Health officials counting on local providers, community groups to reach those hesitant to get the COVID-19 vaccine

As numbers dwindle at mass vaccination sites, officials rely on grassroots efforts to reach those who haven’t gotten the shots yet

(Leah Hogsten | The Salt Lake Tribune) Dr. Edward Redd with the Bear River Health Department is filmed by two filmakers with Penna Powers ad agency May 11, 2021 for public service announcements to encourage Utahns to get the COVID-19 vaccine.

Dr. Edward Redd, physician and soon-to-be regional TV pitchman, doesn’t want to tell people they have to get the COVID-19 vaccine.

“I don’t believe that coercing people into getting vaccines, or coercing people into doing anything, is very helpful,” said Redd, a physician for the Bear River Health District and a former Utah legislator. “People have to arrive at their own conclusion using the information they’re able to gather. What I hope to do is get them good information and let them make their own decisions.”

To help get that information to people in the Cache Valley, Redd sat down in front of a camera Tuesday to tape a public-service announcement for the Utah Department of Health.

Redd is one of several health care professionals, mostly from more rural parts of Utah, who will appear in these TV spots — which will be targeted at people who so far have been hesitant to get vaccinated against COVID-19.

“We need health care providers to stand up and say, ‘Hey, this is safe. We all got it, and we want everybody else to get it,’” said Sheldon Birch, who owns three Birch Family Pharmacy locations in the Tooele Valley, and will appear in another of the UDOH spots.

Reaching the undecided

In focus groups with people who have not yet received the vaccine, health professionals like Redd and Birch were found to be “most likely to hold sway, in terms of moving them one way or another,” said Tom Hudachko, UDOH’s director of communications.

The concerns people in those focus groups have about the vaccine “are essentially the same that we’ve heard from the beginning,” Hudachko said. They include questions about the vaccine’s side effects, how safe it is, how effective it is, and the speed at which federal agencies approved them, Hudachko said.

“The most likely messenger that can answer their questions and alleviate their concerns,” Hudachko said, “is a health care provider — either a doctor, a nurse or a pharmacist — or individuals from their communities who are like-minded and have made a decision to get vaccinated, having overcome essentially the same questions.”

The spots with Redd and Birch will be more micro-targeted to regions of the state than earlier ads developed by UDOH, which were broadcast statewide via TV and radio stations.

“We knew that we would start with the large chunk of people who are open and are willing to be vaccinated,” Hudachko said. The first wave of ads “was dangling the carrot … that getting back to Jazz games, getting to restaurants, getting back to shopping centers, visiting with grandparents — all those things are going to made possible by getting vaccinated.”

UDOH considers that first phase a success — with more than 1 million Utahns now fully vaccinated, and another 300,000 having taken the first of two doses. The widespread TV spots and digital billboards around the Salt Lake Valley will remain in use, Hudachko said, even as numbers at mass vaccination sites decrease and those sites are gradually phased out. (For example, the Salt Lake County Health Department will close its site at the Salt Palace Convention Center on May 29, and the Davis County Health Department is scaling back hours this month at the Legacy Events Center in Farmington.)

For the next phase, “it’s really going to be less about this mass-media approach that you’ve seen over the past several months,” Hudachko said. “We’re going to rely more on geo-targeted paid social media, so that we can get these messages into specific parts of the state. We’re going to rely more on rural newspapers, rural radio, and static billboards in these communities.”

The spots where Utahns aren’t sure

In some rural parts of the state, the message should receive a receptive audience. According to a UDOH survey taken between Feb. 1 and May 1, 77.3% of people in Redd’s Bear River Health District — Cache, Box Elder and Rich counties — who have not received the vaccine yet say they are “likely” or “very likely” to do so. In Tooele County, where Birth lives, the level is 70.1%.

Other rural areas are more skeptical. The rate of unvaccinated residents likely or very likely to get the vaccine in San Juan County was 52.2%, while in the Tri-County Health District (which covers Uintah, Duchesne and Daggett counties), it was just 50.6%, the state’s lowest percentage.

Besides rural Utah, public health workers are trying to reach minority and ethnic communities, which have lagged behind the state’s majority white population in getting the vaccine.

As of last week, 41% of the state’s Asian American adult population, 34% of Hispanic adults, 23% of black adults and 23% of adults in the native Hawaiian and Pacific Islander community had been fully or partly vaccinated, according to Lt. Gov. Deidre Henderson. That compares to just over 50% of the adult white population of Utah that has gotten their shots.

For some in those minority groups, said Caroline Moreno, equitable access manager for the Salt Lake County Health Department, “it’s a matter of trust. There’s a lack of trust in government agencies, and in the medical profession — and that’s all based on historical injustices and some that are not so historical.”

Other issues are logistical, she said: A lack of transportation, or inability to speak English, or not being able to get time off of work.

“You can imagine if there’s somebody who’s not comfortable speaking English, or concerned about how they’re going to be treated, going into one of those huge [mass vaccination] sites can be really overwhelming,” she said.

While the Salt Lake County Health Department has its own ad campaign — with the tag line “This is our shot” — on TV, radio and billboards, there’s also an effort to target to minority communities, said department spokesman Gabriel Moreno (no relation to his colleague).

Gabriel Moreno said his department has placed ads in 36 gas stations, 13 grocery stores, 28 nail and hair salons and five laundromats — mostly in neighborhoods with large minority populations.

The main way Salt Lake County gets the message out, Caroline Moreno said, is to work with community groups — 29 of them over the last year, who have organized pop-up clinics at churches and other gathering spots.

Those groups, “are from and part of these communities and are trusted voices. … They’re the ones interacting with people, they’re the ones who are relaying the messages. The only thing we say about the message is that it has to be scientifically accurate,” she said. “Other than that, however they want to relay the message, however they want to talk to people, is completely up to them, based on their knowledge of their own communities.”

The department augments that effort with information kits and advertising in 10 languages, Gabriel Moreno said.

“If you’re on the fence, please, there’s information,” Caroline Moreno said. “There are a lot of people you can reach out to, to learn accurate information so you can feel comfortable getting your shot.”

Finding the unvaccinated where they live

Robin Marcus, professor and associate dean for clinical affairs with the University of Utah College of Health, said public health experts don’t know if the recent downturn in demand for the vaccine is because of an accessibility issue or because of vaccine hesitancy.

University of Utah Health is working on the accessibility side, Marcus said in a virtual news conference Wednesday, by teaming with Community Nursing Services to send the U.’s Wellness Bus to locations around the Salt Lake Valley this month to stage one-day pop-up clinics in underserved communities.

The first such clinic takes place Wednesday, 3-7 p.m., at the Kearns Library. The bus travels to South Salt Lake on Thursday, Ogden on Friday — with stops the next two weeks in West Valley City, Glendale and Kearns again.

“We’re hoping we’ll get a good uptake of people wanting to be vaccinated,” Marcus said.

Birch, in Tooele, said health experts are “competing against the Internet, which has all sorts of information.”

His pharmacies – the three in Tooele, and Cedar Valley Pharmacy in Eagle Mountain — recently posted on Facebook that they had plenty of vaccine doses in stock, and urged people to register for an appointment. The response was surprising, Birch said.

“I got comments on there — silly things: ‘It’s not a vaccine.’ ‘I know people who have gotten sick from it, and people who have died from it.,’” Birch said. “They were not typically my patients who were saying that. They weren’t traditional clientele. They were a younger, perhaps healthier, group who get their information from other places than their local doctor and pharmacist.”

Redd, the physician at the Bear River Health District, agreed.

“The hope is that people who are hesitant, or worried about possible side effects of the vaccine, will at least ask questions of their physician or health care provider, and try to get good information about what’s going on,” Redd said. “That’s the hope.”