Opinion: With Hope On The Horizon, We Must Support Community-Based Programs In Vaccination Education

As positive news continues to come out about COVID-19 vaccines, there is a glimmer of hope at the end of a pandemic that has been going on for nearly a year.

But a vaccine only works if enough people actually get vaccinated. A recent poll shows that 71% of Americans would get the vaccine if it were free and deemed by scientists to be safe, but that number falls short of the 75% or more needed for herd immunity.

And right now, achieving herd immunity through vaccinations is no sure thing. Thanks to a number of factors—mistrust in government health initiatives (some of which are completely justifiable), the sad politicization of basic science, and more—too many Americans are prone to avoiding or even actively discouraging vaccination. The US has seen a steady decline in childhood and adult vaccination in the past decade. This has led to the return of diseases like measles and whooping cough in major metropolitan areas.

The real challenge in the next phase of our fight against COVID-19 is convincing people to get vaccinated. Otherwise, we will all be at risk. As a community attorney and someone with ten years of experience in public health, I’ve seen over and over again that the only way to successfully build trust and educate communities is by bringing their local leaders and organizations into the process. Right now, many states and cities are doing the exact opposite.

For example in New York City, where I live, the City’s health department, with a budget of $1.6 billion, is one of the largest public health agencies in the world. One of its jobs is to educate the public about how they can help improve public health and stay safe, an especially important task during COVID-19. The de Blasio’s administration has spent nearly $100 million on ads, so many New Yorkers have already seen ads from the current Commissioner about the need for testing and vaccination.

But mass media campaigns can’t build real trust. First, they don’t reach everyone. Second, they’re slick and impersonal, and fail to convince populations that are already skeptical. A recent study reported on in the Washington Post found that “If offered a coronavirus vaccine free of charge, fewer than half of Black people and 66 percent of Latino people said they would definitely or probably take it” This comes as no surprise to me.

Where education programs have found success, it’s not because of flashy campaigns. In the past few years alone, our nation has experienced terrifying resurgences of vaccine-preventable illnesses such as whooping cough, meningitis, and measles.  And when my own community of Brooklyn, NYC faced a recent measles outbreak I saw firsthand just how difficult it was for our city’s leadership to step in and make meaningful steps to combat its spread.

Ultimately, the solution came from within the community. The New England Journal of Medicine found that the Orthodox Jewish Nurses Association was more effective in combating misinformation than city-led efforts. After the OJNA, on their own, developed and disseminated a booklet on vaccination, the city stepped in and provided the funding to print it. And while we should always look for solutions within the local community – people know best how to reach their neighbors and create change – the city should have  provided funding, sooner, to OJNA and other community groups, and held group and one-on-one conversations with folks to build trust.

That is why I’m calling for our nation’s top public health institutions to strategically collaborate with and direct funding towards COVID-19 vaccination campaigns that are led and based within the communities they serve. I’m also calling for cities and states to do likewise.

Not only here in Brooklyn, but in states across the country we have proven that community-based approaches are the most effective at increasing trust and buy-in to public health programs. They’re also more effective at pushing back against the mistrust caused by racial, economic and geographic disparities in our health system, alongside historic and present-day abuses of communities of color. Immigration status offers additional hurdles to those who need medical care. And a general mistrust of government means that even outside these and other communities, desire to sign up to a government list – even to receive a free, potentially life-saving vaccine – is abysmally low.

That’s why we must redirect funding to real, community-based programs. Because trust isn’t built through TV ads. You build it in barbershops, in churches, in shuls, in community centers, and over telephone hotlines – and if  our nation  doesn’t start operating in those spaces, the forces against vaccination will triumph (and in some cases, already are).

The effort to build trust in the Coronavirus vaccine doesn’t need more funding – it needs smarter and more effective use of the funding it already has. In order for the U.S.  to ever hope of implementing a nationwide vaccination program, it must redirect ad spending to community organizations, mutual aid groups, and community leaders who can use their relationships to make sure everyone knows: getting the COVID vaccine is safe, effective, and absolutely necessary. And that must start now – because we have a long way to go, and a lot of trust to build before we get there.