New report offers guidance for equitable vaccine distribution in urban Colorado

In partnership with the Colorado Health Institute (CHI), the Metro Denver Partnership for Health (MDPH) released a report Wednesday providing recommendations on how to ensure the area’s vaccine distribution is equitable and reaches its underserved communities. The “Operationalizing Equity in COVID-19 Vaccine Distribution” report offers ways for providers, health facilities, community members and more to embed equity into their community vaccination efforts.

 

 

Serving the Denver metro area’s seven counties, the MDPH is a partnership of six local health facilities who collaborate with public health facilities, health systems, regional leaders, health systems, regional accountable entities (RAEs), regional health alliances and human services to improve the health of the 3 million Coloradans living in the area.

The report explains that Colorado’s minority populations — including communities of color, low-income Colorodans and undocumented individuals — are at significantly higher risk of COVID-19-related illnesses. These individuals often live in crowded environments, have underlying health conditions or lack access to health care.

A history of systemic racism and medical malpractices has fueled a distrust in the medical system and a subsequent hesitancy to receive the COVID-19 vaccine in communities of color. This only contributes to the disparate health issues faced by these communities.

The first guideline offered by the report emphasizes the importance of partnering with the community. Sharing responsibility for vaccine distribution and ensuring community members are involved in every step of the process is a critical part of community outreach.

The MDPH created a community ambassador program to promote the importance of the flu and COVID-19 vaccines in underserved communities. Through this program, community-based organizations (CBOs) and local public health agencies (LPHAs) advocate for vaccine importance and host vaccination clinics in their communities. Programs affiliated with trusted CBOs can also help increase trust in the vaccine’s safety.

Effective communication is a crucial part of community partnership. The report recommends working with community leaders to ensure vaccination efforts have culturally appropriate messaging. It also suggests targeting specific media outlets used by the communities.

The report offers an overview of MDPH’s suggested community engagement strategy:

The report also says vaccination efforts should be fully transparent to the public. Agencies should be communicative with every community about existing health inequities as well as what they are doing to address them. Vaccine dissemination plans should be made fully available to the public, and the process by which vaccine priority groups were chosen should be disclosed. The report recommends using publicly visible dashboards and other accessible platforms to provide updated information.

Vaccination sites should be designed to meet the diverse needs of the community they are in. Vaccination clinics within health facilities should use additional criteria, such as an individual’s zip code, to determine which individuals to vaccinate first from waiting lists. Sign-up processes should be user-friendly, taking internet access and mobility into consideration. Care coordinators and CBOs can help individuals with the registration process.

Mass vaccination sites can also be effective, especially when functioning as central, accessible vaccination centers in instances of vaccine shortage or overstock. These sites should consider operating at non-traditional hours and ensure there are culturally responsive resources onsite (these can be identified through input from LPHAs or CBOs).

Using up-to-date data to operationalize vaccine equity is critical, according to the report. The report suggests examining local equity data weekly to determine where to place community outreach clinics. Using this data, LPHAs and CBOs should cooperate to determine a location’s capacity to support scheduling, outreach and recruitment for vaccination clinics. These entities should also evaluate partnered local health facilities’ ability to support equity.

The report also recommends prioritizing funding and resources in a way that supports vaccine equity. Vaccination sites should take advantage of their contact with underserved community members and offer them wrap-around services, such as Supplemental Nutrition Assistance Program (SNAP) enrollment, in addition to vaccinations. CBOs should also receive staffing and support for grassroots efforts like door-to-door canvassing.

Providers are recommended to assess their budgets to determine if enough funding is allocated to priority populations. Public health facilities should use federal dollars to invest in underserved areas. Facilities should also ensure they dedicate adequate funding to the communication and transportation needs of community members.

The report emphasizes that the needs of the Denver metro area’s communities differ, and this should be reflected in vaccine outreach.  Registration and scheduling should be made more accessible based on the individual needs of a community. For instance, vaccination clinics shouldn’t require identification and should be considerate of gender reporting requirements — something especially important to LGBTQ+ communities.

Mobility concerns should also be addressed, as many elderly and disabled individuals are limited in where they can travel to. As a solution, clinics should consider conducting drive-through vaccinations or providing home-bound services so these individuals don’t need to travel to be vaccinated.