Perspectives

3 Tactics for Equitable Access to the COVID-19 Vaccine

Written by Missy Britan, Kristine Allen, and Brent Ardaugh

Person getting a COVID vaccination shot.

Abstract

While the Federal Government is committed to executing a comprehensive COVID-19 vaccination campaign, the distribution of vaccines falls individually on state and local government support. In our blog series on the vaccine rollout, Booz Allen’s Chief Medical Officer Kevin Vigilante and our health experts examine best practices and lessons learned from across the health landscape, including potential strategies and approaches that could help state and local governments improve vaccination rollouts.

Improve vaccine uptake with community-based approaches

Equitable access to COVID-19 vaccines is essential to the nation’s pandemic response. As of April 2021, the United States has administered 246 million COVID-19 vaccines. But for many eligible Americans, access to those vaccines has been challenging.

For example, reliance on web-based registration systems has disadvantaged communities with less access to technology. Work obligations and limited childcare options have reduced their ability to chase vaccination appointments online. Consequently, certain populations have been more likely than others to get vaccinated. Equitable access to vaccination means meeting people where they are.

The most effective weapon in ending the coronavirus pandemic is vaccinating a sufficient volume of the population. Doing so will help stop the spread and limit the emergence of additional variants. As state and local health officials focus on their vaccine rollouts, here are three ways they can improve equitable vaccine access and uptake.

3 Strategies to Improve Vaccine Equity

1. Quantify Gaps by Subgroup

Measuring and tracking not only how many people are vaccinated but also who is a key to understanding where different outreach approaches are required. Race and ethnicity data are available for only about 60% of the people fully vaccinated, with the white non-Hispanic group representing roughly 70% of vaccinations, according to the Centers for Disease Control and Prevention.

All states should collect and analyze race and ethnicity data to identify which groups may benefit from different distribution approaches. States should also partner with local organizations that have a history of working in communities with lower vaccination rates and hold events where these organizations have existing infrastructures (e.g., places of worship and community centers).

2. Confront Vaccine Hesitancy, Particularly in Rural and Communities of Color

Rural vaccination is likely to start falling behind urban and suburban areas, according to findings from the Kaiser Family Foundation. While rural residents have outpaced urban and suburban residents in early self-reported uptake of COVID-19 vaccines, fewer rural residents are planning or considering getting vaccinated. About one-third of rural residents say they will either “definitely not” get vaccinated or will only do so if required. And few unvaccinated rural residents (11%) say they have tried to get an appointment.

Similarly, Black, Indigenous, and people of color (BIPOC) communities are confronting vaccine misinformation, including false claims that vaccines can alter DNA or do not work, the New York Times reported. The resulting hesitancy is rooted in both the messaging around the COVID-19 vaccine and the systemic racism, marginalization, and neglect that shape daily life.

Vaccine hesitancy, particularly in rural and BIPOC communities, has the potential to significantly slow progress in addressing the pandemic in the U.S. One successful approach, as seen in Israel's 85% drop in daily deaths and widespread vaccination, is meeting people where they are. This strategy can be applied in many ways such as how mobile vaccine clinic buses were deployed in Colorado; doses were delivered at fisherman docks, places of worship, homeless shelters, truck stops, and casinos in Louisiana; or local organizations and groups led regional vaccine distribution efforts in West Virginia. President Biden’s announcement that 90% of all Americans will have a vaccine site within 5 miles is an encouraging step toward bringing vaccines to people.

3. Partner with Community Leaders

Trusted community leaders in populations with lower vaccine uptake rates are essential messaging partners. They can communicate the availability and importance of vaccines in addressing the pandemic. Leaders from community- and faith-based organizations, and other agencies outside of traditional health providers have community-level reach. They can identify specific needs in the community regarding vaccine access and confidence.

Community leaders are trusted messengers: They can reinforce public health strategies, address contextual challenges and concerns, and ultimately strengthen outreach while building a culture of health and vaccine acceptance.

The Bottom Line: Equitable Access Increases Vaccine Uptake

Addressing race and ethnicity distribution gaps, overcoming vaccine hesitancy, and partnering with community leaders are vital for achieving equitable COVID-19 vaccine access and uptake. By improving vaccine equity, state and local health authorities will help the nation get one step closer to achieving herd immunity—and ultimately ending the COVID-19 pandemic.

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