On Thursday, President Joe Biden beseeched Americans to meet his deadline of having 70 percent of American adults partly or fully vaccinated against the coronavirus by July 4. In a speech, he asked Americans to "knock on doors and talk to friends and neighbors" about getting vaccinated so that the country can reach the much-touted 70 percent threshold — which, public health experts say, marks the point at which the novel coronavirus will slow down and eventually cease in its spread.
The president's plaintive is related to the sudden slowdown in demand for the vaccine, as supply now outweighs demand for the COVID-19 vaccines. According to the Centers for Disease Control and Prevention (CDC), 62.9 percent of Americans over the age of 12 have received at least one dose of the COVID-19 vaccines, and 65 percent of adults over the age of 18 have received at least one dose. The Biden administration has about one more week to reach its goal.
Though the gap may seem small, the nation's ability to close it depends on smaller, more localized efforts. As mass vaccination sites are closing across the country, more counties and cities are turning to mobile vaccination clinics to reach underserved populations, high-risk groups, essential workers, and rural communities.
Remarkably, it appears to be working.
Dr. SarahBeth Hartlage, the interim medical director for Louisville Metro Department of Public Health and Wellness, told Salon that the mass vaccination site in Louisville, Kentucky gave out 110,000 doses of the COVID-19 vaccine between January and April 2021. But by the end of April, it appeared they had entered a "different phase," one in which many people had "questions" and "concerns" about the vaccine.
"[There were] concerns either about the safety of the product itself or the government's involvement or long-term consequences, or even the need for vaccination — especially for younger folks who feel like they maybe don't need it ," Hartlage said. "At that point we went ahead and transitioned to our mobile operations. And since then we've run 137 mobile operations with a little over 5,000 doses given across those events."
Hartlage said at the mass vaccination site, they were vaccinating 1,500 and 2,000 a day. Now, with their mobile clinics— which are actually going into communities and posting up at churches, employers, schools and dollar-store parking lots — they usually vaccinate between 20 to 100 people per event.
"It's a very different strategy, a very different phase of the operation," Hartlage said. "We have found the most success in partnering with community organizations that are tied into smaller groups, smaller parts of the community."
For example, Hartlage said they've had successful partnerships with Colectivo LatinX, a local grassroots organization, which helped provide Spanish language services and answer questions. It's a very "resource intensive" strategy, but it's working.
"In the beginning of the mobile missions, which we started doing in March, the largest number of people we were reaching at that point was people who had access problems — they didn't have transportation, they didn't speak English or they had some other barrier that made it difficult for them to access traditional healthcare and receive vaccination through the other paths," Hartlage said. "As we get deeper into it, we're engaging with people who have concerns and questions that they want to have heard."
Carl Wood, president and pharmacy manager of VaxVan, is leading a mobile vaccination program in the greater Charlotte area in North Carolina. Echoing Hartlage, Wood said partnering with community organizations has been the most successful approach in vaccinating underserved communities who have been marginalized by overall vaccination efforts. For example, when Salon spoke with him, he was gearing up to work with Meals on Wheels, which serves people over the age of 60 who are homebound and unable to purchase or prepare regular nutritious meals for themselves.
"We're going to volunteer and pack meals for them and just include a flower with our information or phone number that says 'Hey, if you need a shot, call us, we'll come to you,'" Wood said. "Our model is to go into the communities with trusted community partners."
But Wood's VaxVan has been "everywhere."
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"We've operated in gymnasiums, we've operated in conference rooms, we've operated lots of drive-throughs — it's been a wide variety of scenarios," Wood said. "I think it really helped to reach two groups, people who are skeptical of the providers and those who were unable to get to those mass vaccination clinics, and waiting hours and hours and hours."
Wood said they're still successful in vaccinating people who have had barriers to access, but now it's mostly an effort to turn the vaccine-hesitant. For this cohort, they're having less success.
Julie Swann, a professor of systems engineering at North Carolina State University, told Salon in the final hours to meet Biden's deadline mobile vaccination clinics are one in a "portfolio" of strategies that need to be used to reach people who have yet to be vaccinated.
"I don't think that one approach is going to solve all of the challenges, because there are different challenges," Swann said. "We've already gotten, as some people say, 'the low hanging fruit' in terms of people who really wanted to be vaccinated, but now you've got to address all of these issues — barriers to access, vaccine hesitancy based on experiences in the healthcare system, vaccine hesitancy based on misinformation online, indifference to vaccination because of youth, vaccination hesitancy because you don't believe the pandemic is important."
"These are different problems that, to some extent, have to be solved in different ways," Swann added, suggesting that incentives might work for some people in addition to incentivizing people by requiring vaccinations to return to school or attend summer camp.
But overall, bringing the vaccines to a broader population has been a success. Indeed, it raises the question as to whether this mobile strategy should have been implemented from the very beginning.
"2020 hindsight is Monday morning quarterbacking," Litjen Tan, chief strategy officer of the Immunization Action Coalition, told Salon. Tan said an early mobile vaccine strategy would have been useful; but, given where the country was during that time, he thinks the mass vaccination sites were a success in rapidly vaccinating people who wanted the vaccine and were eligible then.
Still, he thinks there's a place for mobile vaccination sites in the future.
"I would really love to see how we can work on maintaining this infrastructure," Tan said. "I would love to see how we can keep this going, so that we can continue to reach these populations with other vaccines."
And Tan isn't the only one thinking about that. Wood of VaxVan said he's already planning a mobile vaccination clinic with the flu shot.
"So that's kind of our business model is to take what we've done successfully with COVID shots and just do the same thing for flu shots," Wood said. "One of our thoughts is to reach out to high schools and colleges in the spring and in the fall, and say 'hey, if you have folks who come in who haven't gotten their immunizations, we could do those on site.'"