“More Money, More Vaccines?” Here’s a Solution in a Toolkit

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The vaccine rollout has been messy. In Oregon, the authorities had no plan to ensure seniors were vaccinated and confessed to predicting “chaos.” Although the problem is certainly logistical, it unearthed another more insidious one, the “more money, more vaccines” phenomenon. Connections, web savvy, and wealth determine who gets vaccinated. Marginalization, lack of access, and poverty selects who dies. Such inequality also impacts the health of the community at large. Yet with a more just distribution of information achieved by activating local networks of trust, the most vulnerable don’t have to wait.

I scoured web sites, waited on hold for hours, and navigated the myriad roadblocks that prevent our older community members from scheduling an appointment. I did not want my 90-year-old mother to suffer due to underfunded vaccine access and delivery. But this left me thinking: What about those without the time and resources to do this?

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Author and her 90-year-old mother in Portland, OR

I partnered with my local faith community to set up a vaccine outreach program that breaks down the information barrier. We have a dedicated vaccine information email address and a website consolidating information about vaccine eligibility, sites, and benefits and updated daily. We call community members who don’t have email, offer personal assistance making appointments and connecting to ride services, and provide information about best practices for riding safely in a car with masks and open windows. After vaccine appointments, we check in to see how they are feeling, make sure their second dose is scheduled, and offer to drop off comfort foods. One recipient replied, “It makes this daunting time just a little easier knowing there is someone out there to guide one through this process. My technology skills are minimal!”

My thought turned to how others could benefit from what we were learning within our own community. I consolidated materials and built a Vaccine Access Toolkit for launching additional local organizations by linking to our information resources. Together we create a hub-and-spoke structure for penetrating into the most vulnerable communities. Hubs like ours have the technological resources to author and host web pages and webinars for communities with less staff and funding.

Store to Door, a local charity supporting older community members and those with disabilities, launched an intensive program within just 48 hours using our toolkit. To meet their needs, we developed three new tools for our kit: a flyer to tuck into their grocery deliveries for 600 clients, many without internet access, a phone script, and a web intake form consolidating member data to facilitate appointment booking. We also forged a relationship with a local TV news reporter who broadcasts the open vaccine appointments we find that would otherwise languish due to constantly-shifting pharmacy allotments.

The toolkit provides organizations an array of options, from barebones operations that can be run by a single motivated individual using our information base, to more labor-intensive programs linking into existing structures such as homebound outreach programs. The toolkit offers:

  • a selection of outreach tasks
  • sample announcements to be plugged into newsletters and emails
  • a sample flyer to distribute to those within your organization
  • intake phone script
  • guide to local vaccination sites with information for those with limited mobility
  • web intake form to collect and consolidate member data
  • tips for building on outreach relationships beyond the pandemic

The tools are sensitive to the use of personal information in assisting members or their caregivers.

The Oregon Health Authority distributed the toolkit to 1800 faith-based communities throughout the state, and it can be used by libraries, public parks, and neighborhood organizations as well. In fact, any group can use it, including any state Health Authority. We are working with the Oregon Health Authority’s communications team to develop an iframe HTML element that can be embedded into community web pages like ours, thereby opening a channel for the state to deliver crucial health and safety information directly into social networks of trust, which will help us face the ever-increasing numbers of wildfires, earthquakes, and other natural disasters in our future. Tyler Cowen’s leading economics blog, Marginal Revolution, promoted our program nationally.

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The lesson of West Virginia’s successful vaccine rollout is that trust is the key to vaccine uptake. Networks of trust at the local level need to certify health information, explain it, and initiate engagement and follow-through with their members. By tearing down the walls of inequality and accessibility through vaccine programs like ours, we at the same time address vaccine hesitancy — the offer to help schedule a vaccine legitimizes it — thereby removing the three greatest barriers to recovery in a single gesture of outreach.

The recovery and protection of our community requires social distancing. But it also demands that we harness the power of our social networks to ensure vaccine information and assistance reaches the most vulnerable. Acting through churches, neighborhoods, and other trust communities, we can become the heart and hands of our nation’s lifesaving efforts by sharing a toolkit and distributing our resources today.

I will host a webinar for the Archdiocese of Portland next Thursday, February 25, 11–12. I will also host one for local charities and organizations launching an outreach program using our toolkit. Follow me on Twitter @MargaretScharle for more information or email me at vaccine@themadeleine.edu to sign up.

Thank you for the hard work, ingenuity, and expertise of many dedicated volunteers and staff at The Madeleine who launched our vaccine outreach program, including Rich Hammons, who worked nights and weekends to design the website and graphics for print materials. Thank you to many friends and colleagues, especially Troy Cross, Jess Thomas, Kjersten Whittington, and Steven Arkonovich for comments on this post, and to Kellyn Yvonne Standley for her excellent last-minute editing.

Professor of Philosophy and Humanities, Reed College

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