Opportunities in COVID-19 Vaccine Access and Equity

While COVID-19 vaccine eligibility has expanded and supply has increased, data show that access to vaccines are not equitable throughout California’s communities.

Health care leaders are looking to work together differently as their vaccination efforts shift from trying to meet demand through mass vaccination sites to targeted interventions that address the needs and concerns of high-risk communities and vaccine-hesitant individuals.

In late April, PBGH’s California Quality Collaborative (CQC) hosted a closed roundtable discussion for health plans, provider groups and California state agency representatives to discuss challenges and success stories in their efforts to distribute COVID-19 vaccines and support equitable vaccine distribution for under-resourced populations. Five key actions stakeholders need to take emerged from the conversation:

1. Invest internally in policies supporting equity. During the past year, many organizations worked to improve internal processes that would better enable them to serve the diverse needs of their members and staff. L.A. Care Health Plan, the nation’s largest public health plan with nearly 2.2 million members, for example, developed a set of more robust internal policies to address diversity and inclusion, as well as programs designed to minimize barriers in working with minority or women-owned businesses, an approach described in the Clinical Improvement Network Connections spring 2021 publication.

2. Facilitate real-time data sharing. All groups agreed that, while there had been investments in data-sharing that facilitated collaboration to distribute and ensure access to vaccines, there were still gaps between health care delivery systems, public health and community-based organizations in terms of the accuracy of, and timeliness with which, essential clinical data was shared. As we begin to recover from the pandemic work should be done to ensure real-time data-sharing, especially between the California Immunization Registry and health information exchanges and organizations not traditionally part of health care information exchanges.

3. Provide clear, consistent and trusted communication. It was extremely important for all entities to streamline, test and regularly deliver communications campaigns to stakeholders, including community members, provider groups and member patients.

4. Leverage trusted relationships from primary care providers. Primary care providers were unable to play a significant role in the early days of vaccine distribution, often because mass vaccination sites were prioritized so individual practices received limited vaccine supply or were unprepared to accommodate the stringent storage requirements. With vaccine distribution having stabilized, there is an opportunity to tap into the primary care provider community, which is positioned to leverage long-standing patient relationships and play an important role in vaccination efforts. Increasing primary care’s role in COVID-19 vaccine administration may prove extremely effective in reaching vaccine-hesitant or skeptical patients.

5. Sustain new and strengthened partnerships. Overall, there was a recognition that the public health emergency and response has illuminated how effective cross-sector collaboration between health plans, public health departments, provider groups and community-based organizations can be at solving urgent problems when working together. Now, there is a question about how partnering groups can continue to collaborate while finding ways to become more efficient.

COVID-19 Vaccine Resources

• Cynosure Health – Vaccine Acceptance Toolkit
• Kaiser Family Foundation & the Black Coalition Against COVID – THE CONVERSATION: Between Us, About Us
• Vaccine Distribution—Equity Left Behind? JAMA. 2021;325(9):829–830 (1/29/21)
• Health Equity Focus Needed to Vaccinate Our Way Out of Pandemic. California Health Care Foundation Blog Post (3/4/21)
• Black People Need Better Vaccine Access, Not Better Vaccine Attitudes. New York Times Opinion (3/5/21)
• Getting to Yes: A Nursing Home’s Mission to Vaccinate Its Hesitant Staff. New York Times (3/28/21)
• Are Health Centers Facilitating Equitable Access to COVID-19 Vaccinations? Kaiser Family Foundation (3/10/21)
• Webinar: State and Regional Approaches to Equitable COVID-19 Vaccination Efforts. Network for Regional Healthcare Improvement (3/25/21)
• Data and Door Knocking: One City’s Push for Racial Equity in Vaccines. Tradeoffs Podcast (3/4/21)