Baltimore African-American Faith Community is Key in Promoting Vaccine Confidence
The African-American faith community in Baltimore has been integral to educating the public about the risks posed by flu and the importance of vaccination. This work now provides immunization partners with lessons learned for the COVID-19 vaccination program.
Comforting community concerns
During the past flu season, Rev. Dr. Terris King, pastor of Liberty Grace Church of God, partnered with the International Vaccine Access Center (IVAC) at Johns Hopkins University to create an environment where congregants felt comfortable asking questions about vaccines. The community would then have enough information to make informed decisions about whether or not they want to get a vaccine.
“The population needs to have trust and a situation where they have access to information and are willing to have a conversation about those facts. The last thing we want to do is say we know what’s best for you, and you should do this because we say so,” said Lois Privor-Dumm, director of adult vaccines and senior advisor, policy, advocacy, and communications at IVAC.
IVAC works on initiatives to promote vaccine confidence in the Baltimore area and evaluated the Baltimore City Health Department’s (BCHD) flu vaccination efforts for older adults living in senior housing. IVAC’s work helped promote flu vaccination throughout the city and provided insight into how to do the same for COVID-19 vaccination.
“We need to acknowledge the history that people have had with various institutions around the city, including our own. And this is a challenge for the BCHD, too—any type of government or big institution aren’t necessarily the trusted partners,” said Privor-Dumm. “What pastors do is something that many others don’t. Rev. Dr. King can package information in a way that is most relevant to their community and get it out to their congregants and connect with them in a way we never could.”
Fair COVID-19 vaccine distribution
IVAC also partnered with the city of Baltimore and its partners—pharmacies and Coppin State University, a Historically Black College and University (HBCU)—to bring vaccine administration sites closer to people and the places they trust. IVAC worked with Morgan State University, another HBCU, to evaluate the city’s flu vaccination efforts, including partnerships with senior housing buildings to bring flu vaccines to underserved communities. IVAC also helped a number of churches hold their own flu vaccination clinics.
“A lot of people don’t feel comfortable going to other places to get their flu vaccine, but they trust the in-building or church clinics because they are convenient, and the idea you can drive in and stay socially distant is important,” she said.
Making sure everyone who needs a vaccine gets one
Connecting with people during the COVID-19 pandemic is a tough task, Privor-Dumm recognized. People are staying inside, which means the health department, the churches, the IVAC team, and others must go through a lot of steps to reach them. “You have to be creative and diligent to get to people, which is why we use trusted partners such as pastors and community leaders.”
Vaccination is important for everyone, but especially for people from racial and ethnic minority groups, who are often less likely to be vaccinated and more likely to be hospitalized. This includes non-Hispanic Black, non-Hispanic American Indian or Alaska Native, and Hispanic or Latino people.
In late 2020, one concern was where to locate the COVID-19 vaccination clinics. The city was planning mobile clinics in a variety of settings to take vaccines directly to populations that are underserved or high-risk, such as those living in long-term care facilities, assisted living, or senior housing. The partners were also planning for how to vaccinate people who might be hesitant to receive a COVID-19 vaccine when it’s available to them.
“Considering that there is still hesitancy amongst some communities of color living in senior housing or other congregate settings, they may not seek vaccinations when the clinics are set up, but want it at a later date, so strategies will be needed to come back to communities [so that people who] didn’t receive the vaccines in the first round or weren’t eligible at the time [can still get vaccinated],” said Privor-Dumm.
Active community listening
IVAC, BCHD, Morgan State University, and the Maryland Institute College of Art have conducted 20 listening sessions to hear from underserved communities, faith community leaders, and community organizations about their concerns around COVID-19 vaccination. A medical expert is at all sessions to answer questions. With community ambassadors, the organizations are co-creating educational materials and programs. Ideas have included:
- Regular TV or radio updates
- Video clips from local young artists to explain how vaccines work and the benefits they provide
- “Journey maps” to explain how to get vaccines—from sign-up to what to expect afterward
- “Swag bags” or toolkits to deliver relevant information to the community
“The last thing people want is information that is just generic that doesn’t seem like it applies to them. We need to understand what their specific problems are and be prepared to offer answers to their questions,” emphasized Privor-Dumm.
The lessons learned from conducting flu vaccination clinics in the past have given a preview of the difficulties with promoting COVID-19 vaccines. The partners are aware of what has kept people from getting a flu vaccine in past seasons.
“A lot of it is concerns about safety and whether the flu vaccine will give them the flu,” explained Privor-Dumm. “There are a lot of different myths, and a lot of people said ‘nobody told me I absolutely must do this.’ Also, with COVID-19, a lot of people have concerns about going out. For flu vaccination, there were people that had never received a flu shot in the past but wanted to get one with COVID-19. They realize COVID-19 is really serious and they need to do whatever they can to protect themselves.”
Moving forward, one objective is to build trust. “The goal is to empower the community to make informed decisions and build trust in both vaccination and the broader health system. Our hope is that they will be vaccinated, but we must also recognize that building trust takes time,” said Privor-Dumm. “Based on what we are hearing, some in the community have concerns beyond COVID-19 vaccines, and we will work with them to direct them to other services as well to provide a more holistic and person-centered approach to providing support.”