53: Grassroots Vaccination Strategy

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Monday, October 25th, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.

We've got some good news from the pandemic's front lines, a story to start your week from New Jersey about a data-driven grassroots vaccination strategy that saved lives.

New Jersey commissioner of health, Judith Persichilli, tells us about her county ambassador program and the vaccination rates it delivered in today's morning conversation.

Can you explain the idea of this county ambassador program and how you have used it to tackle the COVID-19 virus in your state?

JUDITH PERSICHILLI:

Sure.

You know, when we first had our vaccination goals, we identified what we called the high watermark—we wanted 70% of eligible adults vaccinated within a six-month period. And I have to say, when we set that goal, we were the only—first state, actually, that set a goal, and people were really surprised that we set it so high. Now, we really want it to be 85%.

So, as time progressed, we noticed that—despite all of our efforts and our mega sites and, you know, vaccinating hundreds of thousands of people—there were a couple of counties and cities and municipalities that had rates significantly lower than our goal.

So, after some brainstorming, we decided to launch what I called the county ambassador program. We identified individuals here at the Department of Health that had the energy—the motivation, still—during this pandemic to get more deeply involved in hard-to-reach communities, and we deputized them as the commissioner's ambassadors. And we sent them out to counties and municipalities with the authority to marshall as many resources as needed to improve the vaccination rates in these targeted municipalities.

They engaged local elected officials, faith leaders; all healthcare-related organizations; FEMA, the Peace Corps, the National Guard for canvassing and pop-ups; churches, small businesses; they engaged street fairs and schools; and they did it as a representative of the commissioner of health.

JOHNSON:

And they hit the streets in June. It's now October.

How has it been going? Is it still going? Is it over?

What happened?

PERSICHILLI:

Well, the formal part of the program is over.

The program was data-driven to a very granular level. The ambassadors received weekly reports and reported weekly vaccination rates by their county, their municipality, zip code, down to age group. And their operating model was data first, try anything, fail fast if you're going to fail—if a pop-up doesn't work, be agile and move on.

So, approximately 216,000 first doses were given and 24 of the 28 targeted municipalities reach their 70% goal. From the program inception, 11 counties that had a gap of greater than 20,000 to reach the 70% goal were reduced to zero—they met their target.

28 municipalities with greater than 50,000 population below the 70% of the eligible population were reduced to four. So, we went from 28 municipalities with 50,000 eligible down to four. We started with 340,000 total vaccinations to reach the 70% coverage. That number was reduced to 55,000.

And lastly, we moved 66% approximate coverage in New Jersey overall to 82%.

We achieved 92% of our goal of vaccinating 70% of adults in our targeted counties. Pretty significant.

JOHNSON:

Looking at the results of this effort, what do you think was the key to its success?

PERSICHILLI:

I think the key to the success was the importance of reaching across institutional lines to forge collaborations. Flexibility and innovation were key to working to reach the goals, as were community outreach and canvassing.

But our priority was really to bring together all of the organizations in a particular municipality—the department of health, the local elected officials, the FQHCs, the hospitals that were there, the schools—and say, "We're all in this together."

JOHNSON:

Commissioner Persichilli says the model is scalable and could work in any zip code where vaccine uptake is low.

Also, she's available if any of her colleagues want to give her a call to talk about it.

Last week, we reported on a New York Times story about the state of America's public health departments. Journalist Danielle Ivory told us how she, along with colleague Mike Baker and a team at the Times, worked to gather data from departments for the report.

We shared that conversation with her on this channel Thursday and Friday, but we saved our final question for today.

If you were a public health official, how would you use this information?

DANIELLE IVORY:

Oh, that's a good question.

The responses from health officials were so similar across the board—I think perhaps some health officials can take some comfort in the idea that they're not alone and that these are shared experiences.

But I think in the end, the story itself is probably—I hope—will educate people who are not working in public health about what has been going on, especially with regard to staffing and funding.

I'm not sure that the public at large understands how difficult it has been to keep public health departments funded.

JOHNSON:

Also this morning, ASTHO has new insight for members looking to improve vaccination rates among people living with disabilities. The experiences and thoughts of 17 full-time specialists working in departments across the country are now available.

You can read their advice in an ASTHOBrief, ready for download, using the link in the show notes.

Finally today, another new ASTHO report addresses the challenges agencies have had fully spending CDC money awarded in support of the Overdose Data to Action strategy to battle the opioid epidemic.

The report offers insights from nine interviews with state teams, managing OD2A agreements.

Visit the show notes for links to both reports and all the stories mentioned in today's newscast.

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Join us tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.