In Washington State, Funders Get Behind a Campaign to Improve Vaccine Equity

It’s not news that, since the COVID-19 vaccine rollout began, more shots are going to white Americans than non-whites—even though the pandemic has taken a far greater toll on Black and brown communities. According to a recent Kaiser Family Foundation report, “there is a consistent pattern across states of Black and Hispanic people receiving smaller shares of vaccinations compared to their shares of cases and deaths and compared to their shares of the total population.”

Early data showed that Washington state was no exception. In February, the Washington State Department of Health reported that Black, Hispanic, and multiracial people received shots at far lower rates than others in the state.

In response, All In WA, a coalition of community groups, businesses and philanthropies, launched its Vaccine Equity Initiative to improve access to COVID vaccines. To date, the initiative has raised approximately $4.5 million from donors including Premera Blue Cross, Starbucks, Pemco Insurance and Microsoft. (Starbucks and Microsoft were both early supporters of Washington’s COVID-19 Response Fund, as IP previously reported.)

This local initiative is part of a nationwide push to correct the inequity in vaccine distribution. Across the country, local governments and community coalitions are working to boost vaccine access in Black and brown communities, and the Biden administration has made equity a pillar of its national COVID-19 response plan. At the state level, leaders are adopting a range of strategies to reach underserved populations. Washington’s Vaccine Equity Initiative provides an example of the critical role philanthropy can play in getting vaccines into as many arms as possible.

Disparities, barriers and misinformation

Washington’s Vaccine Equity Initiative builds on the mission of All In WA, which was created in May 2020 to assist Washington residents impacted by COVID-19. Upon its launch, Amazon founder and CEO Jeff Bezos matched individual donations to All In WA, and the Ballmer Group, the Paul G. Allen Family Foundation, the Bill & Melinda Gates Foundation, the Microsoft Corporation, Howard & Sheri Schultz, the Perigee Fund, Nick & Leslie Hanauer, and Jim and Jan Sinegal also provided funding.

Kris Hermanns, chief impact officer at the Seattle Foundation, which hosts All In WA, says the program was created in response to the disproportionate impact of COVID-19 on Black, Indigenous, and other communities of color. “When All In WA launched in May, we provided emergency financial assistance to families,” she said. “Then we saw that the same disparities were playing out in terms of vaccine distribution, so that led to the development of the Vaccine Equity Initiative.”

The initiative supports community-based organizations’ vaccine distribution efforts by providing technical assistance to aid vaccine registration, transportation assistance (particularly for elders and those who live in rural areas), and support for pop-up and mobile clinics. Grants from All In WA also help community-based organizations increase their communication and outreach capacity, train staff, translate informational materials, reach out to ethnic media outlets and local institutions, and conduct phone and text banking campaigns.

Ticking off the barriers that stand between people and the vaccine, Hermanns cites mobility and transportation issues, as well as lack of access to computers and reliable internet connections. And conspiracy theories about the vaccines are widespread.

“People are hesitant not just because of their community’s historical relationship—or lack of relationship —with the medical system,” Hermanns says. “There is so much misinformation out there. That is why we are supporting organizations that are already working in their communities. These are the trusted messengers who can reassure people that the vaccines are safe and effective.”

Building vaccine confidence

One of those trusted messengers is Jesús Hernández, CEO at Family Health Centers in Okanogan County, in North Central Washington. Okanogan is a rural, agricultural region that employees many farmworkers; it also has a large Indigenous population. On top of the pandemic, the region was ravaged by wildfires in the fall of 2020. Family Health Centers has a long history in the community and provides a range of services including family medicine, obstetrics, dental care and pharmacy services.

Distributing vaccines in the farmworker community presents particular challenges, according to Hernández. Some workers come to the area for just a few months to work the harvest, moving from location to location and crowding into multi-generational households where infection risk is high. Many are undocumented, and understandably reluctant to access government benefits—as well as COVID-19 vaccines.

Other local residents, including white people living off the grid, many of them Trump supporters, are also refusing COVID-19 vaccines. Many people cite myths about the vaccines’ origins and possible side effects. “There are all kinds of crazy rumors going around,” Hernández says. “They’re hearing this kind of thing from friends and from social media, and they don’t know what to believe.”

Hernández and his staff are working on a number of fronts to counter vaccine hesitancy and get people immunized. Family Health Centers has been holding “vaccine events” in remote towns, coordinating with growers, schools and other local partners to get the word out about the events. Sometimes, 10 to 20 people show up; other events draw 100 people or more. They are also reaching out to tribal leaders to increase vaccination rates in Indigenous communities.

“The idea is to develop partnerships wherever we can,” Hernández says. “In some areas, we might contact the local church. In other areas, phone calls are the best way to reach people.”

Hernández sees signs that this multilayered approach is working. “As people have gotten their first and then their second vaccines, we are seeing a gradual change in attitudes,” he said. “As we provide more information and distribute videos of our vaccine events, we’re slowly building confidence in people who were hesitant before.”

He described recent vaccine events where his staff presented to about 376 farmworkers who had recently arrived as guest workers. “At the beginning, there seemed to be a lot of apathy or hesitancy,” Hernández said, but after the presentation and many questions and answers, approximately 90% of the workers registered for the vaccine.

COVID-19 rates are going down in Okanogan County, which currently has one of the highest vaccine rates in the state, but Hernández and Family Health Centers are in a race to push the immunization rate even higher. “We have a lot of ideological people in this county, and we fear that we’re going to hit a wall of resistance at some point,” he said. “Hopefully, we can get above 75% of our population before that.”

Supporting public health

Public-private partnerships like Washington’s Vaccine Equity Initiative demonstrate the important role philanthropy can play in the country’s push for herd immunity—and life after COVID-19. Other big donors, including the Bill & Melinda Gates Foundation and Bloomberg Philanthropies, have supported vaccine distribution efforts, as IP has reported.

We also recently covered a compelling program that emerged over the winter in New York, in which four funders backed a “public deliberation” process that sought to engage community members in vaccine distribution decisions. The philanthropic sector can continue to support work to strengthen the connections between high-level public health efforts and the local communities they aim to serve. These are rarely one-size-fits-all efforts, as Hernández’s work in Okanogan County demonstrates.

At the same time, in Washington state and other areas of the country, nonprofits like the Seattle Foundation and All In WA, with financial help from philanthropists, are essentially filling in for our badly underfunded public health system. When Washington’s Vaccine Equity Initiative was announced, King County Executive Dow Constantine made this very point. “The reason that philanthropy is needed is that fundamentally, public health is underfunded; they are stretched mighty thin right now.” Constantine said. “We are very grateful for (philanthropy) stepping up to fill the gaps created by our failure to step up over the decades.”

Which does raise the question of what philanthropy can do now, not only to pick up the slack, but also to push for a restored public sector. The once-in-a-century pandemic has revealed how dangerous and foolhardy it is to neglect public health. Philanthropy has helped patch some of the holes this time around, but that doesn’t diminish the need to build a robust system that will be ready the next time we need it.

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