A nursing student administers the Moderna Covid-19 vaccine. (AP Photo/John Locher)

Health care providers and the Centers for Disease Control and Prevention (CDC) are trying novel ways to get as many residents vaccinated as possible.

As part of that effort, the CDC recently reached out to extension agencies and other trusted rural community resources to get factual vaccination information into communities.

Called the Extension Collaborative on Immunization Teaching and Engagement (EXCITE), the program provides extension agencies with grants to promote Covid-19 vaccination information.

“The overall goal of this great collaborative effort is to create a precision immunization program based on needs assessments and local partnerships, and then to provide immunization education and linkages to immunization opportunities for the most socially vulnerable audiences,” said Alexi Piasecki, with the CDC Vaccine Task Force. “This will be done through building trust, empowering health care personnel and engaging with communities and individuals.”

The five-year, $9.9 million program is a collaborative effort between the U.S. Department of Agriculture National Institute of Food and Agriculture and the CDC and uses the Cooperative Extension System to reach out to rural and medically underserved communities.

While the CDC is encouraging all of the county extension offices under land grant colleges to participate, there will be competitive grants available for offices as well. Each extension office will get approximately $24,000 for an educational campaign. In addition, offices will be able to apply for $200,000 grants to run 2-year pilot projects aimed at addressing barriers and concerns about Covid-19 vaccinations, and other adult vaccinations.

In Indiana, the Purdue Extension office will focus on reaching the Latino community, said Angela Abbott, Health and Human Sciences Extension Program leader and associate director for Purdue Extension.

“We have several Purdue Extension educators that are Spanish speaking and work in communities that have a large Hispanic population, and we met with them and really brainstormed ‘What are the barriers to getting the vaccines for these communities,’” Abbot said. “And what we heard was that they’re just like everyone else, they have questions about the vaccine. But they were telling us, they were not likely to ask those questions in a group forum, or in an online setting.”

In order to address that need, the extension offices will work with the local medical school to find medical students who speak Spanish to be available for Latino community members. For example, she said, they hope to work with a manufacturer who can provide the student with somewhere private, like an office or a tent in the parking lot, where Latino workers could come and get their questions answered privately by someone who speaks their language.

If they then decide to get a vaccine, Abbott said, Spanish speaking volunteers would be there to help them schedule appointments or help them find where to go to get a vaccine.

The program would make the most of the relationships the extension educators have with those in the Latino communities and the trust that has developed between them.

“They don’t have the medical background to answer medical questions, but they do have the trust from the populations in those communities, so that they can say, ‘Hey – I want you to know that we’ve brought in a medical professional to answer your questions,’” she said. “In that way, we can use those extension educators as a bridge.”

According to the Kaiser Family Foundation’s (KFF) COVID-19 Vaccine Monitor, while a higher percentage of rural residents say they have at least one shot of the Covid-19 vaccine than their urban counterparts, a smaller percentage of rural residents say they are willing to get one.

A KFF survey published in April found that 40% rural residents reported they had at least one dose of a vaccine, compared to 31% for urban residents. But, fewer of them said they would be getting a vaccine anytime soon.

“Three in ten rural residents say they will get vaccinated as soon as possible (16%) or are waiting to see how it is working for other people (15%), compared to about half of urban and suburban residents who say the same,” the report said.

“Three in ten rural residents say they will either “definitely not” get vaccinated or will only do so if required, and few unvaccinated rural residents (11%) say they have tried to get an appointment. These results suggest that vaccination uptake in rural America may start lagging behind urban and suburban areas.”

For Black rural residents, the percentage that have received is higher, but so too is the percentage that say they’ve had difficulty getting the vaccine.

About 64% of Black rural residents said they have received the vaccine or will do so as soon as they can. But, less than half of Black rural adults said their communities have enough supply of the vaccine, and a little over half (53%) said their community has enough vaccination locations.

Dr. George Garrow, chief medical officer for the Primary Health Network in Pennsylvania, said gaining trust is a key element of getting those hesitant to take the vaccine. Primary Health Network purchased a mobile unit to use for testing and vaccinations last year to cover the network’s 16 county service area.

“Before, we had the desire to give the vaccines, but we were at that point where we were struggling with our vaccine supply,” Garrow said. “Now, the vaccines are coming through great but we quickly went to a situation where now we can't find arms to put the vaccine in.”

“We have been able to get the mobile unit out and our success has been really, by building relationships … in these rural communities with people who are trusted. We’ve actually been partnering with faith communities and churches by taking the van to their parking lot… it’s been an important lesson that we need to develop relationships with folks in the community that can help us establish that trust.”

Primary Health will also be using the mobile unit to reach people with mobility issues or who may be homebound. Recently, Garrow said, he and other members of his staff were able to go out and vaccinate some homebound community members.

Garrow said Primary Health will continue to partner with other organizations like area agencies on aging and local Emergency Medical Services providers to identify homebound individuals to vaccinate.

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