Blue Shield of California is helping coordinate a grassroots effort to increase immunization rates among its members, with a particular focus on underserved communities and people of color.
To increase vaccination rates, Blue Shield is working on several fronts. During one campaign, the company made more than 3,600 calls in June and early July to members of the Promise Health Plan (Medi-Cal) who were late for a second injection. About 22% said they were already vaccinated. But more than half of the calls resulted in a voicemail message. And only 14 – 0.4% – resulted in making an appointment or providing a link.
About 79% of Californians aged 12 and older had received at least one shot of the vaccine as of October 12, according to the state’s Department of Public Health. Yet large disparities remain with regard to race and socio-economic status. For example, 89% of Asian Americans were fully immunized, compared to 65% of whites, 53% of Latinos and 52% of blacks, according to state data.
Gaps in immunization rates were also large in urban areas. For example, in Los Angeles, 106,000 members of the Blue Shield of California Promise were still unvaccinated at the end of August. In San Diego, there were 26,000 people to reach. Vaccination rates among members of these towns were between 55% and 58% at the time.
Reaching the unvaccinated
To get more members vaccinated, Blue Shield appealed to organizations with which it has a working relationship to better reach its own members in various communities. Simply put, they are close to their communities – pharmacies in areas where the greatest concentrations of unvaccinated members live or work, and providers who are relied on. For example, in Southern California, Blue Shield works with member organizations such as:
- Herald Christian Health Centers – serves Asian and Pacific Islander communities in San Gabriel Valley and San Diego
- Bienestar Human Services – Serves LatinX LGBTQIA + Communities Across Los Angeles County
- SoCal Pacific Islander COVID-19 Response Team – Focuses on Pacific Island Communities in Los Angeles County and Southern California
- Southside Coalition in South Los Angeles – serves South Los Angeles in the Black and LatinX communities
- Association for a Better Community – focuses on parenting communities in Los Angeles County.
Blue Shield has also helped organize various outreach channels, such as opening pop-up clinics and visiting members’ homes. These organizations also use a platform, Harmony Health, which offers advocates and community leaders a way to reach voters in various languages and formats. With the platform, partner organizations were able to upload their existing content in multiple languages and filter their contact lists for personalized delivery. One campaign sent leaflets by text message to 26,000 Medi-Cal members, starting with a presentation of an advocate representing one of the organizations. Emails have also been sent out and websites have been set up as part of the outreach.
Although the success rate is difficult to follow, the work is likely to help get people vaccinated. Meanwhile, Blue Shield can rely on the COVID-19 vaccination incentive program administered by the state’s Department of Health Services. The agency is making $ 100 million available to motivate all Medi-Cal members to get vaccinated between September 1, 2021 and February 28, 2022. Funds allow Blue Shield of California Promise Health Plan to provide cards- gifts as an incentive to his Medi -Calm members at the end of at least one shot.
“Challenges remain, especially in rural areas like Antelope Valley in Los Angeles County and Vista in San Diego, which are under-resourced,” says Daniel Rivas, senior director of community health at Blue Shield. But with the help of so many different organizations, Blue Shield of California executives believe the group’s effort could achieve an almost 100% vaccination rate among members.
Address systemic disparities in health equity
Relying on various partners to raise awareness of vaccinations is part of a larger Blue Shield effort to find new ways to address health inequalities exposed at the start of the pandemic, according to the executives of the organization.
Much of the infrastructure for testing and vaccination efforts has been designed to reach wealthier, more educated Californians. The mega-treatment sites were located in large complexes built around a drive-up model in metropolitan areas, disadvantaged community members who do not have their own vehicles. Tests and vaccinations had to be scheduled online, placing an undue burden on families and communities without access to Wi-Fi and computers. Online programming and selection systems continued to drive a wedge between those with resources and those without. These barriers have left many Californians behind, especially those with greater health risks.
“Historical issues such as racism, access, education, misinformation and lack of resources have had a disproportionate impact on Black, LatinX and Pacific Islander communities,” Rivas said. “Many resources implemented across the state were not culturally appropriate or community designed and did not reach our members. “
Blue Shield’s work with community organizations aims to bridge the gap. “We will continue to work with our trusted partners to inform our efforts and steer us towards strategies that work,” Rivas said. “We need to remove even more barriers to accessing and entering the institutions where our members live, work and play, instead of asking them to come see us. “