Priority REACH Strategy: COVID-19, Flu, and Other Routine Adults Vaccines

Background

Vaccination coverage for COVID-19, flu, and other routinely recommended adult vaccines in the United States remains low. Many social, geographic, political, economic, and environmental factors create challenges to vaccination access, and acceptance. These factors include job access and working conditions, gaps in healthcare access, and mistrust in medical systems as a result of both historical and current experiences of racism and discrimination. Because of these and other challenges, adult vaccine coverage is lower in racial and ethnic [PDF-1.71MB] minority groups than among White populations.

CDC’s Partnering for Vaccine Equity (P4VE) program focuses on increasing equity in adult immunization and provides funding and support to national, state, local, and community partners. The partners prioritize equity in vaccination access and uptake for groups experiencing disparities in immunization – with a particular focus on racial and ethnic communities. The program aims to increase vaccine equity by partnering with local organizations to increase vaccine confidence in their communities.

As part of a new funding announcement, REACH recipients will have the option to apply for supplemental funds to implement P4VE strategies to increase awareness, confidence, demand, and access for flu, COVID-19, and other routinely recommended adult vaccines. REACH is CDC’s Racial and Ethnic Approaches to Community Health program.

Potential Activities

Conduct health equity needs assessments or update previous assessments

• Details barriers to vaccine uptake, addressing specific disparities, drivers of vaccine hesitancy and successful strategies for improving vaccine uptake.
• Work with communities to identify and address drivers of vaccine hesitancy, identify influential community messengers and partners, and develop community-acceptable approaches for improving vaccination availability, accessibility, and confidence.*
• Conduct needs assessment using methods such as questionnaires, interviews, town halls, and focus groups with community members affected by inequities.*
• Document insights, common challenges, and key lessons learned, based on community interactions and learnings. Share insights of others working to increase vaccine coverage.*

Equip influential messengers

• Educate and empower trusted voices in the community to support vaccine education and delivery.*
• Develop and/or tailor audience-tested materials and messages. “Audience tested” includes community-based, culturally and linguistically appropriate messages that focus on the following:
  • Disease spread, symptoms, prevention, and treatment.*
  • Vaccine safety and efficacy.*
  • Vaccination purpose, need, and opportunities/locations.*
• Identify and train trusted community spokespersons to communicate disparities in COVID-19, flu, and recommended routine adult vaccinations, as well as the importance of vaccination. Community spokespersons could be faith leaders, teachers, community health workers, radio DJs, local shop owners, and barbers. Communication channels might include news media, advertising, social/digital media, partner media, faith-based venues, community events, and other community-based, culturally appropriate venues.*
• Build partnerships with health care providers to increase understanding of:
  • Communities affected by inequities in access to vaccines and those with low vaccination coverage.*
  • Interventions to increase vaccination rates for these groups.*
  • Refer to the Community-Clinical Linkages (CCL) Health Equity Guide.

Increase vaccination opportunities and enhance provider partnership

• Build partnerships between vaccination providers and the community to make more opportunities for priority groups to get vaccinated.+
• Work with vaccination service providers to expand the types of health professionals and administrative staff engaged in promoting COVID-19, flu, and recommended routine adult vaccinations and increasing referrals of individuals to vaccination sites. Health professionals could include community health workers, patient navigators, and patient advocates. Administrative staff could include front desk workers.+
• Guide information exchange between community partners and CDC.+

Evaluate interventions/activities

• Conduct ongoing evaluation to identify priority needs and the actions needed to meet those needs. Ongoing evaluation will measure impact of other activities including conducting needs assessments; equipping essential messengers; and increasing vaccination opportunities. Evaluation can also document improvement in the health status of the community served.+
• Create a yearly evaluation plan to describe the overall evaluation approach. Key elements of the plan include why the evaluation is being conducted, intended use for findings, proposed design, and data collection methods and sources.+
  • Evaluation plan should detail process and outcome measures and address how activities help increase vaccination and access to vaccine services while decreasing disparities and reducing disease rates among priority audience.+
  • Monitoring may also include:
    • Ensuring that work plans are feasible based on the budget and consistent with the intent of the program.+
    • Ensuring performance is at a sufficient level to achieve outcomes within stated timeframes.+
    • Adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.+
    • Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.+
    • Completing quarterly reports.+
    • Submitting monthly progress reports and monitoring calls.+

Resources

Partnering for Vaccine Equity Program
Website used by more than 500 CDC-funded organizations working to address disparities in COVID-19 vaccination by improving vaccine confidence and access. Groups include state, county, and local health departments; medical associations; national foundations; and community-based organizations. They have access to technical assistance, group and peer-to-peer learning opportunities, as well as outreach materials and communication tools.

Vaccine Resource Hub
Website with hundreds of free and accurate educational materials to support COVID-19, flu, and routine adult vaccination. Browse by language or resource type.

Vaccines in the Adult Immunization Schedule
Vaccines recommended for adults, their abbreviation, and trade name(s).

Health Equity Resources
Information and strategies to help communities, programs, and initiatives work to remove barriers to health and achieve health equity. Includes links to health equity data.

What Others Are Doing

Fairfax, Virginia
Fairfax County officials are engaging community organizations and churches to help provide transportation for community members to vaccination sites.

Albany County, New York
Albany County works with a state-approved partnership with Mohawk Ambulance Service to increase COVID-19 vaccine access to homebound seniors. Mohawk Ambulance’s mobile vaccination trailer can hold up to 8,000 vaccine doses at a time, and the company hired an additional 50 staff with another 25-50 on standby to help with the effort.

District of Columbia
The District of Columbia Health Department and local business districts partnered to offer free COVID-19 testing and COVID-19 vaccinations to the district’s essential workers. The pop-up testing and vaccination site was available to hotel staff, restaurant workers, building engineers, and other essential workers and had nontraditional business hours.

Southern Nevada Health District
Southern Nevada Health District developed a multi-component media campaign in English and Spanish, implementing mass vaccination events and developing vaccination strike teams in their respective communities to increase vaccine access. Activities focused on groups at higher risk from both influenza and COVID-19, including staff and residents of long-term care facilities, adults with underlying illnesses, people who are African American or Latino, and adults who are identified as essential workers.

Albuquerque, New Mexico
Presbyterian Healthcare Services used data on population demographics and health outcomes to inform their program planning, specifically to focus on geographic areas needing more outreach, communications, and vaccination drives.