NJHI Grantee Travel Journals: Taking the COVID-19 Vaccine into Communities

Across New Jersey, the availability of the COVID-19 vaccine has expanded from mega sites to local pharmacies, grocery stores, community-based sites and events, and federally qualified health centers. Throughout these vaccination efforts, service providers, nonprofits, municipal agencies, community partners, local public health departments and the state Department of Health have stepped up to make the COVID-19 vaccine accessible to vulnerable individuals, including those who 1) are living on the far side of the digital divide without the capacity to register for a vaccination appointment; 2) need reliable and affordable transportation to reach a vaccination site or sites that are within walking distance, and 3) are experiencing housing insecurity. Recognizing that micro and mobile vaccination models would be essential to the State’s goal of protecting all New Jerseyans, New Jersey Health Initiatives (NJHI) awarded funding to five community-focused collaboratives to develop models for providing the vaccine to those who might have the least access to them.

Four of the five collaboratives that received funding and support from NJHI have chronicled stories and lessons about their work and shared them below. These grantees’ journal entries reflect their COVID-19 vaccination efforts between January and August 2021. Through their commitment to partnership, their efforts became models for increasing the vaccination rate in every community and could drive overall systems change that ensures everyone has what they need to thrive.

Click on the communities below to read reflections from the grantees.

Northwest New Jersey

“I don’t know if I would have gotten vaccinated if you hadn’t made it so easy. I feel more relaxed now.” – Rick, a Sussex Seniors Apartments resident

At Norwescap, we were thrilled to join the national effort to provide COVID-19 vaccinations to our communities with the thought leadership and support of New Jersey Health Initiatives. With these resources, we were able to extend vaccinations to those who lacked access in the northwest part of the state. We accomplished this via strong partnerships and continuous innovation to address the ever-evolving landscape.

Through this work, we met Megan. Megan is a young mom who had heard negative reports about the vaccine that kept her from signing up for early opportunities. “I was very hesitant about getting the COVID vaccine,” she said, “because I was concerned about there not being enough research.” Through her trusted relationship with Norwescap, she accepted a ride to one of our vaccination clinics, where she was able to connect directly with nurses from Atlantic Health System to ask questions. “After speaking with the women at the vaccine clinic, I was more comfortable getting the shot. My mother had COVID.  Being vaccinated makes me feel safer.”  She also brought her father to the clinic. “I was so happy that I was also able to bring my father. Now he’s safer too!”

We also met Rick through this work. Rick is an older adult, residing in Norwescap’s Sussex Seniors low-income housing, who needed a little nudge to get the vaccine. Through this work, Norwescap reached out to Rick, provided an incentive, and arranged transportation to get him to the clinic. He shared, “I don’t know if I would have gotten vaccinated if you hadn’t made it so easy. I feel more relaxed now.”

These are just two stories of the dozens of unvaccinated individuals who were able to get the information and support they needed to make an informed decision about their health.

–Chris Kirk, Chief Program Officer, Norwescap

South Jersey: Atlantic, Cumberland, Gloucester and Salem counties

Early on in the COVID-19 vaccination effort, our team at Acenda and our partners throughout South Jersey recognized that people residing in domestic violence shelters, group housing, motels and boarding homes would not be able to access vaccine locations easily. They would need supports such as a prompt registration process and reliable transportation to and from vaccination events.

Cross-sector collaboration is critical to developing a coordinated effort, and a number of community partners across South Jersey have partnered with us to create a process for identifying and pre-registering vulnerable individuals in our community partners’ neighborhoods: Salem County Board of Social Services, Riverfront Limousine Services, Inspira Health System, Lakeside Manor, Hope Ranch, Gateway Community Action Partnership, Complete Care, FamCare, county officials and staff from Cumberland and Salem counties, Share and Care Meals, the Cumberland County Department of Health, Barnegat School District, the Visiting Nurse Association of NJ, AtlantiCare, Rowan University, Hammonton School District, Oceanside Family Success Center, Hammonton Family Success Center, Ocean Family Success Center, police and sheriffs’ departments, Center for Family Services, Department of Children and Families, AC Link, the Moms Helping Moms Foundation and the Southern New Jersey Perinatal Cooperative.

We have conducted outreach and shared information about the COVID-19 vaccine and vaccination events with residents. More specifically, we: 1) strengthened our partnership with the Department of Health Mobile Unit to offer pop-up COVID-19 testing and vaccine doses, and 2) incorporated vaccine education through dedicated COVID-19 Community Health Workers. The implementation of a one-stop, hub approach was useful in coordinating the partners’ efforts.

Community members who got the shot received aftercare kits to ease post-vaccination symptoms, and groceries or meals as needed. We also distributed care items to support expectant parents we met through this work.

More than 650 vaccines were administered through August 11, 2021, to individuals in Atlantic, Cumberland and Salem counties through pop-up clinics at Family Success Centers, food pantries, houses of worship, and other community spaces. During a clinic at a local high school in Atlantic County, approximately 204 youth ages 12 to 18 took the vaccine with their parents’ consent. Five adults also got vaccinated while onsite for that event.

By developing a model for providing equitable access to the vaccines, we have gained the skills to pivot our work in the face of an immediate crisis such as the pandemic. We have also identified gaps in service and system deliveries to the most vulnerable. Going forward, these lessons learned will inform how our work advances systems-level change that can reduce barriers to access and connect everyone with the supports they need to thrive. We are already working to bring service providers across South Jersey together as a regional learning collaborative to network and exchange strategies that can benefit every community.

– Monica Lallo, Senior Vice President of Prevention, Youth and Education Services, Acenda Integrated Health

Gloucester, Atlantic and Camden counties

Inside a church parking lot in Atlantic City, a 100-year-old woman was first in line when our vaccination team opened a pop-up event. She shared that she is a congregant and that the church is a historic site for the city’s Black community. She inspired everyone, including others in line and our team. When we shared her story with community members who came to get the shot, some said “If she can do it, I can too.” – Richard Jermyn, Project Director, Rowan University School of Osteopathic Medicine and Cari Burke, Family Success Center Program Director, Acenda Integrated Health

The NeuroMusculoskeletal Institute at Rowan University School of Osteopathic Medicine (RowanSOM) started our mobile vaccine clinic initiative with the goal of providing equitable access to the COVID-19 vaccine for New Jerseyans experiencing homelessness or housing insecurity. From March through June 2021, we administered 963 doses of the vaccine at 19 mobile vaccination clinics we coordinated throughout Atlantic, Gloucester, Camden and Cumberland counties.

The commitment of our healthcare, university, public safety and nonprofit partners to this effort made these accomplishments possible. A 100-member team comprising medical students, RowanSOM faculty and staff, and peers from the Camden Coalition of Healthcare Providers, Hope One Foundation, Shore Area Health Education Center, the Camden Area Health Education Center and the Atlantic County Sheriff’s Office came together in a number of ways. These volunteers showed up early for vaccine preparation, managed the logistics and operations at each clinic site and stayed until the last individual was vaccinated. Early on in this work, the Saint Joachim Parish in Bellmawr partnered with us to host a vaccination clinic and Dr. Xitlalichomiha O’Dell, a local physician leader, stood in the middle of the intersection adjacent to the church and conversed with drivers and passersby, asking if they were already vaccinated or would be willing to sign up to be vaccinated that day.

To establish these community-based clinics, we needed to redesign a clinical and operational workflow that emulated the RowanSOM vaccine megasite and would optimize our fast-paced mobile environment. A large part of this workflow and organizational redesign was the development of our Vaccine Implementation Dashboard and our Volunteer Registration Survey, which helped us to streamline our clinical workflow and improve our recruitment capacity. These tech-oriented solutions are a step forward in establishing a concrete model for mobile vaccine clinic development and implementation that could be considered for future mobile clinics for influenza vaccines, COVID booster shots, and other public health measures.

Our mobile vaccine clinic initiative moves us closer to overall system change because it focuses on rapid and scalable vaccine deployment during public health emergencies and critical junctures. Our approach is optimized for resource allocation, stakeholder engagement, and execution of clinical operations on a rapid and malleable scale. We recommend that decision makers and policy makers: 1) plan for unknown challenges and gaps by forming focus groups and advisory boards to tackle local and regional challenges with a diverse array of perspectives from the start; 2) place a larger emphasis on applying and modifying lean principles to improve mobile clinic operations, output, and outcomes, and 3) place greater emphasis on using algorithms and data insights to pinpoint communities with the greatest need for vaccines at a certain point in time. Insights such as these could allow initiatives to better develop and sustain their programs in the long-term. Overall, the role that mobile vaccination clinics have in mitigating health inequity among underserved communities makes them a key strategic choice during public health crises such as the COVID-19 pandemic, and we plan to continue leading the development and innovation of mobile clinic models to address any future challenges that may arise.

– Richard Jermyn, Medicine Professor and Chair of Rehabilitation Medicine, Rowan University School of Osteopathic Medicine

Union County

“The vaccine program has been a blessing for hundreds of families with limited resources and little access to available information. Thanks to the partnership with United Way of Greater Union County, we have been able to bring the vaccine to the community that I serve at the precise time and place.” – Pastor Marcos Pedraza, Ministerio Cristo para Las Naciones

“We are so grateful for the pop-up vaccine clinic. For months we urged local decision makers to help our community members who could not receive a vaccine in the usual way. Many of our community members cannot afford to shelter in place and yet they were unable to get the vaccine. Lack of consistent schedule and communication, lack of reliable transportation and identification made it near impossible to the point that they believed they could not get vaccinated. The clinic took place at GRACE, where people come each week to obtain the goods and support they need the most. It was there that they got the vaccine they thought was out of their reach.” – Amanda Parrish Block, GRACE Founder

In March 2021, the United Way of Greater Union County (UWGUC) launched the mobile vaccination program in partnership with County of Union and the Visiting Nurse Association of Central Jersey. Our initial focus was to ensure that people facing housing insecurity had access to the vaccines. Soup kitchens, houses of worship and other community-based nonprofits opened their doors to UWGUC to host pop-up clinics at their sites. The Salvation Army in Elizabeth was one of our first sites and there, our team vaccinated 40 individuals experiencing homelessness. The Elizabeth Coalition to House the Homeless also partnered with us to coordinate a pop-up event where more than 200 people were vaccinated in four hours. In addition to vaccinating YMCA residents and survivors of domestic violence, we partnered with Angels for Action in Plainfield and vaccinated more than 100 people in one afternoon. The Plainfield Office of Community  Relations and Social Services also collaborated in this work and together, we registered hundreds of community members for the weekly COVID-19 vaccination clinic at Plainfield High School. A number of churches welcomed us and because of the trust they have built with UWGUC and the County, they provided staff time for their ministry teams to do community outreach and enroll congregants and residents for vaccination appointments. We have also identified families in need through the rental and utility assistance services UWGUC has provided from the onset of the pandemic in our state.

The New Jersey Vaccination Learning Network convened by NJHI is a valuable resource. In addition to connecting us with our peers who are also focused on equitable access to the vaccines, NJHI’s partnerships at the state level have been beneficial to our efforts in Union County. As an example, we have collaborated with the New Jersey Department of Health (NJDOH) to expand our work to include seafarers at the Elizabeth Port who have not had access to the vaccine because they have been aboard their ships. This also helps ensure goods coming into the state are safe for the public. We’ve held educational sessions on the importance of vaccination with the NJDOH Office of Minority and Multicultural Health, which have been key to engaging the community. Hosting these sessions in English and Spanish is one way that we’ve reached hundreds of people, particularly in the vicinity of our pop-up clinics.

As the months have passed and the vaccine has become more accessible, we have had to rethink the way we had been doing our work and how we reached out to the community. As part of these efforts, we have strategically partnered with rental and utility assistance fairs and other events to coordinate an on-site clinic as another service that is available to those with the greatest needs. Our relationship with Union County’s vulnerable communities has grown stronger as we continue to expand the services that we offer to help them manage the health, economic and social issues they face due to the COVID 19 pandemic.

– Juanita Vargas, Vice President of Programs and Operations, and Merlis Miranda, Consultant, United Way of Greater Union County