How Native Americans launched successful coronavirus vaccination drives: ‘A story of resilience'

Toronto’s Vaccine Engagement Teams Grant has awarded $5.5 million to community organizations in 140 neighborhoods to hire and train local ambassadors for vaccine outreach. Because the ambassadors share a lived experience with the communities, they can effectively identify the barriers people face. The on-the-ground effort includes sharing information, advocating for community needs, and helping people access services. The outreach focuses on people often overlooked by government services, such as unhoused people and people who do not speak English or have precarious immigration status.

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.

IPSI Palaima is working to vaccinate Indigenous families who live in hard-to-reach areas of La Guajira, where there are no paved roads, electricity, or running water and staff must use cars, boats, and motorbikes to reach them. A team of nursing assistants and a doctor spend 15 days at a time at a local outpost and travel by motorbike to surrounding communities, carrying vaccines in cooler bags. The organization was founded by an Indigenous woman who grew up in the area. Many of the staff members speak the local language, which can ease the communities’ vaccine hesitation and mistrust of authorities.

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.

Hundreds of thousands of indigenous people in remote regions of the Amazon have been vaccinated for COVID-19 in part thanks to programs that send indigenous vaccinators with non-mRNA vaccines to remote villages. There, they meet with community leaders and work to gain the community’s trust before vaccinating those who are willing. Non-mRNA vaccines are used due to the refrigeration needed for mRNA doses, but they also make it easier to address misconceptions associated with the new and unfamiliar mRNA technology.

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.

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.

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.