COVID vaccination clinic

Jennifer Swabowicz, immunization coordinator for Nashua’s Division of Public Health and Community Services, prepares to give a person a COVID vaccine shot during the annual Tree Streets Block Party in Nashua on Saturday.

COVID vaccination clinic

The push to get people vaccinated against COVID-19 is not over, though 55% of the state has been fully vaccinated and 72% of adults have received at least one dose.

Public health officials and community leaders are drilling into the numbers to figure out who they need to reach with information and vaccines. They are mapping out strategies to get vaccination rates up and the risk from COVID-19 down.

Vaccination rates are higher than they were a month ago, but are not uniform across all communities. Working-age adults are less likely to be vaccinated than people ages 65 and older. Vaccination rates among Black and Latino Granite Staters lag behind White and Asian residents.

Persuasion efforts are not really targeting staunch opponents of the COVID-19 vaccine, who make up about 21% of the state’s adults, according to a recent poll from the University of New Hampshire. Instead, the efforts are focused on people who have not gotten the vaccine but could be open to it — about 4% of adults, according to the poll.

Asked what is standing in the way of people who are open to getting vaccinated, health officials and community leaders have identified three factors standing in the way of people who are open to getting vaccinated.

Making them care

The first hurdle is apathy.

Businesses are open. The state of emergency is over. Community transmission is down from “high” to “low” and “moderate” in most counties.

Michelle Graham of the Manchester Health Department said the general feeling of getting back to normal might lead some to wonder why they should rush to get vaccinated.

“It’s no longer a high priority for them because the community transmission is going down,” Graham said.

A big problem is that younger people see themselves as less at-risk for COVID-19, or hope enough other people will get vaccinated to achieve so-called “herd immunity” without them.

Graham said Manchester is trying to make it as convenient as possible to get shots to sway those who are feeling apathetic about the virus.

“Just trying to make it as simple as possible,” she said.

The city health department is holding walk-in clinics at its Elm Street office, no appointment needed, and has seen a steady stream of visitors. Health departments also are bringing mobile vaccine clinics to summer festivals.

Graham hopes to see more vaccine clinics at workplaces. If working people are having trouble scheduling vaccines around their jobs and other commitments, maybe the vaccine can come to them. She urged employers to reach out to the Manchester Health Department if they are interested in setting up a vaccination clinic.

Manchester is not considering incentives to get people to get vaccines, Graham said. Other states have lotteries for the vaccinated. Some city health departments offered smaller inducements to get people through the doors — for example, one clinic in Boston offered free ice cream.

Gov. Chris Sununu has discouraged this approach. “We’re not going to overly incentivize you to making a healthcare choice based on money,” he told reporters on June 10.

In Nashua, Public Health Director Bobbie D. Bagley said the Nashua Health Department has been offering $5 Dunkin Donuts gift cards to people who get vaccinated and then bring a friend to get a shot.

Getting it straight

The second impediment to vaccinations is misinformation.

Working with trusted community leaders is the best way to combat misinformation, said Eva Castillo, director of Welcoming New Hampshire and a community leader in Manchester. Those local leaders are especially key in insular communities, she said, like the state’s immigrant and refugee populations.

“The important thing with a community health worker is you need to make it personal,” Castillo said. “They need to see a face that they know and they trust.”

Nashua and Manchester have been using community health workers — community leaders trained to provide information about health, the vaccine and other social services. Funding from the federal stimulus bills has supported much of this work, as have private grants, including funds from Harvard Pilgrim and Tufts Health Plan.

The community health workers are helping, Castillo said. But there is more work for them to do, and more are needed, especially now that it is safer for vaccinated people to meet others in person.

Face-to-face contact with someone known and trusted will help cut through misinformation and social media rumors, she said.

After connecting with community members, health officials can bring vaccines into the community and make it easier to get vaccinated. Bagley said Nashua has given shots in barbershops and beauty salons, at the city’s outdoor movie nights and summer festivals and in apartment complexes and rooming houses.

Taking concerns seriously

The third hold-up is questions.

Besides making it easy and convenient for people to get vaccinated, Graham said it’s important to take people’s questions seriously. People need to feel heard, she said, and don’t want to feel pressured into making a choice.

After hearing about the very rare side effects like blood clots, Bagley said, some people are less sure about the vaccines.

“When people hear things like that, they have a concern,” Bagley said.

People who have regular doctors can call to learn how the vaccine would interact with their health conditions. A regular pediatrician can help parents decide if they want to get the vaccines for their children.

Providing a forum for questions and providing reliable, trusted answers will be a focus for public health workers and other staff, Graham said — especially community health workers.

Bagley said people can also call their local health departments for information.

Graham said translation services are important to facilitate answers to questions from people who feel most confident in languages other than English.

Manchester is staffing its vaccination clinics with community health workers who can help translate and are making sure to translate flyers into relevant languages for the Queen City.

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