Racial and ethnic minorities have experienced disproportionate outcomes of COVID-19, such as increased risk of infection, hospitalization, and death. Now that protective vaccines are available, Black and Hispanic people are being vaccinated at rates that are disproportionately low compared to their share of COVID-19 cases and deaths, as reported by Kaiser Family Foundation. Health plans can play an instrumental role in protecting the health of members who are racial and ethnic minorities by conducting thoughtful, targeted outreach to promote vaccination.

CMS recently spoke with health plans that shared the following promising practices related to supporting vaccination for members who are racial and ethnic minorities.

• Include race and ethnicity in vaccination data. In order to identify and mitigate vaccination challenges faced by racial and ethnic minorities, plans must first identify and understand where these issues are occurring. ^[1] Many health plans are including race and ethnicity information in their COVID-19 trackers and dashboards. Tracking a variety of demographic data, including race, sexual orientation, disability, gender identity, language preference, etc., can provide an invaluable perspective, as many of these identities may intersect, resulting in a higher impact from COVID-19 (e.g., a person with disability who is also a racial and ethnic minority). Using this information, plans are able to identify where to do additional outreach and if it should be culturally and linguistically tailored. This may include seeing which local communities have been most affected by COVID-19 in terms of cases or deaths. Plans may also choose to focus their efforts on communities experiencing low vaccination rates or low rates of follow-up for the second dose.

• Acknowledge the uncertainties and challenges faced by racial and ethnic minorities, both historically and in the current moment. The COVID-19 public health emergency has added to existing health inequities faced by racial and ethnic minorities; acknowledging this reality and addressing common concerns, including historic racism in the health care system, can help health plans to build trust with their members. Health plans are providing culturally and linguistically tailored outreach to promote vaccination as a way to protect oneself and one’s community against the pandemic. One common concern among some underserved populations is that they were not adequately represented in clinical trials of the vaccines. However, Kaiser Family Foundation reported that trials for the COVID-19 vaccinations have included historically high levels of diversity compared to other drug trials. One health plan is explicitly naming and addressing this concern in their outreach messaging by including facts about the COVID-19 vaccination trials. For more information that may help your plan learn about and acknowledge racism in healthcare, please visit the CDC’s new page on Racism and Health.

• Establish partnerships with community-based organizations. Health plans across the country are working with community-based organizations that have already established contact and trust with different underserved populations. These partnerships may be long-standing or newly-founded as a result of needs identified during the COVID-19 public health emergency. Plans are working with community-based organizations including:
  • Places of worship
  • Food banks
  • Homeless shelters
  • Minority Serving Institutions
  • Trusted organizations in the communities, such as the Black Doctors COVID-19 Consortium, 100 Black Men of America, and the National Hispanic Council on Aging

• Offer materials in languages relevant to your member population. For more information on how other plans are accomplishing language access, see our previous blog post on the topic here. CMS has also developed a Guide to Developing a Language Access Plan. The CMS Office of Minority Health’s COVID-19 Vaccine page has more resources related to vaccination.
• Staff vaccination sites and outreach events with workers and volunteers who represent the communities they are working in. One health plan recently mentioned that they engage staff and volunteers that live in the communities that they work in, which can help facilitate feelings of understanding and trust. Another health plan shared that, when planning outreach events, they consider the target audience and choose trusted panelists based on that population’s needs and interests. For example, they have found that the Black community in the local area is experiencing vaccine hesitancy; in response, they include Black subject matter experts who have themselves been vaccinated in member committee meetings as well as in community health worker trainings. This ensures that those members experiencing vaccine hesitancy more easily identify with and trust those who are providing accurate, up-to-date information.

[1] Plans may also consider completing a Disparities Impact Statement to identify opportunities to advance health equity. For a tool to assist in completing a Disparities Impact Statement, please see https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Disparities-Impact-Statement-508-rev102018.pdf.