Equity, Community and Trust: Building vaccine confidence with marginalized populations

The Alliance for Healthier Communities, a network of team-based comprehensive primary health care organizations across Ontario, is implementing the Community Vaccination Promotion – Ontario (CVP-ON) project to promote equitable access to and uptake of COVID-19 vaccines for in marginalized communities most affected by the pandemic. 12 Alliance member organizations are being resourced to provide tailored vaccine promotion communication and outreach initiatives. This poster outlines the project's priority populations, centre-level initiatives, data collection processes, and early results. 

#Audio Script

Follow this link to view the poster and hearSonia Hsiung, project lead from the Alliance for Healthier Communities, describe the Community Vaccionation Project and the lessons learned from community vaccination initiatives. 

The COVID-19 pandemic has really highlighted deep-rooted social and health inequities. Racialized and lower income communities were hardest hit by COVID-19. Yet if we overlaid a map of covid-19 infections and a map of COVID-19 vaccinations, we see that that they are almost inverse, where areas that bore the highest disease burden from the pandemic, are also areas with lowest vaccine uptake. The data really underscores how challenging it can be for populations that experience systemic and historical barriers to access necessary health information and services, including COVID-19 vaccinations.

We cannot expect one-size-fit-all solutions to work. In a wide variety of settings, as you can see on the poster, the varied initiatives include uncovering the barriers and needs of the community through focus groups, responding by intentional door to door outreach with community ambassadors who reflect the linguistic and ethnic backgrounds of the population, providing logistical support such as booking and transportation, partnering with the TTC, schools, faith leaders and cultural spaces to share information and provide vaccination in familiar spaces that is perceived to be safe, hold townhalls to address misinformation and answer questions in a variety of languages, and providing live interpretation in physician offices and vaccine clinics.

All of these tailored approaches have been very successful in reaching that last mile group and sharing accurate information via linguistically and culturally appropriate forums with specific populations who would not have received or trusted the information otherwise.

The lessons learned have ramifications beyond this current pandemic. We hope this is a catalyst to having robust investments in community-led strategies that can continue to build relationships of trust between the health system and marginalized populations, so that we can emerge from the current pandemic equitably, and address other health needs and for future crises, including the expected tsunami of backlogs in cancer screening and declines in mental health.

** By building on long-standing, trusted relationships with their priority populations, our members have been able to listen deeply and respond innovatively with tailored approaches to advance vaccine confidence in communities where there are long histories of medical distrust and systemic barriers from historical underfunding. **