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Winning Trust to Stop COVID-19

Acting HRSA Administrator Diana Espinosa spoke at the opening plenary of the CDC's nationwide COVID-19 Vaccine Forum this week.
Acting HRSA Administrator Diana Espinosa spoke at the opening plenary of the CDC's nationwide COVID-19 Vaccine Forum last week. A virtual audience of 11,000 people representing some 6,000 organizations tuned in, underscoring the urgency of the Administration's proposed "American Rescue Plan."

​​​​​​​​​​​​​​​"HRSA is playing a vital role in supporting local community responses to the COVID-19 public health emergency … working hard to ensure that the nation’s hardest hit populations receive the vaccine." - Acting HRSA Administrator Diana Espinosa, CDC National Vaccine Forum, Feb. 22., 2021​

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Decades of mistrust of the medical establishment in minority communities – compounded by widespread misinformation about vaccine safety – have left nearly one in five Americans reluctant to seek the COVID-19 shot that could save their lives, experts said this week.

Speaking before an online audience of some 11,000 attendees nationwide, public and private sector authorities urged a concerted effort to educate the public and win back the trust of underserved populations to slow the spread of the Coronavirus.

Announced Jan. 20, the Administration's proposed American Rescue Plan would entail a massive public health campaign by multiple federal agencies – including HRSA, front and center – in a race against time, as the virus morphs into new and potentially more dangerous strains.

“The more the virus is replicating, the more these variants will be a concern,” said Dr. Rochelle Walensky, incoming director of the CDC, which hosted the forum.

Said Joshua Peck, Deputy Assistant Secretary for Public Engagement:  “There is a spectrum of views toward vaccination -- from people who have no intention to get vaccinated, to those who have questions, to those who want it as soon as possible … Our work will place equity at its core.”

Speaking during the opening session of the three-day conference, HRSA Acting Administrator Diana Espinosa assured listeners that the agency’s long history of building durable care networks in remote areas of the country – and forging ties to fragile populations – could give the plan a head start.

From L-R: Joshua Peck, Deputy Assistant Secretary for Public Engagement, HHS; Dr. Rochelle P. Walensky, Director, CDC; Kizzmekia Corbett, Team Lead, COVID-19 Vaccines, NIH; Dr. Cameron Webb, Sr. Policy Advisor, White House COVID-19 Response Team; Dr. Richard Besser, CEO, Robert Wood Johnson, former Acting Director, CDC
From L-R: Joshua Peck, Deputy Assistant Secretary for Public Engagement, HHS; Dr. Rochelle P. Walensky, Director, CDC; Kizzmekia Corbett, Team Lead, COVID-19 Vaccines, NIH; Dr. Cameron Webb, Sr. Policy Advisor, White House COVID-19 Response Team; Dr. Richard Besser, CEO, Robert Wood Johnson and former Acting Director, CDC

Principal Speaker Kizzmekia Corbett provided an overview of the Covid vaccine approval process - which was inordinately fast for a major vaccine. Addressing safety concerns, Corbett said the rapid process was made possible by years of prior research involving such similar viruses as SARS, and breakthroughs by multiple labs around the world. "Scientific integrity," she said, was assured at every step.  

HRSA-funded health centers have administered more than nine​​ million COVID-19 tests so far, and have received 988,600 doses of the vaccine to date. Now, 250 health centers serving 12.6 million patients are poised to take part in a new program under the auspices of HRSA and the CDC to step up vaccinations as the supply increases.

To ensure equitable distribution to underserved communities and those disproportionately affected by COVID-19, this program is directly allocating a limited supply of COVID-19 vaccine to these health centers that specialize in caring for affected populations. This includes individuals experiencing homelessness, public housing residents, migrant and seasonal agricultural workers and patients with limited English proficiency.  

“Since the onset of the COVID-19 pandemic,” Espinosa noted, “HRSA has been at the forefront of … standing up COVID-19 testing, therapeutics and vaccine administration efforts.”

Jim Macrae, chief of HRSA's primary care operations, stressed that delivering a refrigerated vaccine in remote areas -- like the mountain West and Coal Country, and the desert states, to name a few -- presents unique supply chain challenges for state health officials.

"There's not a Nobel Prize for ... taking the vaccine that's been produced, amazingly, to actually get it into peoples' arms," Macrae said.  "That is a monumental task that we're asking" them to accomplish.  

And yet, the job is getting done against daunting obstacles, he said, in the dead of a freezing winter.

CDC director Walensky observed that 7-day averages of new infections have been declining since the federal government’s vaccination efforts got underway; hospital admissions are down markedly from the crisis levels of last summer; and pilot vaccine programs are taking hold​ in major cities.

So far, about 13 percent of the U.S. population has received the vaccine, according to recent surveys by the U.S. Ad Council, a key public information partner.

“We’re mobilizing teams to get more shots in arms,” said Jeff Zients, White House Coronavirus Response Coordinator. “We’re bringing vaccinations to places that communities know and trust ... community centers, high school gyms, churches and stadiums,” health centers and mobile units.

Among other non-profits, nearly a hundred YMCAs nationwide have thrown their facilities into the fight, said Darrin Anderson, executive director of the New Jersey YMCA Alliance.  

Still, federal leaders said, navigating through pockets of “vaccine hesitancy" and outright resistance in certain communities is critical to getting enough people vaccinated to stop the virus from spreading.


Chart showing that vaccine intent among the total population and 4 races. Total Population: 17% resistant (to getting vaccinated), 18% skeptical, 22% open but uncertain, 30% intending; White: 12% resistant, 16% skeptical, 20% open but uncertain, 28% intending; Black: 20% resistant, 19% skeptical, 24% open but uncertain, 17% intending; Hispanic: 15% resistant, 22% skeptical, 26% open but uncertain, 22% intending; Asian: 15% resistant, 26% skeptical, 18% open but uncertain, 38% intending.
A recent survey from the Ad Council revealed that vaccine intent is lower among Black and Hispanic Americans.

Former acting CDC director Dr. Richard Besser, now CEO of the Robert Wood Johnson Foundation, noted that COVID-19 killed so many Americans last year that it caused a one-year decline in average life expectancy – a loss of life unprecedented in modern times.

For Hispanics and African Americans, it was far worse, Besser​ said: two and three years, respectively.

The disparity has given rise to calls for “vaccine equity," a nationwide drive to win back the trust of minority communities and ensure that shots are as available there as they are in health systems serving better-off localities.

“Absent equity," said Dr. Cameron Webb, Senior Policy Advisor to the White House COVID-19 Response Team and assistant professor of medicine at the University of Virginia., the virus will continue to find hosts and spread.

From L-R: Jim Macrae, Associate Administrator, Bureau of Primary Health Care; Ernest Grant, President, American Nurses Association; Lisa Sherman, President and CEO, The Ad Council; Monica Bharel, Commissioner, Massachussetts Department of Public Health; Sybil Madison, Deputy Mayor, City of Chicago, Education and Human Services.
From L-R: Jim Macrae, Associate Administrator, Bureau of Primary Health Care; Ernest Grant, President, American Nurses Association; Lisa Sherman, President and CEO, The Ad Council; Monica Bharel, Commissioner, Massachussetts Department of Public Health; Sybil Madison, Deputy Mayor, City of Chicago, Education and Human Services.

Outside Experts: Lisa Sherman said the Ad Council is prepared to launch the "largest ad campaign in our history" based on extensive audience research and surveys of recent months, while Ernest Grant said testimonials from nurses aides have proven highly effective at convincing hesitant patients. Sybil Madison added that the city of Chicago has taken the pro-vax message directly into grocery stores, laundromats and other local businesses. And Monica Bharel described her state's Trust the Facts, Get the Vax campaign.

Not only are minorities more likely to contract the virus, Webb said, they tend to have poorer access to care. Coupled to deep-seated apprehension about fairness in the health care system, they also are among populations with language and cultural barriers that must be surmounted.

HRSA, with its longstanding ties to multi-ethnic and multi-lingual ​grassroots groups, faith-based organizations, colleges and universities, is ready to have a major impact​, offered Acting Ad​ministra​tor Espinosa.

Nationwide, nearly 1,400 HRSA-funded health centers operate approximately 13,000 sites -- providing primary and preventive care on a sliding fee scale to nearly 30 million patients each year. Over 91 percent of health center patients are individuals or families living at or below 200 percent of the Federal Poverty Guidelines,​ and nearly 63 percent are racial/ethnic minorities.

Health centers across the nation are playing vital roles in supporting local community responses to the COVID-19 public health emergency. And that's why HRSA and the CDC have launched a new program to directly allocate a limited supply of COVID-19 vaccine to select HRSA-funded health centers. The program began February 15 and complements efforts in states and jurisdictions.

Learn more about the the American Rescue Plan.

Date Last Reviewed:  March 2021