As N.C. poultry plants failed to curb COVID-19, Latina workers stood in the gap

After becoming a COVID-19 hotspot, Guadalupe built partnerships and built trust among community members to effectively track cases, dispel misinformation, and increase vaccinations. The Town Council partnered with Pascua Yaqui tribal leaders, the broader Maricopa County, Native Health, and a COVID-19 response team composed of faculty, staff, and students at Arizona State University to lower infection rates. A combination of at-home testing, contact tracing and, eventually, vaccination events helped, as did the use of promotoras – community health workers who talk with residents to help ease anxiety.

Community health workers from One World have gained community trust over the years and now go door-to-door to talk with residents about the COVID-19 vaccine and dispel misinformation. They provide resources in Spanish and carry vaccines in a refrigerated bag so residents can get vaccinated on the spot. The group has invested a lot of money, time, and personnel having intensely personal conversations with people. They also host pop-up clinics in the community and allow at-home vaccination appointments. The areas served by One World has seen more vaccinations than almost anywhere else in Nebraska.

Community health workers are a key part of Connecticut's public health response to COVID-19, particularly in marginalized communities. CHWs connect people to health care and other services, like rental assistance, help with contact tracing, and effectively increased vaccinations by taking the time to answer questions and dispel misinformation. Living in the communities they serve is a critical part of the model’s success and helps clients trust them more readily. The state now offers a CHW certification program, but the largely grant-funded model would be more sustainable with steady funding.

Hispanic residents in North Carolina went from having one of the lowest vaccination rates to one of the highest. The health department ran bilingual ads on a variety of media types, including social media and held virtual town halls and Facebook Live events. They also paid community health workers in each county to use their existing relationships with Latino residents and improve access to information about the vaccine and to the vaccine itself. Outreach from trusted ambassadors has proven more effective among communities that have deep mistrust of institutionalized structures.

West Virginia has implemented a digital platform that allows residents to sign up for notifications if leftover doses of the COVID-19 vaccine are available for use near them. Although the system is only accessible to those with internet, it has resulted in far fewer people phoning the hotline, which in turn has allowed for greater ease for those without internet access to sign up for appointments.

One rural hospital in Indiana vaccinated hundreds of immigrants from Central America by working with trusted community leaders and setting up a Hispanic Health Task Force. Health officials held vaccine clinics alongside trusted community members at locations that were familiar to residents, like a local Catholic church that offers Spanish-language services. The hospital and task force initially established community connections to distribute information about COVID-19, so they were able to utilize the connections to increase vaccination rates once the vaccine rolled out.

The COVID Ambassador program trains people to listen, be empathetic, and acknowledge people’s COVID-19 vaccine concerns. Ambassadors’ training includes substantial practice talking to people who are resistant to getting vaccinated and they receive ongoing support at bi-monthly meetings, which has increased their confidence and led to more conversations with community members hesitant to get vaccinated. Like other community health worker programs, the ambassador program’s ability to be successful relies on the idea that people trust information from their peers more than from the government.

Community-based organizations have been key to reaching historically marginalized populations with COVID-19 information. Grassroots leaders and community workers are effective because they have built trust among communities over many years and they have first-hand knowledge of community needs and barriers. The pandemic shifted the priorities of many organizations. For example, the Self Employed Women’s Association now supplies members with PPE kits, food, and handmade masks to address the pandemic’s health and economic impacts. Proper mask usage increased significantly in the villages where they are based.

Community groups in under-vaccinated areas helped tens of thousands of people get vaccinated, made slightly easier since the FDA approval of the Pfizer-BioNTech vaccine and more employers requiring it. Nonprofits like the Bronx Rising Initiative, Vision Urbana, and Union Settlement are trusted messengers that have a long-standing presence in their communities. They understand their communities' needs and speak their language - both literally and figuratively. The groups conducted door-to-door educational outreach, signed people up for appointments and held community events where people could get the vaccine.

Vaccine Talk is a Facebook group for evidence-based discussion to help both pro- and anti-vaccine people wade through all of the conflicting, and oftentimes wrong, information about the COVID-19 vaccine. The group has a tough reputation because of its strict moderation system and rules of discourse. Each of the group’s 70,000 members was approved by an administrator to join and committed to a code of conduct. Users must be ready to provide citations within 24 hours of posting and the moderators don’t hesitate to kick out members who lack civility, misrepresent themselves, or make unsubstantiated claims.