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Now that we have safe and effective COVID-19 vaccines, getting those vaccines into arms will require improved communication, focused outreach to traditionally disenfranchised groups and a commitment to better funding and support of public health and the public health workforce, according to testimony by American Public Health Association’s Executive Director Georges C. Benjamin, MD, before a House Ways and Means Health Subcommittee hearing today.
Members and witnesses convened to discuss the path forward in U.S. COVID-19 vaccination, a process described as sluggish and inequitable since its initial release, but that’s been gaining some momentum recently.
“The process to actually vaccinate people started off slowly but has begun to pick up and as of February 23, 2021, according to the CDC, we have administrated over 64 million of the 75.2 million doses available,” Benjamin said. “Despite this encouraging progress, we are seeing troubling trends in disparities in who is being vaccinated, particularly in communities of color and among seniors.”
Benjamin highlighted the need to confront barriers related to vaccine hesitancy, racial and economic inequity as well as longtime shortcomings within our nation’s public health infrastructure in order to resolve continuing issues and disparities with the national vaccine rollout.
For many in communities of color, these disparities begin with doubt and mistrust surrounding the vaccine, notions built from rampant disinformation and years’ worth of systemic racism. According to a recent survey, fewer than half of Black adults say they probably or would definitely get a coronavirus vaccine if it were available for free, with only 18% saying they would definitely get vaccinated. Interviews among Hispanic adults found just 33% would definitely get vaccinated. Nationally, racial and ethnic disparities in vaccination rates are of growing concern.
To build trust among these populations, Benjamin urged the practice of tailoring the message to the audience. This includes using positive, non-judgmental language designed to hear people out while promoting factual information, dispelling myths, and easing concerns. Trusted messengers are also important, he said, whether they be community or faith leaders, or local health care workers as well as pharmacists.
For those sold on the vaccine’s safety, though, there still remains the possible hurdle of not having the ability to receive a first or second dose in your own community. According to Benjamin, the term “vaccine redlining” has been coined to describe areas of affluence receiving more vaccine deliveries out of preference, along with “vaccine tourism,” when people jumping state lines to get ahead of resident populations waiting for their dose. He also emphasized the need to address systems that make it harder for disadvantaged populations to schedule their appointments, including lack of internet and public transportation access and jobs with shift hours that limit scheduling abilities.
Potential solutions, Benjamin said, include enlisting more pharmacies, building transportation support into the vaccination effort and calling on federally qualified community health centers to improve access.
“These centers are located in the community and have the trust of these communities that is needed to address the hesitancy issues” Benjamin said. “Additional programs that provide transportation to and from vaccination sites or bring vaccines to a specific community are also needed.”
He also voiced APHA’s support for the Biden administration’s proposal of additional funding for strengthening America’s public health workforce, to be included in Congress’ current COVID relief bill. This would go toward hiring more front-line health workers while also bolstering vaccine distribution and testing efforts. Along with a loan repayment program to encourage a new generation of public health leaders, APHA also called for long-term, mandatory funding for the Centers for Disease Control and Prevention and public health agencies on all levels. This ask reflects recent demands of ending a long, repeated cycle of budget cuts to public health organizations during non-crisis periods.
“We also support the enactment of legislation that directly targets existing disparities and promotes health equity,” said Benjamin. This includes legislation that provides direct federal support for addressing racial disparities by promoting health care equity, workforce representation, and data collection. Existing legislation aimed to accomplish this that APHA has endorsed includes The Health Equity and Accountability Act, introduced last Congress, as well as The Improving Social Determinants of Health Act of 2021.
“We look forward to working with Congress and the administration to prioritize efforts to ensure the nation has a strong and equitable public health system and the needed well-trained public health workforce to address the current pandemic and future public health emergencies.”
Read Benjamin’s full testimony.
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The American Public Health Association champions the health of all people and all communities. We are the only organization that combines a nearly 150-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Learn more at www.apha.org.