COVID-19 vaccine doses are now plentiful in Philadelphia, yet less than half the city’s 16-and-older population has received at least one dose.

Decades of disenfranchisement from the health-care system for those in poverty, particularly people of color, and a torrent of misinformation about the vaccines through social media, play roles in keeping vaccination rates low in those populations. What’s needed, community leaders have said, is outreach and information. Yet five months after vaccines debuted in the city, a coordinated outreach initiative remains in the works.

“Every day is someone else potentially losing their life and if there’s anything we can do to prevent that we need to be doing that,” said Stephanie Reid, executive director of Philly Counts, a community engagement unit under the city managing director’s office which has been tasked with spearheading that outreach.

Volunteer organizations, nonprofits, and government agencies have done outreach, ranging from phone calls to door-to-door canvassing to share information about the vaccine, but Philly Counts’ effort will resemble the citywide strategy the organization brought to census and voter outreach last year. In an interview with The Inquirer, Reid described what the group’s efforts will look like, and how they hope to connect with people who, for a range of reasons, either have been left out of the vaccination process or are reluctant.

Vaccine providers’ reliance on digital registration and scheduling has made it harder for less tech-savvy seniors to get vaccinated, health officials have said. There are language barriers, and bridging those, as the Esperanza Community Vaccination Center has in North Philadelphia for Spanish speakers, can result in more vaccinations. There’s also the stew of rumors and misinformation, along with a history of health care’s mistreatment of Black Americans, that have left people unnecessarily concerned about the vaccine’s safety.

» READ MORE: Esperanza has been a success at vaccinating Latinos, but Black Philadelphians still lag behind

“I just think the thing is with all of these things, we have to really hear what people are saying,” Reid said. “It’s like an onion. There are layers of reasons.”

Phone banking from Philly Counts has been underway for months, she said, and three months ago began focusing on seniors. Philly Counts had called almost 50,000 people, she said, and texted nearly 400. Those led to about 6,000 conversations and, since last week when they began making appointments for people directly, the callers have scheduled four people. TPrior to that, callers put hundreds into the city’s interest database.

Face-to-face contact is going to be critical to the outreach effort, Reid said. Getting communities informed about vaccination and comfortable getting the shots is likely to be a gradual process with repeated conversations.

“There’s a theory in organizing [that] it takes seven to 12 times before you do whatever it is that someone wants you to do,” Reid said. “Just because I get a very icy, ‘No I’m not talking to you about that,’ doesn’t mean that the door is closed. It might make it easier for the next person.”

Starting the weekend of May 22, she expects her team to collaborate with city agencies and community organizations to begin a two-month, comprehensive, door-to-door canvassing in 18 neighborhoods identified as being in need of outreach. Canvassers will provide information and help register vaccinations for people in neighborhoods identified using vaccination rates, a social vulnerability index, and high rates of English as a second language in zip codes. Those neighborhoods include Belmont, Mantua, Strawberry Mansion, and Cobbs Creek.

» READ MORE: Interested but skeptical, Latinos benefit the most at North Philly mass vaccination site at Esperanza

About 26% of Philadelphia’s Black population and 27% of its Latino population have received at least one shot, city data shows, a rate well below that for whites (45%) and Asians (55%).

“It’s areas where we know that we have to do work anyway because there’s historically not great access to health care,” Reid said. “The way that we are incorporating that understanding into our work is that we’re trying to be really thoughtful neighborhood by neighborhood about what the different complexities are.”

After that two-month period, during which the goal will be to achieve a vaccination rate that meets federal standards for herd immunity, Reid said, canvassers will be assigned to another set of neighborhoods and focus on those for another two months. Philly Counts is prepared to continue the process through May 2022, if needed.

On June 10, Philly Counts will also begin its ambassador program. These ambassadors, paid for 15 hours a week for 10 weeks, will work with Philly Counts to develop plans to boost vaccination in neighborhoods targeted for outreach.

The effort is being coordinated with the Philadelphia Department of Public Health, which will be conducting its own outreach efforts, is debuting an advertising campaign that will include television and radio spots, and will recruit doctors from communities of color to speak to the most common concerns in those neighborhoods.

“We know that people trust health-care providers who look like them and are from Philly,” said James Garrow, a spokesperson for the health department.

Of particular concern in Philadelphia is the low vaccination rates among young adults. About 39% of those ages 20 to 44 have received at least a single dose, and Black Philadelphians are the least vaccinated group within that demographic, with just 19% of that population receiving a shot.

Reid envisioned her canvassers focusing on places like basketball courts to meet younger adults during their leisure time. Fliers they hand out will have stickers on them that identify vaccine providers in the neighborhood. She also contemplated being able to coordinate with the health department to have mobile vaccination sites set up in neighborhoods as her staff canvasses, allowing people a place to easily and immediately get vaccinated.

» READ MORE: ‘The challenge to come’: Vaccinations are open, but demand is down, turning Pa. and Philly’s focus to fighting hesitancy

“If we could have water ice and music and a mobile vaccine pop-up event it might be easier to get people to walk down to something that seems a little more fun,” she said.

Reid noted the areas identified for outreach frequently have other challenges, such as being among the poorest or most victimized by gun violence. Talking to people there, she said, means recognizing that COVID-19 may not be the most vexing concern for those residents.

“We just have to be aware it might not be the worst thing going on for someone,” Reid said.