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UNC Health goes mobile to reduce racial and ethnic disparities in COVID-19 vaccination

UNC Health goes mobile to reduce racial and ethnic disparities in COVID-19 vaccination

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SELMA — As COVID-19 vaccination clinics go, the one in a church parking lot down a side street in Selma on Wednesday was a modest affair. Over six hours, 50 people with appointments received their first dose of the Moderna vaccine as they sat in their cars.

But it was the location and the way people learned about the event that set it apart.

This was UNC Health's first mobile vaccination clinic, held at an African-American church in a Johnston County town where Blacks and Hispanics account for the majority of the population. In North Carolina, those two groups lag in COVID-19 vaccinations, receiving about 14% of the first doses so far even though they make up about 31% of the state's population and account for as many as 40% of coronavirus cases in the state.

Public health officials say the reasons for those disparities include a lack of transportation or the time and the internet access needed to make an appointment.

But they also cite skepticism about the COVID-19 vaccines or the medical system in general, and say reaching out through churches and community groups can help people feel comfortable getting vaccinated. Many of those receiving shots at Howell's Chapel Church of Christ belong to the church or were referred by members who helped spread the word through the county.

"We have found that when the word is getting out through the community rather than through official channels, people hear about it and are much more trusting, especially in a small tight-knit community," said Eleanor Wertman, program manager for community health at UNC Health Alliance, which put on the clinic.

The UNC group began offering mobile coronavirus testing last summer with the same goal of reaching minority and low-income residents who might not otherwise get tested. With the state making vaccine available to the general public last month, starting with people 65 and older, UNC decided to switch from mobile testing to vaccination.

After consulting the UNC hospital in Smithfield and community leaders, Wertman's group asked Howell's Chapel if it would be willing to host a clinic and help find people to get vaccinated. The answer was an enthusiastic yes, said Paul Norman, a deacon at the church.

Rather than wait for people to ask for an appointment, UNC takes referrals from the church, town council members and others and contacts people directly to see if they'd be interested. This week's slots are full, said Norman, who said he thinks the reluctance among Blacks to get vaccinated has eased, as reassuring messages from doctors, politicians and pastors have gotten through.

"They have been educated enough to know that this is important, and they're calling," said Norman, who is still hearing from people who want an appointment. "I think now, because of the seriousness of the COVID, people just want to be proactive."

Lucille McNeill of Dunn wasn't planning to get vaccinated for COVID-19, because she worried it might give her headaches or make her sick. Then during a recent routine check-up, McNeill's doctor told her she had already gotten the shot without any trouble and urged McNeill to get it because of her age, 84.

That helped McNeill's daughter, Debbie Smith, commit to getting vaccinated as well.

"I had been considering it," said Smith, a postal clerk in Dunn. "Then I kept seeing on the news there's so much shortage, we didn't really know where to go."

The doctor told them about the mobile clinic, so Smith, her husband James and McNeill all made appointments for Wednesday.

UNC limited the first day of its mobile clinic to 50 people, but planned to double it to 100 a day Thursday and Friday. It plans to do another 100 per day on Wednesday, Thursday and Friday in Benson, then continue the following week somewhere else. It will be back at Howell's Chapel in 28 days, so those who got their first shots this week can get the second dose needed to complete the inoculation.

About a dozen UNC employees ran the clinic Wednesday. They greeted and registered people in a parking lot on one side of the church, then asked them to drive to the lot on the other side, where a nurse administered the shot through the car window. Others then monitored each person, to make sure they didn't have any adverse side effects. A sticky note on each car's side window noted when the 15-minute waiting period would be over.

Before they got started, Jonathan Barrett, the project leader, called everyone together. Barrett noted it was the first day and that not everything would go perfectly, but he emphasized the mission.

"Today is a very exciting day, a day we get to connect with our community on a more deeper level," he said.

Wertman said one goal of the mobile clinics is to create evangelists for vaccination, who will go back to their families, friends and neighbors and vouch for the process.

"Our goal is really to have them have a positive experience, really take care of them, make it easy, so they can go back into their community and share their experience of having gotten vaccinated and hopefully increase that trust," she said.

Smith said she had already persuaded two sisters to get vaccinated and will pass the word on to others.

"I'll tell them, I did take the shot, the initial step," she said. "It's their personal choice, but I think they should do it, too, and give us all the protection."

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