In Baltimore, and across the country, supply now outweighs demand for the COVID-19 vaccine.
That has led city health officials to shift their strategy to reach their goal of vaccinating 80% of the population by February. Part of that means moving away from mass vaccination sites and ramping up more accessible mobile clinics.
“How do we allocate resources directly to the community to really meet people where they are?” Baltimore City Health Commissioner Letitia Dzirasa said at a recent vaccine hearing with city council members. “Engage people at the level of where they live, where they work, where they play.”
Dzirasa told council members that daily vaccination rates have slowed since May.
“The vaccine is very widely available now,” she said. “And still, there are many who are unvaccinated.”
As of Tuesday morning, only about half of Baltimore city’s residents have gotten at least one dose of the COVID-19 vaccine.
The health department has launched VALUE Baltimore, a vaccine education and community engagement program.
VALUE stands for Vaccine Acceptance and Access Lives in Unity, Education, and Engagement. It’s a partnership between the health department and institutions like the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, Morgan State University and the Maryland Institute College of Art.
Dzirasa announced the partnership in February, when vaccines were scarce. Now, as many of those who want the vaccine have gotten one, the project will be a key tool for ramping up vaccination numbers.
Lois Privor-Dumm, director of adult vaccines at Bloomberg’s international vaccine access center, called VALUE a “new way” of doing vaccine education.
“It's not about us as public health professionals, telling people in the community what we know,” Privor-Dumm said. “It's about having the community be an equal partner.”
Faith leaders like Reverend Terris King help the VALUE team build trust with the community. King is the pastor of the Liberty Grace Church of God in Baltimore. He said vaccine education done right is not a one-way street.
“Institutions come into the situation too often thinking they know the answer for the community,” King said. “But the community is the answer.”
The VALUE project recruits “ambassadors” directly from the community. These ambassadors represent one of various groups, including Latinx residents, young men, pregnant and lactating women, seniors and residents experiencing homelessness.
Those groups each have their own particular concerns about the vaccine. Some seniors, for example, have concerns about how the vaccine would interfere with their medications.
Young men, on the other hand, may feel they’re at low risk, especially now that cases of COVID are going down.
Ambassadors canvass neighborhoods and hold listening sessions over Zoom. Health experts like Privor-Dumm can answer any questions residents may have.
“We can figure out, what are the things that they're most concerned about? How can we address them?” she said.
Residents who are part of these listening sessions can also volunteer to be ambassadors themselves.
That’s only part of the listening session. Becky Slogeris is the associate director of the center of social design at MICA. MICA helps design pamphlets and other communication materials to build vaccine confidence.
For Slogeris, a core piece of listening sessions is what she calls the “co-design process.” During the co-design process, artists and residents brainstorm ideas together on community outreach for the vaccine.
“After doing that brainstorming, it's not like we just go away and they never see us again,” Slogeris said. “We keep continually showing up and saying, here are the ideas. Should we tweak the language? Should we tweak the visuals?”
Slogeris and other MICA artists gear their work to each VALUE group. For example, they adjust the text on pamphlets for people with disabilities and seniors, who may be visually impaired.
“There are versions that are Braille, and then there are versions that are large print,” she said.
Young men also offer design ideas for t-shirts they can wear after they’re vaccinated. Kayla Joy is a MICA alum and design strategist for VALUE. She helps oversee that project.
“One of the guys at one of the listening sessions was like, you know, we just need a shirt that just says that I did it,” Joy said.
Those shirts aren’t out yet - though Joy does have some draft designs.
“We kind of took this concept that they came up with, and we gave it a Baltimore flair,” she said.
With small rewards like these, the VALUE team hopes to broaden its community outreach.
In May, Terran Roundtree, a clinical assistant from West Baltimore, was getting her vaccine at a mobile clinic at the Orleans Street Enoch Pratt Free Library. She noticed a VALUE team distributing flyers and light refreshments, as well as diapers and other resources for expectant and new mothers who might pass by.
Roundtree, who is the mother of a five month old, says that’s a good way to get their interest.
“Made you want to come and see what's going on,” she said. “It was a nice setup. It was easy.”
Roundtree did not always want a vaccine. When the rollout began, she was still pregnant, and she wasn’t sure how it would affect her breastfeeding.
“I really wasn't interested in possibly getting it at all,” she said.
The CDC says while there is limited data on how pregnant women specifically are affected, there are no indications it shouldn’t be safe.
Roundtree also wasn’t sure why she should get a vaccine if there are some people who can still get COVID. But COVID cases among fully vaccinated individuals are rare and usually not as severe, according to the CDC.
As Roundtree considered the country’s staggering death toll and did more research, she changed her mind.
“I’d say more so for my children, not for myself,” she said. “I believed that had I gotten sick, or if I'd get sick in the future, that I have a better chance of living and getting out of the hospital.”
But for others, it may take more than this one-time program to change course.
Pastor King said building trust in Baltimore -- a predominantly Black city -- will mean addressing larger and ongoing racial inequities, and treating health issues beyond COVID with the same urgency.
“There is unequal treatment in healthcare,” King said. “There is not the kind of long term plan as it relates to healthcare that says, here's what we're going to do, in addition to what we're doing now, to ensure that your diseases, diseases that are more prevalent among African Americans are addressed.”
Design strategist Kayla Joy reflected on a conversation she had with one young man during a listening session.
“He said there's so many other issues that have been killing us for decades, literally decades. Whether it's food deserts, whether it's, you know, violence, whether it's police brutality,” Joy said. “Why all of a sudden, is the government concerned about my physical well being when everything around me in my neighborhood says that you don't care?”
Nearly three weeks ago, on June 16, more than 47% of residents of all ages had at least one dose of the COVID-19 vaccine. As of Tuesday morning, that percentage is at 49.5%.
