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By: Katherine H. Capps, Executive Director, GTMRx Institute

Needed: a sense of urgency to get shots in arms

June 16, 2021

Unless we get more needles in arms, more people will die. As of June 15, only 43.9% of country’s population was fully vaccinated against COVID-19, according to the CDC. Even if we meet President Biden’s goal of 70% of U.S. adults at least partially vaccinated by July 4, that means 30% will remain completely unvaccinated.

I think everyone knows that. But here’s what’s truly concerning: A lot of those people in that 30% have no plans to get the shot. In short, we’re running out of people who want the vaccine. The unvaccinated “wait and see” group (12% of U.S. adults in May) has decreased over the past several months, but the “definitely not” group has remained steady at around 13%, according to a new Kaiser Family Foundation report.

Most of those who continue to say, “definitely not,” lack confidence in the vaccines. That lack of confidence may be deadly: It is a barrier to public health efforts and increases the risk that those new strains will thrive, driving up cases, hospitalizations and deaths.

We already see the consequences: Infections are dropping in places where most residents have been immunized and are rising in many places people have not, according to a recent analysis by the Washington Post. States with lower vaccination rates also have significantly higher hospitalization rates.

Are you surprised? I’m certainly not.

Beyond a sense of urgency
A recent CNN analysis piece concluded with this: “The key over the next month will be for these unvaccinated people to have a sense of urgency to receive their first dose.” That’s absolutely true, of course. But where will that sense of urgency come from? To get those needles in arms, we need to boost confidence in the vaccines.

And that’s one of the key points of a new report. The GTMRx National Task Force on Building Vaccine Confidence in the Health Neighborhood recently released Report and Recommendations of the GTMRx National Task Force—Building Vaccine Confidence in the Health Neighborhood.

The report contains an array of recommendations, but I want to focus on this: It will take a local, grassroots efforts, neighbors who trust one another, to build vaccine confidence.

Deploying trusted messengers
Many factors affect the uptake of vaccinations, such as fear of harmful side effects, concern about how quickly vaccines were developed, distrust of political leaders, religious objections and a variety of conspiracy theories. (And yes, I can say for the record that the vaccine will not magnetize you or connect you to 5G.)

Those who hold these fears and misconceptions are unlikely to listen to the CDC, state officials or even Dr. Fauci. They are much more likely to listen to a trusted messenger: a neighbor, a pastor or a local community organizer.

Vaccine Confidence Leagues
Among its many recommendations, the GTMRx report calls on local health leaders to establish “Vaccine Confidence Leagues,” which will mobilize local efforts and recruit health and civic leaders as trusted messengers.

These messengers may include physicians and nurses, pharmacists, faith leaders, business leaders respected civic and tribal leaders and organizations and enterprises that play key roles in communities, such as barber shops and hair salons. They have the ear of the community, and they can address immediate vaccine concerns and instill long-term confidence in ways the government cannot.

No one is swooping in from the government to tell them what’s best. The bottom-up approach we propose builds on existing trusted relationships. It will focus on fact-based conversations and understanding of attitudes and behaviors, not lectures. The goal is person-to-person outreach, respectfully listening to and addressing an individuals’ concerns. Vaccine Confidence Leagues complement and run along-side national efforts, expanding the impact among those who haven’t been vaccinated yet and who trust their doctors, ministers and community leaders to work in their best interest.

And consider this: Local isn’t only more effective: It’s also more efficient.

Vaccine Confidence Leagues can adapt and pivot to meet community needs as they arise. There’s no need to wait for direction from on high. (Although, I have to add that seed funding from on high wouldn’t hurt. But that’s another blog post for another day.)

Ideally, these efforts will outlast the pandemic. They will spring from the community. They can then take on health in their communities and work to expand utilization and take-up of all adult and childhood vaccines.

Not only local
In addition to development of Vaccine Confidence Leagues (VCLs) and community-building activities, the report also includes recommendations directed at federal and state regulators. These include the following:

  • Accelerated approval of vaccines
  • Public education
  • Payment reform
  • Support for the public health infrastructure.
  • Improved vaccine access for primary care practices—in fact, parity of vaccine supply to all vaccination sites.
  • More effective immunization information systems (IIS)
  • No cost-sharing for certain patients
  • Enhanced diversity, inclusion and equity

Read the Report. Share it. Learn more.
This report represents 90 days of work by the GTMRx National Task Force on Building Vaccine Confidence in the Health Neighborhood, led by

  • Paul W. Abramowitz, Pharm.D., ScD (Hon), FASHP, CEO, American Society of Health-System Pharmacists
  • Georges C. Benjamin, MD, executive director, American Public Health Association
  • Susan Dentzer, senior policy fellow, Robert J. Margolis Center for Health Policy at Duke University

It contains a wealth of information on vaccine confidence and spells out each of our recommendations in detail. I urge you to read it and share it.

It’s not only the unvaccinated who need a sense of urgency. We need one if we are to improve vaccine uptake, save lives, move past the pandemic and get back to normal.

In addition to being Co-founder and Executive Director, Katherine H. Capps served as staff officer on the the GTMRx National Task Force on Building Vaccine Confidence in the Health Neighborhood.

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