Our Continued Commitment to Improving COVID-19 Vaccine Literacy

By Rashi Kumar, Director, Research and Policy, Healthfirst, and Lauren Rauh, Program Director, NY Vaccine Literacy Campaign, CUNY Graduate School of Public Health & Health Policy

When the COVID-19 vaccine became publicly available in December 2020, many eligible Americans rushed to get protected from the devastating virus. But a rush turned into a trickle and then, the stream dried up.

By May 1, 2021, 35% of Americans completed their primary series of COVID vaccines. That slowly grew to 57.6% by October 1, 2021, and stands at 68.5% as of November 1, 2022, according to nationwide data from the Centers for Disease Control and Prevention (CDC).

Some racial and ethnic groups lagged behind the national average. The CDC noted Black and Hispanic/Latino Americans were less likely to be vaccinated against COVID-19 than people in other racial and ethnic groups. These same groups are more likely to get seriously ill or even die from COVID-19.

Academic institutions, community organizations and health plans sprang into action to figure out what was stopping these groups from accessing the vaccine.

The CUNY School of Public Health and Health Policy (CUNY SPH) started the New York Vaccine Literacy Campaign (NY VLC) in May 2021 to combat this phenomenon. Through partnerships, the NY VLC aimed to increase access to trusted vaccine information and education so more people would feel comfortable getting vaccinated.

Healthfirst partnered with CUNY SPH to uncover the underlying perceptions and hesitancies that drive low uptake among marginalized communities. Healthfirst’s 1.8 million members represent more than 16 ethnicities and speak 76 languages and dialects. This diverse group of New Yorkers are among the most underserved and under-represented in the nation.

By participating in the NY VLC, Healthfirst aimed to better understand these communities and ensure their voices are heard.

What we found

CUNY conducted quarterly surveys of the general population living in nine New York counties about COVID-19 vaccine accessibility, perceptions, and hesitancies. At the same time, Healthfirst surveyed households of its members in English, Spanish, and Mandarin.

Healthfirst’s COVID-19 vaccine attitudes and uptake analysis did differ from that of the general population.

1. Roughly the same percentage of general population and Healthfirst surveyed households were unvaccinated as of June 2022 (8.59% and 8.09%, respectively).
2. A larger percentage of the Healthfirst population were not at all likely to get vaccinated in the future (63%) than the general population (45%).
3. Vaccine safety was less of a concern of unvaccinated respondents in the Healthfirst sample (58%) than in the unvaccinated respondents in the general sample (80%). Interestingly, 20% of unvaccinated Healthfirst respondents were hesitant to get the vaccine because they didn’t have time to seek one out or deal with possible side effects than the general population.
4. Fewer Healthfirst respondents who took the survey in Mandarin were extremely confident in knowing what to do if they were exposed to COVID-19 (27%) than Healthfirst respondents who took it in English (42%). In the general population, which was surveyed in English, 41% were extremely confident.

The difference between the two surveyed groups in vaccine perception and hesitancy highlight the need to target underrepresented communities, speak to them in their preferred language, and listen to and address their specific concerns.

These findings dovetail Healthfirst’s multipronged effort to overcome vaccine hesitancy among our members:

• Working with community organizations and faith-based groups to hold town halls on vaccine education and resources in multiple languages, including Spanish, English, Haitian Creole, Bengali, and Urdu.
• Partnering with community providers and hospitals to hold vaccine clinics in the communities we serve.
• Featuring “vaccine ambassadors” from our communities sharing their reasons for getting vaccinated in a social media campaign.
• Proactively reaching out via phone calls and text messages to our members at high risk for COVID-19 with tailored messaging in their preferred language.

CUNY’s NY Vaccine Literacy Campaign also took action based on survey findings. Following each survey, the NY VLC wrote up data reports to distribute the findings to their community-based partners. This quarterly, county-level data aimed to help community workforces recognize possible barriers to COVID-19 vaccination and which populations or groups may be more impacted. The NY VLC is now in its second year and has entered a new phase broadening to routine vaccination for all ages. Working in partnership with community-based organizations and local leaders, the NY VLC creates tailored resources to support vaccine communication and education needs for recommended vaccines across the lifespan.

We look forward to continuing to partner across diverse stakeholders to drive vaccine literacy and pursue health equity for all New Yorkers.