How a rural hospital broke language barriers to provide COVID vaccines to immigrants

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.

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.

To extend aid to the Minnesotans most vulnerable to the coronavirus, state and local health departments, backed by $4 million in state funding and by community groups' on-the-ground help, conducted an extensive campaign of culturally appropriate outreach to offer free COVID-19 tests and healthcare advice. The efforts have included one-on-one contacts, email blasts to free-school-lunch recipients, and TV and radio ads on media targeting Black, Latinx, immigrant, and refugee populations. Immigrant communities and people of color have been disproportionately hit by the pandemic.

Spain achieved one of the highest vaccination rates among Western countries in part because of longstanding trust and confidence in the public health system and data-informed strategies. The public generally trusted the safety of the COVID-19 vaccine because of a history of cooperation and positive public health outcomes. The norm of inter-generational living also gave young people more incentive to get vaccinated to protect their elderly residents and officials used this as part of the public health messaging. Officials also personally called and set up vaccine appointments for everyone they could reach.

Wayanad is the first district in Kerala to have vaccinated the entire adult population with at least one COVID-19 vaccine. Rather than waiting for people to make appointments, officials went door-to-door providing all adults with appointment times. The district’s efforts started early, setting up vaccine infrastructure and assigning people appointment dates by where they live. Rapid Response Teams conducted outreach and education efforts, particularly among tribal populations, and made sure people showed up at their appointment. Getting vaccinated with their neighbors also decreased vaccine hesitancy.

Accredited social health activists (ASHA) across India fight COVID-19 related misinformation on WhatsApp. ASHAs provide basic health care to people in their villages, which puts them on the frontline of treating COVID-19 patients and educating people to dispel the many myths about the virus and its treatments. ASHAs' local interactions often identify prevailing myths, which they quickly dispel in their face-to-face exchanges and by posting in the many local WhatsApp groups that have been created. The local groups have been an effective mode of educating people and helped ASHAs gain villagers’ trust.

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.

Building trust, engaging in personal conversations, and providing services that reduce barriers to getting vaccinated have helped increase the COVID-19 vaccination rates in some Cleveland neighborhoods. Posting information in local businesses and apartment building allows people to access information in private. Community health workers also meet people where they are in order to build relationships and gain their trust. Many community groups and health workers offer services that reduce common barriers to getting vaccinated, like transportation, child care, and wage replacement for taking time off.

Health centers around Cleveland seek to build trust with residents in order to dispel misinformation and increase vaccination rates against COVID-19. Health officials use social media, engage with trusted messengers like local religious leaders, and acknowledge fears while gently pushing back against misinformation to effectively build trust among the community. Culturally competent and targeted outreach has also been an effective way to convince people to get vaccinated within some immigrant communities.

Political cooperation and an infrastructure of existing relationships and trust built by NGOs and community leaders during Hurricane Maria and a devastating 2019 earthquake allowed for a quick public health response to COVID-19 focused on prevention and vaccination. All trusted public figures, across political backgrounds, advocated wearing masks and getting vaccinated. As a result, Puerto Rico achieved the highest COVID-19 vaccination rate among all other U.S. state or territory. It also had among the lowest Covid-19 death rates since the start of the pandemic.