Creating vaccine equity in Ottawa County

As people everywhere attempt to navigate the vaccine registration system to secure their dose of the Pfizer, Moderna, or Johnson & Johnson shot, some have more barriers than others.

The Ottawa County Department of Public Health and community partners are working to reach everyone in an equitable way. It isn’t always easy.

For groups who have historically not been offered a seat at the table, there is a reluctance to trust those trying to help now.

Trust and technology

As it rolls out the COVID-19 vaccines, the Ottawa County Department of Public Health has worked with community organizations to work toward equitable vaccine distribution in communities of color.
“It takes trust,” says Kavy Lenon, an Asian community leader with Holland-Zeeland Model Community Initiative.

The South East Asian community in West Michigan is isolated, she says. Lenon has reached out to elders through printed fliers at area Asian grocery stores.

“Most of them don’t have a smartphone, let alone a computer,” she says.

The health department has created a hotline for those who do not have email or reliable Internet access (616-396-5266). 

Home health

Then there are those who cannot leave their homes at all. Holland Hospital Home Health Services has reached out to its current home health care patients. All are homebound — many because their medical issues make them especially susceptible to COVID-19, says Carrie Van Oss, RN, clinical manager at Holland Hospital Home Health Services

In its first round, Holland Hospital administered 140 doses of the vaccines to current patients and their spouses.

“Our ability to provide these valuable services helps our patients remain at home safely and avoid hospital and nursing home stays,” Van Oss says. “It has just been amazing. Our community members have been very grateful for the opportunity to receive the vaccine. They don’t have to worry about “How am I going to get out (of the house)?’”

Reliable information

Immigrant populations may not receive the same information about the vaccine as those whose first language is English. Reliable printed and broadcast news is not as accessible to them, says Reyna Masko of St. John’s Episcopal Church in Grand Haven, which has a robust Latino outreach.

Health departments produce informational brochures and websites in a number of languages. However, some who fled their homelands to come to America might not be able to read their own native languages, Masko says. Work has begun to produce informational videos in those languages.

For the Spanish-speaking community, it is best to go to them, to physically show up and talk to them in person, Masko says. 

Trust in government does not come easily for some, Lenon says. Many escaped from their own countries where state-run media was merely propaganda. Many spent time in refugee camps, waiting to hear they had been accepted in a new home country.

And trust is easily broken.

Although Ottawa County has worked conscientiously to include immigrant populations and people of color from the beginning, there were mistakes, organizers say. Interpreters were not where they needed to be; the correct signs were not posted; people were turned away, because the system wasn’t working correctly.

Improving

“Every week, we meet, and we listen to community partners and say ‘What went well? Where can we improve?” says Patrick Cisler, executive director of the Lakeshore Nonprofit Alliance. “We want to be equitable with the little vaccine we have.”

The LNA has been helping to bring a variety of community partners to the same table to ensure that equity.

“We’re all accountable to make sure people of color have access and feel they’re included,” Lenon says.

Inequity

Communities of color have been harder hit by the pandemic than others.

Hispanics and Blacks are about three times as likely as whites to be hospitalized from COVID and twice as likely to die from the disease, according to the Centers for Disease Control and Prevention.

The reasons race and ethnicity may indicate risk are myriad. Black and Hispanic Americans are statistically more likely to have underlying conditions that affect health such as generational poverty and lower socioeconomic status, less access to health care, and jobs considered frontline and essential that expose them more to the COVID-19 virus.

Immigrants and people of color are more likely to be essential workers; they are less likely to have access to paid sick or vacation leave or employer-supported health insurance. They are more likely to live in multi-family households. They are more likely to have jobs with little protection from being fired if they need time off.

The county typically notifies patients of available vaccine appointments via email. However, in order to make use of the appointment, the patient has to 1) have reliable Internet access and be somewhat tech-savvy, 2) be available, 3) have transportation to the vaccine site.

There’s only so much vaccine and only so many appointments.

“Whoever gets there fastest, wins,” Cisler says.

Equity

A more targeted outreach program from the county health department hopes to help some of those populations who face those additional barriers.

Every week, the Ottawa County Department of Public Health learns how many doses of COVID-19 vaccine it will receive. It sets aside a certain number of those for the outreach population. Community partners ID people and help them through a special registration process to secure their appointment.So far, outreach clinics have been hosted at Holland’s Civic Center Place, St. Francis de Sales Catholic Church, and Grand Valley State University — Meijer Campus.

More clinics within centers of the BIPOC (Black, Indigenous, People of Color) communities are on the horizon, organizers say.

The Ottawa County Department of Public Health and its partners have run vaccine clinics for those who don’t have access to email, for those whose native language is Spanish or Laos or Vietnamese or Chinese.

“When (equity) is addressed, it’s because things are just not the same with these communities. And access is just not the same across the board,” Masko says. “Equality is providing everyone with a pair of shoes, but equity is providing shoes that fit.”

The future

There is a hesitancy in the BIPOC community that will take work to erode, Masko says.

“Usually there’s not this push to reach our BIPOC community,” Masko says. “We normally don’t go to the extent we are going to now, so they are not trusting of the system. We’re not in their communities regularly. … Organizations haven’t done a good job of maintaining those deep relationships, so they can be trusted, so the system can be trusted by our communities.”

However, she adds, “This is the perfect time to build those relationships”

Organizations that target the broader community can take this opportunity to build relationships directly with the communities of color, she says, and not just leave that work to “minority” nonprofits.