A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: From theory to practice

• Published in: PloS one 2021-09, Vol.16 (9), p.e0257111-e0257111
• Main Authors: Marquez, Carina, Kerkhoff, Andrew D, Naso, Jamie, Contreras, Maria G, Castellanos Diaz, Edgar, Rojas, Susana, Peng, James, Rubio, Luis, Jones, Diane, Jacobo, Jon, Rojas, Susy, Gonzalez, Rafael, Fuchs, Jonathan D, Black, Douglas, Ribeiro, Salustiano, Nossokoff, Jen, Tulier-Laiwa, Valerie, Martinez, Jacqueline, Chamie, Gabriel, Pilarowski, Genay, DeRisi, Joseph, Petersen, Maya, Havlir, Diane V
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biology and Life Sciences; Clients; Community; Computer and Information Sciences; Coronaviruses; COVID-19; COVID-19 - immunology; COVID-19 vaccines; COVID-19 Vaccines - immunology; Delivery systems; Earth Sciences; Ethnicity; Female; Geography; Health care; Hispanic Americans; Hispanic or Latino; Hospitals; Humans; Immigration; Immunization; Infectious diseases; Influence; Laboratories; Male; Medicine; Medicine and Health Sciences; Middle Aged; Minority & ethnic groups; Neighborhoods; Noncitizens; Phlebotomy; Population; Public health; Racial Groups; Residence Characteristics; San Francisco; Severe acute respiratory syndrome coronavirus 2; Social networks; Social organization; Social Sciences; Supervision; Task forces; Time Factors; Transport buildings, stations and terminals; Trauma centers; Treatment Outcome; Vaccination; Vaccines
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0257111

COVID-19 vaccine coverage in the Latinx community depends on delivery systems that overcome barriers such as institutional distrust, misinformation, and access to care. We hypothesized that a community-centered vaccination strategy that included mobilization, vaccination, and "activation" components could successfully reach an underserved Latinx population, utilizing its social networks to boost vaccination coverage. Our community-academic-public health partnership, "Unidos en Salud," utilized a theory-informed approach to design our "Motivate, Vaccinate, and Activate" COVID-19 vaccination strategy. Our strategy's design was guided by the PRECEDE Model and sought to address and overcome predisposing, enabling, and reinforcing barriers to COVID-19 vaccination faced by Latinx individuals in San Francisco. We evaluated our prototype outdoor, "neighborhood" vaccination program located in a central commercial and transport hub in the Mission District in San Francisco, using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework during a 16-week period from February 1, 2021 to May 19, 2021. Programmatic data, city-wide COVID-19 surveillance data, and a survey conducted between May 2, 2021 and May 19, 2021 among 997 vaccinated clients ≥16 years old were used in the evaluation. There were 20,792 COVID-19 vaccinations administered at the neighborhood site during the 16-week evaluation period. Vaccine recipients had a median age of 43 (IQR 32-56) years, 53.9% were male and 70.5% were Latinx, 14.1% white, 7.7% Asian, 2.4% Black, and 5.3% other. Latinx vaccinated clients were substantially more likely than non-Latinx clients to have an annual household income of less than $50,000 a year (76.1% vs. 33.5%), be a first-generation immigrant (60.2% vs. 30.1%), not have health insurance (47.3% vs. 16.0%), and not have access to primary care provider (62.4% vs. 36.2%). The most frequently reported reasons for choosing vaccination at the site were its neighborhood location (28.6%), easy and convenient scheduling (26.9%) and recommendation by someone they trusted (18.1%); approximately 99% reported having an overall positive experience, regardless of ethnicity. Notably, 58.3% of clients reported that they were able to get vaccinated earlier because of the neighborhood vaccination site, 98.4% of clients completed both vaccine doses, and 90.7% said that they were more likely to recommend COVID-19 vaccination to family and friends after their experi