By Hannah Sullivan
I started serving as an AmeriCorps VISTA member at Jefferson County Public Health (JCPH) in August of 2020. As the end of my service year now quickly approaches, I have been taking time to reflect on my experiences.
COVID-19 Vaccine Rollout – The Early Days
Easily the most exciting event over the past year was the Emergency Use Authorization and subsequent rollout procedure of an effective COVID-19 vaccine (well, technically three vaccines). When this process began in December, it was elating to think that life could potentially return to “normal,” but daunting to ponder the logistics of the mass distribution effort. The biggest challenge during this phase was trying to balance efficiency with equity. It was imperative to vaccinate as many people as possible while working to provide opportunities for people who had been most impacted already by the pandemic, and those facing barriers to access the vaccine. For example, a clinic with 1,000 appointment slots could fill within minutes if it was posted on the JCPH website, but it would be filled by folks with access to the internet, time, and flexibility. To make 1,000 calls and register people without computers would take many more resources.
During this challenging phase of the rollout, I witnessed passion and dedication from everyone on my team. It was inspiring to see everyone put in so much extra time to personally help people and to come up with creative ideas for being equitable with appointment allocation. We stretched our limited resources as far as possible to reach as many folks facing increased barriers as we could. While these efforts cannot be understated, there were and are still many disparities in COVID-19 vaccine access and information.
Current Vaccination Opportunities in Jefferson County
As public demand for the COVID-19 vaccine declined in the spring, so too did mass distribution sites that were previously administering thousands of vaccines a day. Although appointments are now going unfilled, there are still people willing to be vaccinated but unable to do so due to a lack of information, concerns about missing work or side effects, difficulty finding a place to go, language or transportation barriers, concern about cost, and much more. The next phase in our vaccine distribution efforts is to try to reach these folks.
In May, JCPH began partnering with a state contractor to set up small mobile vaccine clinics across the community, particularly in areas with low vaccination rates (according to data from the Colorado Immunization Information System). These clinics happen daily and are set up in shopping centers, community gathering spaces, apartment complexes, and even restaurants. By meeting folks where they already are and ensuring that there are always Spanish-speaking staff and other translation services available, we have already reached many people who were either unable to access a vaccine in the past or were waiting to make their decision. These clinics continue to see a slow trickle of interested folks, and each person vaccinated is one more step on the path to ending the pandemic.
Canvassing to Reach the Unvaccinated
In addition to setting up vaccine clinics in convenient locations, we also decided to increase outreach by engaging with community members directly. In early June, we recruited nursing students interested in volunteering as canvassers. Their role would be to go into the community and provide people with information face-to-face.
Before sending the canvassers into the field, we held an orientation which included some background on vaccine hesitancy (particularly with regards to the COVID-19 vaccine) and an overview of Jefferson County and the areas with low vaccination rates. The orientation process also included a Motivational Interviewing training that focused on engaging strategies for open-ended and empathetic communication. Given the fact that the decision to get a COVID-19 vaccine is becoming more and more contentious and polarizing, the most important point emphasized in the orientation was vaccine safety. We also stressed that everyone has the right to make their own decision about their health. Our goal is to provide community members with accurate information about the vaccine and its safety, not to embark on a crusade of persuasion.
We canvass at businesses, apartment complexes, and even parks. For each session of canvassing, we meet in a location, go over the plan for the day, and make sure that each small group of canvassers has the flyers they need. The flyers are double-sided English and Spanish and contain general information about the vaccination process, upcoming vaccine clinics in the area, and a phone number to call for the county’s “C-VIC”: the COVID-19 Vaccine Information Center. This eliminates some of the pressure to be immediately vaccinated and provides a resource for community members to ask further questions and share concerns about the vaccine. The Spanish side also includes a phone number to reach community navigators: a group of Spanish-speaking community members dedicated to connecting members of the Latinx community with resources beyond just answering vaccine questions.
Each canvassing location is slightly different, but they all entail a similar process. Typically, the canvassing takes place in an area where there is a mobile clinic happening, so people who are interested in getting the vaccine will be able to easily get one same-day. We frequently enter businesses and let them know that we are having a clinic nearby in case any employees are interested. We also provide these businesses with flyers to hang and small hand-outs for customers. Finally, we respectfully engage people passing by. The more people that we can inform, the better.
Overall, nine volunteers have been able to assist with this project, each providing about 20 hours of service. We have canvassed in 13 locations and distributed nearly 3,000 small flyers. Through canvassing, we have been able to learn more about the public’s motivations to be vaccinated. I have found, anecdotally, that the people who ultimately decide to be vaccinated at these mobile clinics tend to belong to one of two groups. The first group are excited to be vaccinated but have not yet done so due to their work schedule, lack of knowledge about convenient sites, or language barriers. My favorite moments from canvassing have been informing these people about a nearby clinic and seeing them excited about the simplicity of it. The second group are on the fence about the vaccine. They are hesitant enough to avoid scheduling an appointment but decide to get vaccinated when they encounter a convenient opportunity like our mobile clinics, which also provide them the chance to speak with health professionals about the vaccine before getting it. In both cases, we have found that the most effective approach is not to push the vaccine on people but instead to offer up trustworthy, honest information.
It is difficult to measure the impact of the canvassing project. On one hand, we have seen successful outreach; people have chosen to get vaccinated, promised to send friends and family, and some have reported that they found a site through a store that they visited. But sometimes it takes passing out hundreds of flyers to find one person who is still looking for a vaccine. We have seen our flyers immediately thrown in the trash. There is undeniably a group of people who feel very strongly against being vaccinated. I can only hope that as the COVID-19 vaccines continue to have safe outcomes and the data becomes even more robust, more of these people will make the choice to protect themselves and vulnerable people around them.
As time goes on and people continue to be vaccinated, canvassing becomes more difficult. It is, however, very reassuring to see that even as the country opens and it feels like we have a bit more control over the pandemic, these volunteers still care about finding and assisting those left behind.
Working Together for Our Community
The canvassing project has been a great conclusion to my year as a VISTA volunteer. After spending so much time over the past year virtually meeting community stakeholders, it has been a wonderful opportunity to finally engage with the community face-to-face. My time canvassing has really highlighted the way the people of Jefferson County are connected and want to help each other out. In fact, this has been a theme through the whole pandemic. From the days of expanding COVID-19 testing access through the vaccine rollout, it has been amazing to see different organizations and entities work with us for the greater good. And it has been inspiring to see this reflected in my colleagues at Jefferson County Public Health. I have never worked with a group of people who genuinely care so much about helping the community. I would like to give a special shout-out to Marius Nielson, Kari Perry, my supervisor Christine Billings, and the rest of my team for being such tremendous role models for me over the past year. It has been a privilege having the opportunity to work with such dedicated people on this effort. I am excited to see their work continue, and hopeful that people will continue to get vaccinated and protect themselves from COVID-19.
Hannah Sullivan is an Immunization and Outreach & Education Coordinator, on assignment with Jefferson County Public Health through the CO-mmunity Corps AmeriCorps VISTA program.