Connecting communities to COVID-19 vaccine

Dr. Chinonyelum Obih (left) and Dr. Nwando Anyaoku (right) at one of Swedish's mobile vaccination clinics.

The COVID-19 pandemic has disproportionately affected vulnerable populations and communities of color. Yet organizations across the nation have struggled to find an equitable balance in vaccine distribution. 

With a focus on community health needs, Swedish caregivers and providers recognized the impact public-private partnerships would have on our ability to get COVID-19 vaccine to those who need it most. 

In partnership with CellNetix, T-Mobile and Denali, Swedish assembled an ambitious vaccine team, comprised of hundreds of community volunteers and our caregivers, who successfully created and launched a mobile clinic program in a matter of weeks. To date, the mobile clinic has delivered more than 2,500 doses to eligible people in nine locations throughout King County. Together, with the help of community-based organizations, Swedish has connected with families and individuals who otherwise would not have access to vaccine. This month, the team will continue with phase two of mobile vaccination clinics.

Swedish Chief Health Equity Officer Nwando Anyaoku, M.D., who leads Swedish’s mobile clinic efforts, is often called upon to speak with community groups and panels about her work and experience in addressing health disparities among various communities and populations. She recently answered questions about Swedish mobile vaccine clinics and how that work fits into larger efforts to reduce disparities across communities.  

Where did the idea for the mobile vaccine units come from? 

Dr. Anyaoku: Early on, when we got our vaccine supply, we made a commitment to use a portion of our allocation to support the community. As we got past Phase 1A and started to review who we were serving, it became apparent that we needed to have a particular strategy to reach minorities and marginalized populations, because the systems that were in place were not necessarily serving them well.  

We started thinking about how best to do that and quickly arrived at building a fully mobile option where we would take the vaccine from place to place. 

How did the vaccine team decide which communities to visit? 

Dr. Anyaoku: We wanted to make sure that our efforts were directed by data. We identified zip codes and populations that were particularly affected by COVID-19 and had difficulty accessing the vaccine. From there we decided that the best way to distribute the vaccine would be by partnering with community-based organizations. When you want to serve people, you have to figure out where they live, where they go, who they trust. 

The definition of a community-based organization is very vast. Some of them are churches, some are nursing homes, some are federal qualified health centers, some are just groups that get together around some common bond or affinity. We knew that working with them would give us two things: a trusted partner that the people in those communities already knew, and access to those particular communities in a way that would be more efficient and targeted than if we were to do a blanket outreach. 

There’s a well-founded distrust of healthcare among communities of color and marginalized populations. How did you overcome that? 

Dr. Anyaoku: We went into this with the assumption that we were going to have to do a lot of work to convince people to get vaccinated. But it turned out that wasn’t the case. There were so many groups interested in working with us that one of our biggest tasks was deciding who to work with. 

We still put a lot of thought into how to begin these conversations and gain community members’ trust, though. For instance, our first location was at the Ethiopian Community Center in South Seattle. The week before our clinic, the community center held a webinar for their constituents and answered lots of questions—and they got tons of people to sign up. As it turns out, there was hesitancy, but there was also a lot of people who just needed information--which was understandable, considering the newness of the vaccine. People wanted to know if they could take it, given their own particular diagnosis or medications. So having those information sessions and being able to address peoples' concerns was extremely helpful.

We also asked each community-based organization to provide five to eight volunteers to be part of the workforce on the day of the clinic to help with wayfinding, mobility assistance and general support.

You were recently named Swedish’s first chief health equity officer. How does this project fit into larger health equity efforts? 

Dr. Anyaoku: It fits right in the middle. The work of health equity is aiming to reduce disparities in care. People are marginalized for all sorts of reasons, from race to ethnicity to sexual orientation to gender identity. 

In order for you to achieve equitable care, you need to be looking at how you're delivering care to all those different groups. The big challenge is that a lot of people think that the difference is due to a biological construct. But race or ethnicity, they really are just a proxy for several social determinants of health that affect the ability to effectively deliver or receive healthcare.

In the case of this vaccine outreach, for instance, people aren’t having trouble accessing the vaccine because, they’re elderly, African-American or allergic to the vaccine. It's because they can't readily navigate the mostly tech-based scheduling process, due to a well-documented digital divide. Nor can they easily get into a car and get to a mass vaccination site due to mobility issues. Elderly BIPOC populations are disproportionately poor or lower income. They have tech challenges. They can’t afford to take a day off, or their children can't afford to take a day off from work to take them.

Ultimately, we need to sustain these channels over time as work on reducing health disparities in other areas beyond COVID. We are hyper-focused on managing the relationships and the experience of these community-based partners, building and maintaining trust with the recognition that the relationships will be crucial to allow us to come back and talk to them about high blood pressure and diabetes or any other health challenges faced by their communities. 

Where does Swedish go from here to improve health equity? 

Dr. Anyaoku: When you walk the length and breadth of Swedish, I promise you will never find a more dedicated and committed group of caregivers. They are extremely passionate about what they do and how they care for their patients. And they’re committed to giving their very best to everyone equally. But the truth is, not all patients need to be treated the same.  

You always have to be asking, "Who am I serving? Am I reaching the people that I need to reach? Am I getting everyone served in the way that they need to be served?" My goal is to have health equity be the way we do business.