Philadelphia’s badly botched COVID-19 immunization response has a chance to right itself now with the eligibility of teens, and soon younger children, to be among those inoculated. As adolescents in the region begin to get shots in what has been described as “patchwork” efforts, the success of the city’s 1991 coordinated measles vaccination campaign offers valuable lessons for today’s COVID-19 crisis. The threats are different, but the responses can be similar. In 1991 a strong public/private partnership resulted in a national model for community action. We can do it again now.
Surfacing in 1990 and gaining speed in 1991, a raging measles epidemic infected 1,400 people in Philadelphia, mostly youngsters. Nine children tragically died. In a world that had chalked up measles as a childhood disease of the past, it came as a rude awakening to the realities of un- or underimmunized vulnerable populations. Admittedly, six of those nine deaths were associated with fundamentalist churches that believed in faith-based rather than medical interventions. But the overall increases in measles and other childhood diseases alerted the community that they were in trouble.
A volunteer civic organization, the 21st Century League, decided to tackle the problem by forming a broadly based public, private, corporate, and neighborhood coalition. As members of the league, Lucy Durr Hackney and I cochaired the effort. Lucy was president of Pennsylvania Partnerships for Children and I had recently served as a health commissioner of Philadelphia.
The ensuing campaign targeted a spring weekend that offered free vaccines at 37 different sites, including public health centers, housing projects, schools, and hospitals. A cadre of 700 dedicated volunteers — doctors, nurses, students, and outreach workers — were enlisted. No appointments were necessary, no fees charged, and no medical records requested. A young infectious disease doctor at Children’s Hospital of Philadelphia advised us on the medical aspects of vaccinations.
A major publicity drive was funded by Merck Pharmaceuticals, which also made a prize-winning film about the campaign. SmithKline Pharmaceuticals loaned us their top public relations wizard, Tobey Dichter, to plot our messaging with radio spots, subway cards, and newspaper ads. The Red Cross established a hotline for parents with questions, West Philadelphia’s Parents Against Drugs did door-to-door canvassing, ongoing mayoral campaigns circulated bilingual flyers along with their own literature, and the Phillie Phanatic greeted children as they arrived for their shots. Afterward, the kids were consoled by snacks from Tastykake, the Girl Scouts, and Elliott’s Amazing Juices and Drinks. When it was time to return home, the Black Clergy of Philadelphia and Vicinity had donated bus tokens to all comers.
We had built a meticulously detailed 72-hour assault. The burning question on our launch date of May 4 was, “Will anybody come?” Our goal of 1,000 kids to be vaccinated was surpassed. Astonishingly, we had 6,000 kids inoculated by the end of the weekend. Philadelphians had pitched in with gusto. And their children were all the safer for it. The spirit of cooperation and the joy of people coming together over a crisis was palatable.
It is a pity that a similar coalition was not pulled together when COVID-19 started hitting Philadelphia. Surely it would have led to a planful strategy to vaccinate our citizens rather than the chaos that ensued. But it is not too late. As Philadelphia embarks on inoculating teens aged 12 to 18 against COVID-19, with children ages 2-11 potentially eligible for the vaccine this fall, we could recreate a version of the widely touted 1991 campaign.
Unfortunately, the 21st Century League no longer exists, but the Phillie Phanatic, the mascot of eternal hope, has lived on and been joined by Gritty, the mascot of abiding pluck. Surely they could be enlisted to encourage Philadelphia’s youth to get a shot in the arm. Maybe even a hesitant unvaccinated parent or two could be brought along. We now have the benefit of social media to get the word out. The young doctor, Paul A. Offit, advising the 1991 campaign is still at Children’s Hospital of Philadelphia and has become an international vaccine expert. Other things are in place: a new generation of activists, a city desperate for an upper, and a community commitment that can be reawakened. The challenge is formidable. We owe it to Philadelphia’s children to meet it.
Bettina Hoerlin is a former health commissioner of Philadelphia and taught courses in health disparities for 16 years at the University of Pennsylvania. In 2011 she authored a book “Steps of Courage: My Parents’ Journey from Nazi Germany to America.”