Sharing Lessons Learned to Bring COVID-19 Vaccines to the World

  • Atrium Health, which has held mass vaccination events at Bank of America Stadium and Charlotte Motor Speedway, as well as establishing innovative roving vaccination sites for underserved and rural communities, to ensure equitable access.
  • Bellin Health, which operates the Lambeau Field Community COVID-19 Vaccination Site in partnership with Brown County Public Health and the Green Bay Packers.
  • The Canada International Scientific Exchange Program (CISEPO).
  • CIC Health, which operates mass vaccination sites in Massachusetts at Gillette Stadium, the Reggie Lewis Center, and Hynes Convention Center (the latter currently in partnership with FEMA). Mass General Brigham provides medical direction for all CIC Health vaccination sites.
  • CORE (Community Organized Relief Effort), which operates sites at Dodger Stadium in Los Angeles alongside its partners at the City of Los Angeles, LAFD, and medical partners Carbon Health, Curative, and USC School of Pharmacy. CORE also staffs the Mercedes Benz Stadium in Atlanta, in partnership with AFCEMA of Fulton County.
  • The State of New Hampshire, which operates the New Hampshire Motor Speedway Mass Vaccination Site in partnership with Regional Public Health Networks, and local police, fire and EMS, and hospitals across the state.
  • UCHealth, which operated the mass vaccination site at Coors Field in partnership with the Colorado Rockies, Denver Police Department, Colorado Department of Public Health and Environment, City and County of Denver, and Verizon — and continues to offer vaccines to up to 40,000 people a week at its 11 locations across Colorado.
  • UC San Diego Health, which operated the Petco Park site and maintains a site on its campus.
  • Metro Public Health Department, which operates mass vaccination clinics in Nashville, TN, in partnership with Meharry Medical College, the Music City Center, FEMA, U.S. Forestry Service, Nissan Stadium, and the Tennessee Titans.

Table of Contents

Boost and the Effort to Support Vaccinators Around the World

What the numbers tell us about vaccine equity

COVID Campaign 101: How Holy Cross Used the Spirit of Competition to Achieve a 90-plus Percent Campus Vaccination Rate

The Complicated Effort to Reach Those Reluctant to Get the COVID-19 Vaccine

How Do We Reach Vaccine Deserts?

Could Schools Be A Vital Link for Widespread Vaccinations?

Bottom up, not top down, will be solution to vaccination efforts in India

Incentives and Disincentives for Vaccination

Canada’s Fragmented Response to COVID-19

Shifts in Vaccination Focus: International and Children

Assessing Risk on a Plane — As You Fly It

Fear? Football? Free drinks? Freebies? What Motivates People to Get Vaccinated

Be Our Guest: Turning Vaccination in an Experience

The Rules of Engagement for U.S. Military in Emergencies or Medical Crises

Coping With an Ever-Changing Vaccine Landscape

Dream Helps Solve Potential Nightmare

Charlotte Motor Speedway and Bank of America Stadium: >36,000 vaccines in less than 10 days

CORE tackles vaccinations from mass sites to mobile units

Kickoff Meeting Delves into Logistics of Nashville Event that Vaccinated 10,000 in a day

Boost and the Effort to Support Vaccinators Around the World

Key Takeaways:

  • Provide a platform for immunization professionals and other health professionals involved in vaccination efforts to share perspectives.
  • Creating two-way conversations so that immunization staff can reach and support each other, and experts. Make sure immunization staff at all levels “feel heard.”
  • When creating incentives for immunization, know your audience and proceed appropriately.
  • Enhance equitable vaccine delivery by identifying areas that would benefit from additional country-level support.
  • Utilize adaptive leadership and community building capacity building at all levels in the immunization system to move organizations, communities, and teams beyond the status quo.
  • Utilize the power of narrative and storytelling to advocate for change.

What the numbers tell us about vaccine equity

Key Takeaways

  • Vaccine hesitancy has many roots but the dominant one is fear of side effects.
  • Those who adopt a “wait and see” attitude will be much harder to convince than those concerned about side effects.
  • The Delta variation is having an effect on decreasing hesitancy.
  • More education is needed about infection rates versus hospitalization rates to show that the vaccines are, indeed, having an effect on saving lives.
  • A high Social Vulnerability Index seems correlated with a lower vaccination rate, which may help to devise more effective interventions.

COVID Campaign 101: How Holy Cross Used the Spirit of Competition to Achieve a 90-plus Percent Campus Vaccination Rate

Key Takeaways for Campus Vaccination Campaigns

  • Keep it simple. Have easily recognizable incentives for vaccinations.
  • Work with partners and stakeholders, such as student government leaders, the college communications department, student ambassadors and senior administrators.
  • Meet students where they are — which is usually by social media and text messaging. Parents read emails — students are more likely to read texts.
  • Positive peer pressure really works, even with young adults.

The Complicated Effort to Reach Those Reluctant to Get the COVID-19 Vaccine

Key Takeaways

  • Safety and side effects; they may have had bad experience with previous shots.
  • Efficacy. Will it work as promised?
  • Concern about the speed in which the vaccine was developed. Was it rushed?
  • General mistrust of the government and health care system
  • Personal physicians can be trusted messengers but there are others, including community and religious leaders.
  • Reasons for declining a vaccination may be multifaceted; there is often no one fact or piece of evidence that will be convincing.
  • Every reluctant person who agrees to a vaccination is a victory and should be celebrated.

How Do We Reach Vaccine Deserts?

Key Takeaways

  • The Vaccine Equity Planner tool identifies vaccine deserts, where people have little or no convenient access to vaccination and potential new vaccination sites to address the gaps.
  • Some barriers that interfere with reaching and supporting vaccine deserts include time, distance, and cost limits, as well as vaccine storage and wastage.
  • It is essential to locate these vaccine deserts and address the need for potential sites in order to improve access and distribution of the COVID-19 vaccine on a federal level.

Could Schools Be A Vital Link for Widespread Vaccinations?

Key Takeaways

  • Schools are familiar, public places of safety and trust and school buildings can be ideal sites for vaccination centers.
  • Schools can be places for debate on policy concerning vaccinations but can also play a role as a source of reliable, vetted and credible evidence on COVID-19 and vaccines.
  • Acknowledging the differences among groups hesitant to get the vaccine is a step in developing the ways and means to reach those different groups.

Bottom up, not top down, will be solution to vaccination efforts in India

Key Takeaways

  • Convenience is key for the hesitant. Minimize travel and wait times, cater to the schedules of daily wage-earners and provide respectful and safe services.
  • Use existing trust capital. Reach out to trusted local leaders and community-based organizations.
  • It’s not just medical. Utilize non-medical personnel and trained volunteers for community mobilization, crowd control and support, registration, and overall management and troubleshooting.

Incentives and Disincentives for Vaccination

Key Takeaways

  • Incentives include: Awards or prizes; relaxing mask-wearing policies; sponsored meals.
  • Disincentives include: Elimination of paid absent time for suspect COVID exposure; limiting participating in activities like conferences and travel.
  • Mandate all new hires to be vaccinated.
  • Offer vaccine during health screenings.
  • Increase vaccine availability at on-site clinics.
  • Establish “Vaccine to You Rounding Team” to bring vaccine units in key areas to acute care facilities.
  • Support rounding teams with vaccine ambassadors and/or infectious disease experts.
  • Push “safety for patients” message.
  • Share internal data of vaccine effectiveness.

Canada’s Fragmented Response to COVID-19

  • A fragmented vaccine effort, with community-based organization bearing the brunt of reaching out to hot-spot areas.
  • Essential/frontline workers faced unsafe conditions and burnout due to high demand.
  • Pushback on using age as the determining factor for vaccine priority.
  • A major lack of vaccine supplies that severely affected distribution plans.
  • Burnout and stress among health professionals trying to administer vaccines.
  • Over reliance on volunteers, who were not compensated.
  • Difficulty in getting professional staff to operate in different locations due to licensing rules in Canada that do not transfer from province to province.

Key Takeaways

  • Vaccine reluctance does not respond to “shaming” and there are often other root factors preventing those interested in being vaccinated from obtaining vaccination such as: work schedules that don’t align with clinic hours, lack of sick pay or time off for vaccination, difficulty in getting to mass vaccination sites, poor access to childcare, or linguistic barriers. Instead, teams should work with community members and trusted local leaders (faith based, community interest groups, residents committees) to understand the variable barriers to vaccination.
  • Lead with compassion by designing vaccination centres that are trauma informed and anti-oppression through practical measures like providing “hearts” at registration to indicate the need for private tents or areas for youth with anxiety, seniors with mobility issues, or immigrants and newcomers with cultural needs for privacy or additional vaccination support.
  • Try to partner with like minded groups like Vaccines Hunters Canada; use social media and stage events such as Doses After Dark and Jabapalooza to get to where the people are and bridge the need/availability gap.
  • Advocate for pan-Canadian licensing so professionals can practice in different provinces.
  • Focus on integrating principles of Just Recovery for All, which prioritizes people’s health, wellbeing, and equity.

Shifts in Vaccination Focus: International and Children

Key Takeaways

  • Be cautious about shutting down mass vaccination sites if there is a chance they will need to be re-opened in the fall. Considering building plans on how to quickly and efficiently re-open sites if needed.
  • International efforts should consider how to relieve fatigued and stressed health-care workers as well as getting shots in arms.
  • Consent forms for getting children vaccinated will be a challenge. Plan ahead as much as possible.

Assessing Risk on a Plane — As You Fly It

  • Examine errors. Is it the person or the system? Most of the time it’s the system.
  • There are two reasons why humans follow rules. One: You’re afraid you are going to get caught if you do not follow rules. (You drive differently when a police car is behind you.) Two: You appreciate the risk of not following the rules.
  • You cannot punish somebody into better task performance.
  • Avoid attributing vaccine hesitancy to specific groups. Rather, emphasize that there is a “well-earned distrust of the medical community.” Roy noted that you can really only say there is hesitation when you have the supply and the opportunity for vaccination, which was not the case. “We shot ourselves in the foot right out of the gate,” he said.
  • Humans are only vigilant to a certain level for a certain period of time. People have to be acutely attuned to risk to remain aware of it.

Fear? Football? Free drinks? Freebies? What Motivates People to Get Vaccinated

Key Takeaways

  • Incentives for vaccinations can take many forms, from offering shots in an alluring place (like Lambeau Field’s top-level suites) to handing out a free beer from a site in a brew pub.
  • Media campaigns can be most effective when they employ local influencers, rather than actors.
  • A hub and spoke model for vaccine distribution, in which a central location then supplies mobile or satellite clinics, can be effective.
  • People may be losing a sense of urgency about vaccination but vaccination efforts should not be deterred, rather teams should settle in for a long haul.

Be Our Guest: Turning Vaccination into an Experience

  • Setting up pop-up sites on Revere Beach, a popular location for the area.
  • Working with cities to set up special vaccine buses that would move from bus stop to bus stop to administer doses.
  • Use pop-up sites like churches, high school stadiums, and community centers during some days of the week for first doses, while maintaining a fixed site for second doses.

Key Takeaways

  • Vaccination is not merely a procedure. The experience of the vaccine is as important as the vaccine itself.
  • A communication strategy should be set at the beginning of the operation and refined throughout.
  • Vaccination sites should utilize design principles and consider human factors, such as how you welcome people, set expectations, and provide information.
  • Strive to amplify the effect of vaccination by creating social media platforms.
  • Aim to turn every guest into an advocate for vaccination.
  • Highlight and create assets out of milestones; share and allow guests to share these assets.

The Rules of Engagement for U.S. Military in Emergencies or Medical Crises

  • The President or the Secretary of Defense must authorize the support.
  • It mitigates the effects of a disaster or catastrophe (manmade, natural, or terrorist).
  • It provides temporary essential services at home or abroad.
  • Department of Defense always operates in support of the Lead Federal Agency.

Key Takeaways

  • The U.S. Military is prepared and ready to lend aid. The Department of Defense follows set protocols to ensure that military personnel always coordinate with civilian authorities.

Coping With an Ever-Changing Vaccine Landscape

  • Stay flexible.Vaccination efforts may morph from mass sites to smaller sites, but a hybrid model might work at the current time.
  • Be clear about guidelines for thawing vaccines as teams may have more doses than they first realize.
  • Be creative. Go to where people are — even if it is a bar.

Dream Helps Solve Potential Nightmare

Key Takeaways

  • The use of a “bail-out” or snafu space for drivers with registration issues to pull into is crucial to keep the general traffic flowing.
  • When the team began to use Epic Rover, a mobile app that allows clinicians to record documentation and conduct barcode validation at the point of care, they were able to substantially reduce the time from registration to vaccination.
  • The creation and implementation of a real-time data collection tool allowed for visualization of throughput and actionable data for day-of and post-hoc clinic improvements.
  • The reduction or elimination of post-vaccine observation time for a second dose might be considered, although this was not a point of universal agreement.

Charlotte Motor Speedway and Bank of America Stadium: >36,000 vaccines in less than 10 days

Key takeaways

  • Utilize healthcare staff, especially nurses, to lead the efforts.
  • Think like Disney and “prime the line” so that people get through quickly with the goal of making it a pleasant experience.
  • Keep track of data and use it to make real-time adjustments. For example, if you find you are running no-show rates of 2–3 percent, schedule more appointments using social media to alert people.
  • Manage private-public partnerships for effective results.
  • Set up processes and policies so doses can be taken off-site to manage the left-overs, i.e., establish a chain of custody.
  • People feel more comfortable going somewhere in the community rather than being shuttled to another location.

CORE tackles vaccinations from mass sites to mobile units

  • Ensuring sufficient supplies across such a large, spread-out venue.
  • Having all staffers HIPAA certified.
  • Oversight in such a large, spread-out venue.
  • Traffic impact in the neighborhood.
  • Ensuring enough vaccines were on hand but not overdrawing and risking the vaccines expiring.
  • Maintaining communications among the many partners, which included the mayor’s office, the local fire department, medical software companies, local universities, and community organizations.

Key Takeaways

  • Be prepared for unexpected difficulties.
  • Mobile units are helpful for reaching those without access to computers or wifi or with limited computer skills.
  • Walk-in clinics may prove to be the most cost-effective option.

Kickoff Meeting Delves into Logistics of Nashville Event that Vaccinated 10,000 in a day

Key Takeaways

  • Have emergency plans in place to ensure that if something happens, health officials can move quickly.
  • Keep an eye on traffic flow in mass sites and pivot as needed to avoid bottlenecks.
  • Be prepared to deal with weather — either to reschedule or power through.

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