Rural and low-cost health care providers are no stranger to the old proverb, “It takes a village.”
“We’re used to leaning on each other to get the job done,” Danielle Persky, spokesperson for the Van Buren/Cass District Health Department (VBCDHD).
That’s why when it comes to getting COVID-19 vaccines into the arms of people in Berrien, Cass and Van Buren counties, it has been a team effort, especially when trying to reach the hard to reach.
Geography, socio-economic status, race and age have all created their own challenges.
Velma Hendershott, president and CEO of InterCare Community Health Network, said its their mission to take care of all of the underserved communities in its service areas of Allegan, Berrien, Cass, Ottawa and Van Buren counties.
“Clearly, I think we all recognize that COVID has disproportionally hit some of our most vulnerable and that’s many of the patients that we serve,” she said this week.
InterCare, a federally qualified health center, has been working to vaccinate homeless people, migrant agriculture workers, residents of public housing and people with limited English proficiency.
It was chosen as one of the first 25 health centers in America to participate in a direct allocation of vaccine from the Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC).
“We got going in mid-late February and since then we’ve been able to get direct shipments from them on a weekly basis of Moderna and some Johnson & Johnson,” Hendershott said.
InterCare and the VBCDHD have been holding vaccination clinics anywhere they can find.
“We get really creative. We look around and ask, who has the most available indoor space or parking lot space?” Persky said.
While there are convention centers and stadiums to rent out in larger communities, vaccine providers surrounded by miles and miles of farmland are limited where they can hold mass clinics.
Clinics have been held at schools, churches, community centers, fire department bays, and at their clinic offices.
Partnering with employers has proven to be an effective way to reach large groups of people.
For example, Persky said the VBCHD did a second-dose clinic at Coca-Cola in Paw Paw earlier this month.
“They have a significant number of employees, and so we went on site and did a drive-thru clinic for them,” she said.
Last week, additional vaccination clinics took place at Covert Fire Department and South Haven Senior Services.
Hendershott said InterCare did a clinic at Burnette Foods in Hartford in March and got 100 of its food processing workers vaccinated.
As migrant farm workers begin to arrive in Southwest Michigan this spring, InterCare is traveling out to farms to get that population protected.
“We never know the mobility of our migrant farm workers, so we really want to take advantage when they arrive,” Hendershott said.
InterCare has also sent some of its staff to help other vaccine providers, specifically with interpretation services at clinics in which more Spanish speakers are going to be present.
“It’s taken a village, so to speak, to try to get to everyone,” she said. “Communication, collaboration and coordination is what’s happening and we’re using all venues possible.”
Persky said transportation and internet access have also been barriers to getting people to clinics.
“Just in general, I think in that rural component, we also just have smaller health departments, smaller partners and smaller staff. Your bandwidth, even with volunteers, is still at some sort of limited capacity,” she said.
A hesitant shift
While InterCare and the VBCDHD have seen a super high demand for the vaccine, that’s starting to wane.
“We may have to shift gears into communication, education and taking on that health promotion aspect to the vaccine, which initially was not really an issue we had to address because the demand was so high and the supply was so limited,” Persky said.
Hendershott said vaccine hesitancy is proving to be a big problem with the population InterCare serves because many are people of color, who the health care system has not always treated well.
“If they’ve heard stories or know someone who maybe had a bit of a side effect with the vaccine, that impacts them,” she said.
She said InterCare staff have spent a lot of time lately working to make sure their education and messaging is simple, clear and accurate.
“A lot of people who are not taking advantage of the vaccine have barriers to getting it,” Hendershott said. “Whether it’s language, transportation, education or outreach. The barriers that people normally who use our services would have are all compounded now with COVID and all the information and misinformation that’s out there.”
She said many hesitant individuals are looking for the Johnson & Johnson one-shot vaccine, however, last week, health officials have postponed use of the vaccine until further study (see related story).
“So we’re doing the best we can to teach, outreach, educate, promote, anything we possibly can to try to combat all the myths,” Hendershott said. “Our goal will to be doing this as long as it takes.”