COVID-19 has had disparate effects on different demographic, ethnic, and economic groups (CDC, data used for graphic, below: Kaiser Family Foundation). Now that vaccines are rolling out, we have the responsibility to respond to the inequities the illness has produced, and ensure that the rollouts themselves do not exacerbate disparities. Therefore, as part of our ongoing work centering equity, the THCC Advocacy Committee met in early March with Ms. Monique Anthony, the Director of the Office of Minority Health and Disparities Elimination, within the Tennessee Department of Health. An office like this one, if granted sufficient authority, is one way to ensure a thorough review of health department policies using an equity lens.
There are many national documents that emphasize vaccine equity best practices. Some emphasize “vaccine hesitancy”, a complex term meant to encompass an uncertainty surrounding vaccination, generally attributed to specific populations such as some political groups, ethnic minorities, African Americans and rural populations. When we met with Ms. Anthony, we were able to address this concern, and discuss how they are partnering with trusted entities like churches, social groups, and non-profits that already serve at-risk communities. Our suggestions were well received and we learned since our meeting that several have been undertaken. We encouraged approaching underserved areas in culturally congruent ways, with empathy and an open-ear for concerns. Accurate and timely information in language that is readily understood is essential.
Our national partner, Community Catalyst, emphasizes going beyond issues of hesitancy, and ensuring that providers and agencies adjust their policies and procedures to ensure equitable outcomes. They recommend the establishment and public sharing of a specific vaccine equity goal, along with the collection and sharing of adequate focused data to measure it, while preserving client confidentiality and trust.
A sampling of recommended additional tactics follows. The link has a complete list.
- Be sure that recipients know and understand that there is no personal fee by posting large and understandable signage at vaccination sites.
- If military or law enforcement personnel are present at vaccine sites, make clear what they will and will not be doing there.
- Be sure to include phone and texting-based scheduling systems. Be flexible about ID required of recipients.
- Provide transportation options to vaccine sites and provide mobile and pop-up vaccine sites for populations that are especially challenged by transportation issues.
- Include significant measures of localized social vulnerability in parts of entire states, cities, or counties, to be sure these geographic areas are receiving the attention and resources they need.
- Partner with non-governmental advocacy and support organizations for the disabled.
- Require employers to provide paid sick leave for vaccination and any work missed due to any significant vaccine side-effects.
- Be sure that jailed and imprisoned populations are vaccinated, at least according to the same criteria used for the general population, including any special criteria for equitable policies and results.
Overall, we at THCC believe that implementing the policies described above will have a big impact on the equitable allocation and uptake of COVID-19 vaccinations across our state.
The latest data on vaccination can be accessed at the Tennessee Department of Health website.