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Closing the Vaccine Gap

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Many places in the world still don’t have easy access to the COVID-19 vaccine. But, in countries like the United States, where people can get it by going to their nearest pharmacy, the so-called “vaccine gap” presents a complex problem.


Many individuals registered to get vaccinated as soon as their age groups became eligible, while others are still holding out. Here, we explore some of the reasons behind vaccine hesitancy and highlight potential ways to combat the issue.

Empathize with a person’s fears

Experts often cite misinformation as a significant factor causing vaccine hesitancy. That’s a valid point, but it’s not the only issue. Anthropology Professor and author Heidi Larson has studied vaccine-based rumors and their effects for more than two decades. She urges people to remember the emotional aspects that can cause uncertainty.


Larson clarified, “Fear is the neglected dimension of health in terms of us actually characterizing it, studying it and recognizing how it can help inform not just our communication but how we engage and interact with people from an empathy perspective.” She continued, “When people say, ‘I’m afraid of this,’ we can’t correct them. We have to empathize, and we always need to have credible information.”

Shape the conversation

Kathy Barringer, a behavioral health therapist at Cleveland Clinic, also noted that it’s helpful for a person to know their audience when engaging with someone about vaccine fears. “All hesitancy isn’t created equal. Some people are absolutely terrified of needles or side effects like vomiting. Others might be hesitating because they don’t have access to a nearby vaccine clinic, or some people might have doubts because of political reasons,” she explained.


Knowing what to focus on during the conversation helps, too. “If I’m talking to someone who’s really afraid of the vaccine side effects, I’m not going to go into great detail about how sick I was after my first dose. I’m not going to lie to the person, but I’m not going to scare them in the opposite direction, either,” Barringer said.


A person’s fear of the COVID-19 vaccine may not stem from that dose itself. Perhaps they had an adverse reaction to a shot as an infant or knew someone who did.

Recognize how access and work schedules bring complications

Vaccine hesitancy can also occur because of logistical challenges, particularly if people worry about experiencing short-term side effects afterward. A fever, body aches and fatigue are common symptoms associated with receiving a COVID-19 vaccine. The immune response begins when the body’s defense system recognizes an unknown antigen. Briefly feeling ill is a sign that the immune system is working as it should.


However, some people cannot afford to take time off work if they feel bad for a day or two after getting vaccinated. That’s why vaccine clinics at workplaces help.


An April 2021 survey found that, among people most eager to get their vaccines, 12% said they could not take time off from their jobs to do it. Additionally, 48% of all respondents in the 18-49 age group worried about missing work due to side effects.

Tackle transportation-related troubles

The Pfizer-BioNTech vaccine was the first approved option against COVID-19. However, early data showed it must get stored between -60 °C and -80 °C to stay safe and effective. Those specifics made it challenging to ship and brought additional obstacles when transporting it to patients in rural locations. Later, US regulators reviewed updated data and ruled it was safe to store refrigerated vials at temperatures of 2-8 °C for up to a month.


Transportation obstacles can also affect people who want the vaccine and have no way to get it. Statistics indicate an estimated 2 million people aged 65 and over are mostly or entirely homebound. Another 5 million have health conditions that make it difficult to leave the house.


Being aware of those barriers and working to break them down increases vaccine access for everyone. For example, in Maryland, United Way set up a hotline where people can book free trips to vaccine appointments or get help with registering for them. Other initiatives feature health care providers going to workplaces or directly to the residences of people who want their doses.

Use the power of established trust

Many people heard a lot about the COVID-19 vaccine from politicians or other figures they only knew from watching on a TV screen. If they get little or no information from individuals they know, it’s understandable why they may balk at getting their shots.


Roseann Bongiovanni understood this as a third-generation resident of her Chelsea, Massachusetts, neighborhood. Through GreenRoots, the environmental and public health advocacy group she directs, Bongiovanni sent community ambassadors door-to-door to answer questions, help people schedule appointments and take them to the necessary locations when needed.


By teaming up with two nonprofit partners, GreenRoots made more than 18,000 doorstep visits and placed at least 3,900 informational phone calls to residents. Bongiovanni also said it was vital to offer vaccines at a community health center people already trusted and liked. This approach led to Chelsea reaching a vaccination rate exceeding 70%.


This example shows why it’s so valuable for people to engage in honest, open conversations with people they know. The COVID-19 vaccine can be a tricky subject. However, trust between both parties makes it easier to navigate.

Explore how to meet individual needs

Delivering high-quality, effective health care requires staying attentive to a person’s specific needs and preferences. The same is true when trying to close the vaccine gap.


Perhaps someone wants a one-dose vaccine because it’s more convenient with their childcare commitments. Another person may not care what kind they get as long as they can receive it without waiting. The option to get transportation assistance for a vaccine appointment or having someone administer it at a patient’s house could also be game changers.


Vaccine hesitancy is a multifaceted matter. Overcoming it starts with listening to a person’s obstacles, then working together to address them.