Coronavirus (Covid-19) and the vaccine: Outreach efforts build to get people vaccinated and combat vaccine hesitancy

Filed Under: Costs, Patients, Providers

- photo by Colleen Klutz of Kenny Herzog

Kenny Herzog spends a lot of his time off from work by working — on getting vaccine appointments for people in and around the Westchester County town of Greenburgh.

He’s one of the earliest members of the Greenburgh Covid Angels, a group of volunteers trying to ease the Covid crisis by getting shots in arms.

The rollout of the vaccine has been rocky nationwide, marked by crashing websites, too little available vaccine and a sense of desperation among some that they are not able to find the shot. So volunteer groups have sprung up to help people make appointments through the various state, city, local and other programs.

As the vaccines become more available, the Greenburgh Angels and other similar groups have begun to tackle a big parallel problem: Encouraging people who are vaccine-hesitant to get the shot.

Herzog, 41, is a digital content director for entrepreneur media in his work life. In a phone interview, he explained that the program was the brainchild of longtime Greenburgh town supervisor Paul Feiner. The initial impetus was to connect seniors to appointments, he said, but the mandate has expanded to encompass teachers, people with pre-existing conditions and others — essentially anyone eligible for the vaccine, primarily in the lower Westchester County area where Greenburgh sits. Currently 300-plus volunteers are at work, and have made more than 2,000 appointments.

Scheduling, script-writing, database maintenance

The work, he said, includes “making calls to individuals who’ve been referred to us, by any number of referrers — it could be a county agency, someone’s neighbor, someone’s son, or father. It could be the person themselves heard about us, and submitted a request for help.” In addition to scheduling appointments, people in the group  are coordinating resources, writing scripts, maintaining databases and acting as team leaders.

It’s been challenging for many different reasons, he said — lack of available vaccine is just one. Homebound people are in need of a personal visit. People with mobility challenges and other disabilities also need to get vaccinated, so creativity is required on the part of the angels. Expanding eligibility has meant every day is different.

“Just the sheer fact that every pharmacy, every pop-up, every distribution site has tended to have different eligibility criteria every step of the way” has been another challenge,” he said, adding: “You kind of have to keep that straight in your head.” Beyond that, he said, the list of sites with available vaccines changes, and the group’s coordinators work to have that updated — a county pop-up site, a mom-and-pop pharmacy, the state-run sites, the pharmacy chains. So connecting the willing arms with vaccines might start with an independent pharmacy — which has no online booking system, and no extra staff, but plenty of vaccine — reaching out and saying to the Angels, “We have 400 doses. Can you schedule them for us?”

Vaccine hesitancy FOCUS

The group has recently begun efforts to grapple with vaccine hesitancy.

Krista Madsen, who works in Feiner’s office and is supporting the hesitancy initiative, wrote in an email: “It’s a collaboration between town staff and volunteers. We received grants for vaccine hesitancy initiatives from the UJA-Federation of NY for $6,000 and then a second grant for $9,000 from the Westchester Community Foundation.” The initial plan was to employ teens in a program to offer incentives to the vaccinated in the form of discounts to local businesses, which would also support the businesses, but that approach is being re-thought, she wrote.

“We are still working to support businesses and employ teens, but we won’t be asking businesses (already struggling) to be giving anything away by offering incentives to the vaccinated! We are paying teenagers to help us with these efforts and will use funds for printing/production costs as needed (with most of the funding going to pay teens who are going through a job-readiness program at the Theodore D. Young Community Center).

“We would like to focus on making/compiling quick videos of folks encouraging people to get vaccinated. And knowing that not everyone will be online to see these videos, there will be print versions of these faces/quotes from people they may recognize from their community. The hope is the teens could have fun with the social media aspects of this and receive mentorship along the way.”

Planning is still under way, she said, and the program is “not fully cooked yet.”

The Greenburgh efforts have received national media attention, and Herzog said he thinks that’s because this work is a model of what can be done locally, in a town, a neighborhood, a block even.

Marist students in Dutchess outreach

Another form of outreach is taking place in Poughkeepsie, N.Y., north of Greenburgh. Students at Marist College are translating English-language outreach materials into Spanish in a for-credit independent course under the guidance of Patricia Ferrer-Medina, the chair of the Department of Modern Languages and Cultures at Marist.

The work is part of the Dutchess County Vaccine Outreach Coalition in the Hudson Valley, she said, made of a number of organizations — government, faith organizations and others — working to connect people to vaccines in the Hudson Valley area. The goal of Ferrer-Medina’s group is is to facilitate access to the Spanish-speaking population of the area.

The students translate into Spanish educational and informative material, she said. It gives them a chance to escape the “Marist bubble” and take part in the community, as well as gaining real-world job experience, “which is difficult to find in college environments.”

Such programs are not that easy to guide as a faculty member, she said, though she and her students are enthusiastic and are fulfilling a clear goal — rather than paying for a translation, the coalition gets quality work free. A similar student project that she was guiding last year was to involve students in outdoor outreach for the U.S. Census in April. That project was completely turned on its head when the pandemic struck, she said, and in-person Census work was no longer possible.

Vaccine hesitancy is not uncommon in the Hispanic community in the Hudson Valley, she said, for many reasons — including the presence or absence of documents. “Perhaps you’re documented, but your mother is not,” she said, meaning that connecting with officialdom carries a very real risk.

Queens hyperlocal news group becomes a vaccine finder

Epicenter-NYC, which identifies itself as a newsletter launched to help New Yorkers get through the pandemic, became a finder of vaccines for its community. Epicenter’s publisher is S. Mitra Kalita, a journalist and former executive at CNN, Quartz and The Los Angeles Times, and CEO of URL Media, a network of Black and Brown community news outlets.

“As a media organization, we know this is a nontraditional way to report a story and we never planned to pivot from a weekly newsletter into a full-service vaccine registration company,” Kalita wrote in an article describing this work. “But three pandemics are colliding right now:

  • Systemic racism
  • Loneliness/absence of community
  • Coronavirus

“On its own, each would pose a significant obstacle to an efficient vaccine rollout. Together, they are creating a public-health crisis and exposing the limitations of business as usual. We at Epicenter feel uniquely positioned to be a part of the solution, born out of serving hard-hit communities, connecting intersectional audiences we consider our neighbors, and leveraging communications across platforms, media and languages.”

Epicenter has made more than 4,000 appointments, she said, with more than 200 volunteers doing booking, outreach and translations.

In addition to connecting people in the community with vaccines, Epicenter is also making available other resources, like form letters documenting employment, which were required for some job-related eligibilities (before New York expanded eligibility to all people 16 and over on April 6), as well as making links to transportation, delivering information on the vaccines, securing second doses, providing translators in Spanish, Chinese and Bangla, and easing special concerns such as booking elderly people and their caregivers at the same time.

“Epicenter was founded during a really painful period in our community, which was dubbed the ‘epicenter of the epicenter,'” she wrote in an email interview. “We feel like we, in the very collective sense of that word, are uniquely equipped to be a part of the solution now. How we spend this pandemic truly determines life on the other side of the pandemic. And in the case of Black and Brown communities, whether there is life on the other side.

“Epicenter is pivoting our efforts to a combo of outreach (how to tell people they qualify) and helping the neediest cases like the elderly and folks without time or internet to get their shots. To get more shots in arms, we need to keep making it easier for people. I would say post-May 1, we want to try to decentralize efforts and go to neighborhoods, houses of worship, schools, anywhere people gather.

“We want to incentivize the vaccine and make it unacceptable in both social and economic contexts to not have gotten it. Our best ambassadors on this are each other — we have seen literally waves of people from churches, restaurants, even entire industries come ask for help getting a vaccine once they know ‘someone like them’ has gotten it.”

National outreach

These hyperlocal outreach efforts are mirrored in national efforts aimed at broadening vaccine uptake as the rollout heads for a place where there are more vaccines than willing recipients.

Vaccine refusal has motivated governments, faith organizations, celebrities, nonprofits and for-profits to roll out efforts to persuade people to abandon their opposition.

The Biden Administration, for example, has an initiative to build trust in coronavirus vaccines called the Covid-19 Community Corps. For more information, see here.

The artist Carrie Mae Weems has an installation in Eugene, Ore., about resisting Covid, including reducing vaccine hesitancy. A School Vaccine Hub has been founded for school communities to combat vaccine hesitancy and celebrate uptake.  The artist community Amplifier has a campaign worldwide to generate art that “to create symbols that build trust in the safety and efficacy of vaccines, advocate for vaccine equity, and help combat vaccine disinformation.”

“New York is launching a new ad campaign aimed at overcoming vaccine hesitancy in Black and brown communities — though vaccine hesitancy remains highest among Republicans and white evangelicals,” The River newsroom reported.

Rural residents and caregivers are also declining vaccines at a higher rate than their urban counterparts, studies find.

She saw a need, and went to fill it

Back in the hyperlocal context, a New York entrepreneur, Sindy Sagastume, was motivated to do a homegrown outreach effort by her own experiences.

Sagastume, who lives in East Harlem, struggled to make an appointment on the official state and city sites, finding them buggy and seeing little availability, she said in a phone interview. Then an acquaintance at a restaurant pointed her to the site at the Fort Washington Armory in Washington Heights, which was used by restaurant workers seeking appointments. It is run by NewYork-Presbyterian, the hospital giant, and not by the city, and books through the NewYork-Presbyterian electronic records system at MyConnect. She spent all of 5 minutes on the site, and got an appointment. When she went to the Armory to get her shot, she found that it was practically empty.

“I joked to my partner that I think there are more people working here than there are people getting vaccinated,” she said. The whole experience made her “upset,” she said — since she realized there were many appointments at the Armory though they were then limited to people living in certain zip codes in upper Manhattan, including hers.

Knowing this, she said, she began to tell people — a women’s network that she and I are both part of, the people at her Crossfit gym, and others.

“Everybody, please, please go get vaccinated,” she told acquaintances. “Some people didn’t believe me about how accessible it was. It was literally empty.”

She started a one-woman vaccination campaign. She passed out homemade flyers in English and Spanish, taking them to the restaurant where she learned of the Armory and distributing them in her building. She signed up the doorman in her building, and the porter. The porter asked her to sign up his friend, the UPS guy. She made a separate email for the flyers, harlemvax@gmail.com.

She helped people navigate the confusing MyConnect system. She was trying to book a person, but the identity verification — that series of questions including your old addresses, for example — wasn’t working. So she called the hospital, explained the problem, gave the phone to the person she was trying to book, and removed that seemingly impossible obstacle. Another person tried to book, but it rejected his address with the apartment number — and accepted it without the number.

She said she understands that verification is necessary, but some of the obstacles to members of her East Harlem community keep them from getting shots. Some sites require people to have a lease or a bill under their name, she said, and many people don’t have that. Others who qualify with a pre-existing condition may not currently have a doctor who is able to certify that — so they don’t get vaccinated. Beyond that, she said, the identity certification requirements on site are murky. She went with her green card (which doesn’t have a New York address) and a utility bill, to prove that she is a New Yorker and in the proper zip code, but she was not asked for proof of her address. She also wasn’t asked for a doctor’s note of her qualifying condition, and neither was her partner, who was simply asked to confirm that he had one of the conditions.

Knowing the way through the system and explaining it to others has been very gratifying, she said. It also became easier on Tuesday, April 6, when all New Yorkers 16 and up became eligible, regardless of pre-existing conditions.  “So from the Hispanic community, there’s no more hesitancy about underlying conditions and whether they qualify or need proof,” she said. But still, she argues, the Armory and other sites need to ease the cumbersome signup process and accept walk-ins.

“Every person I have given the information to has just been like, ‘Oh, my God, thank you so much. This was so easy,'” she said.