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Working to improve vaccine rates in rural areas in Texas

USA Center for Rural Public Health Preparedness partners with rural health departments and communities to understand and address the drivers of vaccine hesitancy

As communities begin to transition out of the emergency response phase of the COVID-19 pandemic, many unanswered questions remain. The most perplexing is, why, after all this time, are vaccination rates around the country still so low? To answer this question and better prepare for the next pandemic, the USA Center for Rural Health Preparedness at the Texas A&M University School of Public Health partnered with local health departments and non-profit organizations to conduct “Community Conversations” in Texas counties with identified vulnerable populations with low rates of vaccine uptake. The counties included were Angelina, Colorado, Fayette, Lee, Polk, St. Augustine and San Patricio, representing a diversity of populations in predominantly rural communities.

Funding for the project, The Texas Vaccine Outreach and Education Grant, was awarded from the Centers for Disease Control and Prevention through the Texas Department of State Health Services and funded 12 focus groups in these selected counties where participants were shown current material featuring the COVID-19 vaccine. The participants were asked questions about their thoughts on the material shown, as well as what their concerns were about the vaccine itself. The groups consisted of pregnant mothers, mothers of young children, young adults, rural families, African Americans and Latinxs. They asked questions about the vaccine and discussed what might have given them more confidence in the vaccination effort.

“One of the most remarkable aspects of our response to COVID-19 was the speed with which we built on existing knowledge and technology to develop an effective and safe vaccine,” said Angela Clendenin, PhD, instructional associate professor of Epidemiology and Biostatistics and associate director of the USA Center. “However, it is that very speed that led many of our participants to question the safety of the vaccine, leading to hesitancy and low vaccine uptake in many parts of our nation, but most notably in rural and underserved areas.” Clendenin also noted how important it was to also listen to specific populations about their concerns about vaccines to better inform and empower people to protect themselves and their families from COVID-19 or any other future infectious disease outbreak.

“One of the main failures in the response to the pandemic has been communication and trying to address people’s concerns with the development and distribution of the vaccine,” Clendenin said.

In addition, the USA Center team attended local health fairs and back-to-school events to distribute information about vaccines, the COVID-19 vaccine, and family preparedness. These events provided additional opportunities to hear from local residents of all ages about their experience with the COVID-19 vaccine. More such events are scheduled throughout the fall at the invitation of community partners.

The USA Center team has begun developing new material based on the feedback from conversation participants that will be distributed at future events. These include a new coloring book, information cards on what is in the COVID-19 vaccine and the timeline of mRNA technology development, and a BINGO game featuring COVID-19 and vaccination-related items.

“The opportunity to partner with local health departments and organizations is a tremendous asset to understanding where people are coming from based on their personal experiences with COVID-19,” Clendenin said. “We heard stories of lost loved ones, frustration with getting needed answers, and a commitment to keeping families safe and healthy. To take their stories, their information, their perspectives and develop something new that perhaps makes a difference in someone’s decision to get the COVID-19 vaccine, or to at least have a conversation about it with their loved ones, is what makes this project so important and so rewarding.”

Working with the USA Center to produce the new materials and attend the events is a cadre of public health graduate student research assistants. These students are participating in public health practice that shows them the value of evidence-based information and the challenges of communicating science to the public.

“People just want to be heard, seen and understood. They want to know the truth in its most simple state and be able to make informed decisions on their own health while looking out for their families and community,” said Osarumen Omorogbe. “It’s our role as public health practitioners to bring that unbiased simple truth to them and find the right words to communicate it inclusively.

As someone who was initially hesitant about the COVID-19 vaccine, Haley Mathis says participating in this community project has been a “full circle” moment in her life. “Sensitive topics, such as COVID-19 and the vaccine, can be very challenging to discuss, especially in hesitant communities. Working on this project, with this team, has taught me how to respectively combat misconceptions, while ensuring people know that their concerns are valid.”

The funding for this project extends through May 8, 2023, and the USA Center team will be continuing to listen, learn, and work with their partners to further understand the drivers of vaccine uptake and to use those to improve vaccine rates in rural areas in Texas.

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