Being in front of a camera isn’t in Rotonya Carr’s comfort zone.
“I’m just not used to seeing myself on video,” said the hepatologist from the Hospital of the University of Pennsylvania. “I much prefer to be in the background of things and making my contributions in that space.”
The doctor weathered the discomfort, though, to participate in a Philadelphia Department of Public Health messaging campaign designed to boost the city’s vaccination rates, particularly among its Black and Hispanic residents. For too long, she said, government at every level had not coordinated outreach about vaccinations from messengers who look like the people in communities of color.
“It seems like an obvious starting point that unfortunately we didn’t have at the beginning of the pandemic or at the beginning of the vaccine rollout,” Carr said. “It is disappointing, another example of how the messaging hasn’t been complete enough in my view.”
The results, she and other health experts have said, are communities that have been too vulnerable to misinformation, and have not seen a robust effort to address their concerns about COVID-19 vaccinations.
“If you don’t see someone who looks like you or even comes from your community, you may ask, do they understand my perspective,” said Priscilla Mpasi, a pediatrician at Children’s Hospital of Philadelphia and one of the six doctors of color who participated in the city’s ad campaign. “The more you see a trusted messenger, the more you’re going to trust that message.”
The city-sponsored PSAs are now being shown on Comcast cable and four local stations chosen because of their viewer demographics, 6 ABC, Fox 29, CW Philly 57, and PHL17. They will run through August, said health department spokesperson James Garrow, and are also on YouTube. The five 30-second PSAs, with a sixth in production, include focuses on the still significant dangers of COVID-19 infection, the vaccines’ safety, and show that people of color played a role in their development. The prime targets are younger Black and Hispanic Philadelphians.
The city paid for the spots through its $1.5 million-budgeted VaxUpPhilly ad campaign.
Black and Latino residents have consistently lagged behind the city’s overall vaccination rates, according to health department data, and that disparity is particularly pronounced among people aged 20 to 44. About 27% of the Black population in that age group and 46% of Hispanics have been vaccinated, according to city data, compared with 52% of white and 74% of Asian Philadelphians. While 70% of Philadelphians overall have received at least one vaccine shot, in some zip codes only about a third of residents have received a shot.
Nearly two-thirds of all Black or Hispanic Philadelphians have yet to receive a vaccine dose.
Nationally, the country will not meet President Joe Biden’s goal of getting at least one shot to 70% of the population by July 4.
Addressing such disparities is necessary to prevent continued COVID-19 outbreaks, said Rupali Limaye, a social and behavioral scientist and expert in health communication in the Johns Hopkins Bloomberg School of Public Health’s international health department.
“We are now at the point where it will take some persuasion to nudge individuals who still have not gotten a COVID-19 vaccine,” she said in a panel discussion hosted Thursday by her school.
In Philadelphia, that outreach has included Phillies tickets and a cash-prize lottery for people who get vaccinated. A door-to-door outreach campaign is targeting the city’s undervaccinated neighborhoods. Mpasi worked with the All Faiths Vaccination Campaign, an initiative to coordinate vaccine clinics from Memorial Day to Juneteenth hosted by 24 places of worship with messaging from faith leaders and congregation members with medical expertise. The emphasis was on the freedom that vaccines offer.
“This is also a way for us to regain freedom,” Mpasi said. “To get back into the community by getting vaccinated.”
Outreach must acknowledge the array of reasons people have for not having been vaccinated, Carr said. Some, she noted, are willing, but their jobs don’t allow them the time to easily get the dose or recover from side effects. Others were told for too long they had to wait.
Lisa Cooper, a professor of medicine and health equity at the Johns Hopkins Bloomberg School of Public Health and Schools of Medicine and Nursing, who also participated in Thursday’s panel, said early vaccine rollout policies that prioritized seniors were less likely to reach Black Americans, a population that tends to skew younger than white Americans.
“I think by making the eligibility criteria focused on age,” she said, “we perhaps unintentionally disadvantaged our communities of color.”
Hesitancy comes in different forms too, Carr said. There are people who are convinced by the misinformation and falsehoods flooding social media. Others are uneasy because they think the vaccines were developed too quickly.
“People not in science or not in medicine or who don’t get exposed to that type of research aren’t aware of that long process that led up to vaccine development,” she said.
And, among some Black Philadelphians, she said, there is a deep-seated distrust of new medical technologies and developments, due to a long history of racism in medicine that included unethical research methods.
The doctors participating in the ad campaign got draft scripts but could make changes they thought would hone the message. Carr wanted to convey how many people have already been vaccinated.
“One of the most common things I hear, even still, is ‘I don’t want to be the first one,’” she said. “I love that we’re able to amplify how many in our area have already been vaccinated.”
Mpasi hopes to get across a simple thank you to the bus drivers, grocery store workers, security officers, and others who didn’t have the luxury of working from home over the last year. In Philadelphia and elsewhere, workers in jobs with high risk of COVID-19 exposure were disproportionately Black and Hispanic.
“I don’t even think they recognized their value to the community,” she said.
After spending a year risking COVID-19 infection to keep the city running, she said, they should accept the protection vaccines offer.
“That’s me speaking on behalf of physicians,” Mpasi said. “You cared for us. Now it’s time for us to take care of you.”