Waning demand for COVID-19 vaccinations in recent weeks has driven healthcare providers to move away from their initial strategy of operating mass vaccination sites in favor of a more targeted, but arguably more daunting approach involving community outreach.
In many ways, the next phase of the vaccine rollout is proving to have more challenges than the initial vaccination effort, said Dr. Rachel Rubin, senior medical officer and co-lead for Cook County (Ill.) Department of Public Health.
"Not only has demand gone down, but we're still dealing with very low pick-up of the vaccine in our most vulnerable communities," Rubin said. "So it has made it much more challenging."
Cook County Department of Public Health is working with the county health system, Cook County Health, on the community outreach effort. The health system recently reduced the number of mass vaccination sites it has run since December from six to three. The plan is to commit 30% of the health system's total resources toward expanding its hyperlocal vaccination initiative across 32 communities throughout suburban Chicago. A staff totaling 750 personnel have been committed to the rollout since its launch. A substantial portion of staff members who worked at the sites that are closing will be re-assigned to the mobile vaccination unit program.
Data from the Centers for Disease Control and Prevention's social vulnerability index and from the National Institutes of Health's COVID-19 Pandemic Vulnerability Index were used to identify the county's priority communities for outreach. Most of those communities have large ethnic and racial minority populations where the rates of those who are fully vaccinated are well below the county's average of 41.8%, as of June 2 .
Since the beginning, one of the goals of the vaccination effort was to build a system that was responsive to the needs of community members, said Cook County Health CEO Israel Rocha. As such, teams of mobile vaccination units have been deployed over the past several weeks to set up more than 200 temporary, pop-up sites that have administered 86,000 doses. Rocha acknowledged many of the rollout's earlier achievements were supported in part by the high level of demand for the vaccine from residents.
The plan moving forward will need to focus more on expanding and modifying the program's education and awareness effort, Rocha said, adding those efforts will involve engaging more with vaccine-hesitant individuals in the hopes that offering more of a "personal touch" will encourage those individuals to get the shot.
"Really changing the hearts and minds of individuals who still have not made the decision to get vaccinated—that is truly the hard part, so we're deploying everything," Rocha said. It's really about creating the right mix of services and education and information that will get people to make the choice to get vaccinated."
The pivot in vaccination strategy will also mean a change in expectations in terms of how success is measured moving forward. With the number of individuals getting vaccinated moving forward expected to be when compared to the early months of the rollout, it will be crucial to have vaccination personnel focus on their smaller successes to keep them motivated, said Iliana Mora, chief operating officer of ambulatory services for Cook County Health.
"What I tell the team is the hundred people we may vaccinate at a church are a hundred people who would have otherwise never gotten vaccinated or wanted to or had so many reservations," Mora said. "We overcame that barrier for those hundred people—our success will be small each day at each venue, but they will be no less critically important."