The CDC defines COVID-19 vaccine equity 1 as fair and just access to COVID-19 vaccination for all people. There are a myriad of social, geographic, political, economic, and environmental factors that create challenges to vaccination access and acceptance, and that often affect racial and ethnic minority groups disproportionately. These may include:
Education, income, and wealth gaps
Job access and working conditions
Racism and other forms of discrimination
Gaps in healthcare access
Transportation and neighborhood conditions
Lack of trust as a result of past medical racism and experimentation
In 2021, El Sol Neighborhood Education Center’s COVID 19 Response Efforts were recognized by Dr. Anthony Fauci. El Sol promotores were invited to the White House to commemorate their efforts. Dr. Facui lauded El Sol for its leadership in addressing equity gaps and expanding vaccine access among underserved Inland Empire communities. The State of California recognized El Sol as the leader in equity-centered approaches to raise awareness and address vaccine hesitancy for COVID-19 in 2021. And in 2020, the CDC selected us as one of 10 national organizations excelling in effectively deploying CHWs to address COVID-19 in the Inland Empire – especially those who live in vulnerable neighborhoods.
El Sol’s process
When the pandemic began to affect communities served by El Sol Neighborhood Educational Center in April 2020, El Sol immediately developed a COVID-19 script and began conducting phone calls to participants from its various programs. We initiated community conversations about the coronavirus and how it affects adults and children, especially at-risk community members. During every phone call, we ensured everyone had access to information, testing access, vaccination updates, all the while leveraging resources
As soon as families began to disclose Covid-19 positive diagnoses to CHWs/Promotores, El Sol immediately allocated three part-time El Sol CHWs/Promotores to work in San Bernardino and Riverside County communities to provide social support to these families and others who were high-risk. To ensure families who are diagnosed or at high-risk for Covid-19 have access to necessary resources, the CHWs/Promotores safely delivered food and other supplies to ensure community wellbeing by promoting safe quarantine practices. El Sol’s COVID-19 prevention efforts also included leading dozens of pop-up vaccination events and clinics throughout the Inland Empire to deliver nearly 6,000 COVID-19 vaccinations, distributing nearly 7,000 COVID-19 care kits and training community health workers.
El Sol’s COVID-19 Communication and Educational Resources
As the pandemic gripped California, El Sol created culturally relevant, accurate, and comforting Spanish and English COVID-19 resources, incorporating pop culture elements, to engage Inland Empire communities most affected by COVID-19. These included COVID-19 self-care toolkits, COVID-19 comic strips, educational activity books, engaging videos, theatrical plays, and song and dance videos (A Time to Heal and the official COVID-19 song). Through these, we met CDC recommended Communication and Educational milestones[1] for the pandemic:
- Help build vaccine confidence
- Share clear and accurate information to educate about COVID-19
- Raise awareness about the benefits of vaccination while addressing common questions and concerns
- Adapt key messages to the language, tone, and format that will resonate with Latinx, Black and Asian communities
- Understand community needs regarding COVID-19 vaccines
Perhaps most importantly, El Sol CHWs/Ps did whatever it took to empathize with, support, and heal people
“I remember January 2021 we did 600 + tests in one day and 400 people tested positive. The head of the Collaborative said if any of you get infected, we will shut down. In 4 hours we could not go to the restroom or eat, or anything. In your 4 hours, you had to be standing, doing tests, waiting for people. After those 4 hours someone would come to replace you so you. Therefore, we had to eat or go to the restroom before putting on the equipment. After putting on the equipment, you could not take it off. Therefore, it was something that made us mature, grow, be empathetic.”
– Esperanza Sotelo, El Sol COVID Vaccine Equity Promoter Director
Conclusion
CHWs have played a critical role in the COVID-19 pandemic response through educating populations, early detection, community surveillance, and contact tracing. Because they hail from the communities in which they work and understand community perceptions and beliefs, CHWs/Ps possess another invaluable asset: local trust. This makes them ideally placed to combat vaccine hesitancy and misinformation and to encourage their peers to get vaccinated. By working within the existing social structures of a community, CHWs have the opportunity to increase vaccine uptake through engagement, education, and myth-busting. The COVID-19 pandemic reminds us that CHWs/Ps who are equipped, trained, and paid as part of a well-functioning health system can help keep pandemics in check and maintain health services equity and access.2 To learn more about El Sol’s culturally responsive media resources, contact media@elsolnec.org.
[1]https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/vaccine-equity.html
[2] https://www.ghspjournal.org/content/10/2/e2100648