Community Ambassadors Are the Link to Toronto's Unvaccinated Populations

The Greater Lowell Health Alliance offered COVID-19 vaccines using a “block party” model where community members enjoy free food, music, activities, and even childcare, while also having access to information about vaccines in multiple languages as well as the ability to actually get vaccinated. This model reduced barriers for immigrants, refugees, and other people who don’t speak English fluently, as well as caregivers who can’t attend vaccine appointments due to their caregiving responsibilities. The relaxed environment, where loved ones can support each other, increased comfort with getting the vaccine.

Because of coordinated partnerships between local governments, state health departments, and nonprofit groups, more and more farmworkers are receiving COVID-19 vaccinations. Through the N.C. Department of Health and Human Services Farmworker Health program and its partners, nearly 14,000 doses were administered to the farmworker community over two months. Advocates also have to dispel rumors and myths about the vaccines, but they are working to combat that misinformation and make it easier for them to get vaccinated.

Comprehensive COVID-19 vaccination strategies helped some Native American Nations achieve high vaccination rates. Tribal sovereignty gave Nations the flexibility to create their own methods of distributing the vaccine and allowed officials to distribute doses to hard-to-reach areas – even by dog sled in Alaska. They could prioritize who to vaccinate and diversify how vaccines were offered – from private appointments to mass-vaccination events – to ensure broad accessibility. Medical professionals, tribal leaders, and Native youth used social media to share information and encourage people to get vaccinated.

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.

Members of Asociación Cultural Latino-Acadiana and the Rotary Club of Lafayette North went door-to-door in neighborhoods that are home to Spanish-speaking households to find people eligible for COVID-19 vaccinations. After compiling a list of unvaccinated residents who wanted the shot, they coordinated with the Department of Health to organize three vaccine events. The events were held within the communities, which eased transportation burdens and the inability to take time off of work. The presence of interpreters also helped ease residents’ concerns of being able to communicate with the medical providers.

The Neighbourhood Organization has helped organized pop-up clinics to administer the COVID-19 vaccine, including a culturally inclusive pop-up clinic in Thorncliffe Park, which has a large Muslim population. The vaccine rollout occurred during Ramadan and some had concerns over whether the vaccine was halal or if it would break one’s fast. As a workaround, organizers decided to extend the clinic until midnight so that people could come after they completed their fasting. Community ambassadors helped spread the word and the well-attended clinic ended up running until after 1:00 am.

A partnership between WakeMed and Wake County Public Health made 1,700 shots available with vaccine clinics in 16 churches and a community center. Trusted messengers, like pastors, are more effective at communicating why people should get vaccinated and convincing them to actually get the shot. Local availability helps people overcome transportation and other equity concerns, like needing access to the county’s online registration system or waiting on hold to make an appointment. The sites offered on-site registration and on-site and culturally and linguistically appropriate information.

Black immigrant women are serving as informal "health connectors" in their communities, using shared language and cultural understanding to help immigrants navigate the U.S. health care system. These unpaid navigators guide people through insurance applications, connect them to doctors, host community events and distribute multilingual information to break down barriers to health care.

Community groups and individual doctors ran pop-up vaccine clinics to combat the lack of access to care and the disproportionate impact of COVID-19 on Black and Brown communities. Umoja Health’s pop-up clinics vaccinated up to 80% of residents living in San Francisco’s most vulnerable areas. Del Paso Heights clinic had such a huge demand for vaccines that the waiting list swelled to 4,000 people at one point. The Greater Sacramento Urban League ran free pop-up vaccine clinics while also canvassing neighborhoods to talk with residents about getting vaccinated.

After a COVID-19 outbreak at a Hamilton apartment complex, officials began offering on-site appointments, particularly for people who are homebound. About 1,400 people have gotten the shot at their residence and many more at pop-up clinics. The decentralized approach is more resource intensive but is effective at reaching people at high risk for contracting the virus. Doctors at the University of Toronto’s Temerty Faculty of Medicine used the patient-centered approach to vaccinate a pre-identified list of Scarborough residents, mapping routes to ensure vaccines were used up within their six-hour time limit.