Dr. Marcella Nunez-Smith Explains Why the White House’s Multiple Vaccine Initiatives Are Starting At The Community Level

The chair of the White House's COVID-19 Health Equity Task Force talked to about the administration’s plans to increase vaccine confidence and distribution.

As the COVID-19 vaccine rollout continues, the Centers for Disease Control and Prevention is encouraged by the increase in vaccinations nationwide. Approximately 130 million doses of the Pfizer/BioNTech, Moderna and single dose Johnson & Johnson drugs have been administered. But there is still a race to get them to underserved and marginalized communities.
President Biden was set to announce new goals on Thursday (March 25), and said at a Thursday press conference that he hopes to have 200 million vaccine shots in American arms within his first 100 days in office. He says the government is investing $10 billion to give greater access to the vaccines in the communities that need them most, particularly communities of color using funds from the American Rescue Plan.
The initiatives include:

  • $6 billion toward Community Health Centers to get members of underserved communities better vaccine access.

  • An expansion of vaccine eligibility to patients who are served by the Community Health Centers.

  • $3 billion toward strengthening vaccine confidence by supporting state and local governments who in turn support the launch of community programming.

  • Partnering with dialysis clinics to vaccinate dialysis patients

  • $330 million investment to support, train and assist community health workers.

The White House reached out to to talk about the initiatives behind the expansion. Dr. Marcella Nunez-Smith, chair of the White House's COVID-19 Health Equity Task Force, and associate professor of internal medicine, public health, and management at Yale University, discussed what it all means, how the programming will reach people where they are and what the expectations are once the Biden-Harris administration moves forward with the plan. That’s a large initiative the administration is undertaking to get the vaccine equitable distributed, particularly among people of color. Has there been a timeline established to meet all these goals?
Dr. Marcella Nunez-Smith: We definitely are looking at opening eligibility more widely. The president has certainly challenged all governors to make everybody in their state eligible by May 1. And we expect that we will have supply for every adult in America by the end of May, so we’re making a real push. 

Some of our challenges have been around the data that we need. In these federal channels we have really high levels of reporting race, ethnicity data. So we feel with that, we are confident in our ability to really track some of these variables that matter, such as ZIP code ,race, ethnicity, and age. We'll have a good picture of who we're reaching.

Dr. Marcella Nunez-Smith (Courtesy: Yale University)
Dr. Marcella Nunez-Smith (Courtesy: Yale University) You’re talking about expanding access in a lot of these underserved communities so can you paint a picture of what that process looks like on the ground level?  

Nunez-Smith: Community Health Centers are federally qualified health centers. We recently launched and expanded that program. There are over 1,400 federally qualified health centers and look-alikes in the country. And the goal is to be able to provide federal allocation of vaccines to any of them who are interested. But what some of this funding will do is to provide some resources to the partners and organizations that can make a difference.
A couple weekends ago, one of our Community Health Centers in Connecticut, Fair Haven Community Care, called for a vaccination campaign. So we all gathered at the Community Health Center and knocked on over 5,000 doors in that neighborhood to get people signed up. So you can see that those organizations will be able to have some resources for that kind of activity. There’s vaccine hesitancy in the African American community and a lot of other communities as well. How does this plan push back against the hesitancy?

Nunez-Smith: We definitely are working on the resources here: $3 billion to strengthen vaccine confidence.  At the core is understanding the science and the science behind communication in this space. We know that messages really need to be tailored. So for example, if we're going to be thinking about doing outreach to African American communities, you have to start with acknowledging the earned distrust that’s there. 

For some people when it comes to medical healthcare institutions, the government, that’s historic and contemporary in nature for why people might pause. So you have to speak to the specific issue, but importantly that trusted messenger as well. Who is it that people want to hear from? That’s why we see the role of partners and stakeholders to be central. What will the administration do if the numbers in the Black community do not reach the intended number that you’re looking to have vaccinated over a certain span of time?
Nunez-Smith: I think we’re taking a very data-driven approach to this. Everybody is being very nimble so we pivot when we need to. We’re in a push with the variants and everything else that we know. The president has set us on a very hopeful course with all the efforts of this administration to push on supplies and open eligibility earlier. 

He’s given us the Fourth of July as the potential time if we all hang in there a little bit longer, doing the things we need to do. We’ll target resources and deploy resources as necessary, wherever we see that there might be communities that are lagging or need more help or more support to get people vaccinated.

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