-friendly environment. Only three families per hour receive their vaccines, which allows for customized care for each patient, quiet rooms and an uncrowded waiting area. Prior to a family’s arrival, child life specialists ask questions about a child’s needs and interests and develop an individualized coping plan.
Dr. Kathleen Angkustsiri, a former KL2 Scholar and co-director of the UC Davis Clinical and Translational Science Center’s (CTSC) Integrating Special Populations Into Research (INSPIRE) Program is one of the doctors participating in this effort. The clinic is being funded in part through a grant from the CDC to the MIND Institute’s Center for Excellence in Developmental Disabilities, led by Dr. Aubyn Stahmer and Dr. Scott Akins.
Additional information about how CTSA Program hubs helped vaccinate communities across the United States:
- Columbia Vaccinates Hundreds at Community Pop-Up Vaccination Site in Harlem
- Investigator uses ICTS resources for COVID-19 research and clinical trial efforts
- One College’s Mission: Vaccinate 120,000 People
- Community members in Richmond’s East End share why they got vaccinated
- How Black church leaders and USC are overcoming vaccine hesitancy in Watts