Editor's note: This story is part of Southwest Michigan Second Wave's On the Ground Calhoun County series.
Calhoun County residents who aren’t listening to the science or the experts about the benefits of the COVID-19 vaccine may listen to people who aren’t scientists or experts who have been vaccinated.
This is what architects of the County’s Vaccine Ambassadors program are hoping for.
These ambassadors are community members, some of whom hold leadership positions in their churches or community organizations. They are recognizable by the purple T-shirts they wear emblazoned with the words “Don’t Hesitate Vaccinate” #AllInCalhoun.”
While there are plenty of physicians and health experts who discuss the benefits of the vaccine on television and other information platforms, their messaging isn’t finding a receptive audience within Communities of Color, says Angela Stewart, Director of the Population Health Alliance of Calhoun County. This is how conversations began about the Vaccine Ambassadors initiative, she says.
The Population Health Alliance received a $70,000 grant in January from Community Partners through Bronson Battle Creek Hospital to support education around COVID for people ages 18-35 and Communities of Color because infection rates among these groups have been consistently higher than other groups. Stewart says the messaging initially was centered around the importance of safe practices such as social distancing and wearing a mask prior to the availability of a vaccine. The discussion now is focused on disseminating information to lessen the instances of vaccine hesitancy.
“Our messaging is not to say you must go and get this vaccine, but you can make an educated decision about whether or not to get it,” Stewart says.
She refers to the Ambassadors as “trust agents,” many of whom already have established levels of trust within diverse populations in the community that have the highest rates of vaccine hesitancy.
The Calhoun County Vaccination Ambassadors are, from left, Daniel Ramos, Karla Fales, Mildred Mallard, Charlie Fulbright, Don Myers, Freddie McGee, and Nolan Stewart.
Stewart says she’s heard members of the community who support getting vaccinated say that they have interacted with others who wouldn’t be vaccinated until they’d had a conversation with someone they know.
“One woman had a conversation with her pastor and that changed her mind about not getting the vaccine,” Stewart says. “Another woman who was still hesitant when she showed up to the clinic decided to get vaccinated after she confirmed that her daughter received the same vaccine that she was getting that day. Who you have trust in and a relationship with has the most impact with people who change their minds and decide to get the vaccine.”
When vaccine hesitancy became an issue within Communities of Color, the Battle Creek Chapter of the NAACP (National Association for the Advancement of Colored People) hosted virtual panel discussions that included physicians and leadership of Bronson Battle Creek Hospital, Pfizer, and Calhoun County’s Health Department to educate individuals about the benefits of the vaccine.
Stewart says that there needs to be continued collaboration and the work of the NAACP is one piece of the collaborative efforts, but “we need more.”
“In Communities of Color there is a lack of trust based on previous interactions with the healthcare system that were negative,” Stewart says. “We needed people who already had trust with these diverse populations.”
In February, conversations began about getting accurate information to populations served by organizations like the Population Health Alliance. This was around the same time that the state made doses of the vaccine available to Calhoun County which resulted in vaccination clinics held within specific Census tracts.
These Census tracts represented socially vulnerable communities that also were primarily Communities of Color, Stewart says.
“The Health Department asked how we could get communications about the vaccine to residents living in these Census tracts,” she says. “We called our trust agents and asked if they had people who could go door-to-door to ask if they wanted the vaccine. They pulled in people who were part of their churches and organizations and these people who became some of our ambassadors went door-to-door to ask people if they wanted the vaccine. They also called people and we had robocalls going on too.”
Through the grant, this initial group of ambassadors received a stipend. The newest ambassadors received gift cards. There are more than 50 Vaccine Ambassadors in the county who have embarked on an informal way to meet people where they are to talk about the benefits of getting vaccinated and respond to concerns people have about the vaccine.
Stewart says when the first group went out, they came back and asked for more training so that they could answer questions that they weren’t anticipating.
Dr. William Nettleton, an Assistant Professor in WMed's Department of Family and Community Medicine, Medical Director of Kalamazoo County Health, and Community Services Department and Calhoun County Public Health Department, did a virtual training with the volunteer ambassadors on May 18 where he was able to provide guidance on very specific questions that participants had.
“The ambassadors program was a nice evolution to the work we were already doing,” says Rod Auton, Administrator for the Albion Health Care Alliance. “When we first started this journey the challenge was that more people wanted vaccines than we had vaccines available. We were dealing with a shortage issue. As time has gone by and the older population was able to get vaccinated, the vaccine became more readily available. Healthcare experts predicted that we would see opportunity for more doses of the vaccine than people who wanted them.”
The latest CDC (Centers for Disease Control) data shows that close to 134 million people in the United States are fully vaccinated and an additional 166 million have received at least one dose. Statewide, 59.1% of Michigan residents 16 and older have received their first dose of the vaccine as of June 1. In Calhoun County, 46.1% have received their first shot, and 40.2% of residents 16 and older have been fully vaccinated.
Calhoun County Public Health Officer Eric Pessell continues to express frustration over the county’s lag in vaccination rates compared to other areas of the state. He urges people to get the vaccine and says a focus on educating those with vaccine hesitancy will continue.
“We’re already seeing the effects of people prematurely relaxing their approach to social distancing from Memorial Day weekend,” said Pessell during a Joint Information Center call on June 1. “We don’t want to see this jump back up. The rise in cases we started seeing at the end of last week is not one we want to see continue to climb.”
Stewart says when discussions take place about disparities in vaccination rates and the underlying reasons why people are not getting vaccinated her organization has seen a difference in access to the vaccine for white people and Communities of Color.
In response to the issue of access, the county’s health department partnered in February and March with local churches with predominantly African American congregations, the Burmese Center, VOCES, and Grace Health to offer micro-clinics focused on Communities of Color.
Auton says these clinics did not see the numbers of people they were hoping for. Like Stewart, he says that people have strong feelings about the vaccine and the important role it plays in bringing infection rates down. He admits to being surprised by this.
“I didn’t realize there were so many different reasons why people don’t get the vaccinations, including historical racism and a lack of trust in the health systems,” Auton says. “There are lots of reasons why people are resistant.”
Stewart says of the Vaccine Ambassadors program, “The biggest takeaway for us is that we’re just a small piece of a larger communications effort. We’re just trying to get into pockets of the city and county where other efforts may not be reaching Communities of Color and the 18-35 age group.”