In early April, Monterey County and a group of community organizations held a COVID-19 vaccine clinic in a school gym in the rural city of Soledad. In a promotional video produced about the event, locals shared what brought them out to get their vaccinations. “I did it to protect my kids,” said Greenfield farm worker Rosa Chavez in Spanish. “My family encouraged me to take the COVID vaccine…and I feel more secure now,” said Soledad resident Maria Ruiz.
The video highlights a Monterey County program known as Virus Integration Distribution of Aid (VIDA), which uses rural clinics and other outreach efforts to bring COVID-19-related resources to people like Chavez and Ruiz in hard-to-reach communities. The crux of the program involves community health workers (CHWs), lay people trained to deliver important public health information to the communities where they live.
“When this VIDA program started, there was four different focuses. One was around COVID-19 education: So what is COVID-19, how is it spread?...You feel that you need to isolate, how do you do that properly?” says Joel Hernandez Laguna with the Community Foundation for Monterey County, one of the organizations leading VIDA.
Together with the county, Hernandez Laguna’s group trained more than 100 community health workers not just for pandemic-related education and outreach, but also to assist with testing and vaccination efforts. “We have CHWs now hosting vaccine clinics and doing all that work behind the scenes,” he says.
Since the program’s launch in January, a county administrator says COVID positivity rates have improved in the communities they targeted.
The inspiration for VIDA came from a multi-organization collaboration in Fresno County that put community trust-building at the core of its pandemic response. “We were intrigued by Fresno having a very innovative approach and wanted to look at how we could replicate aspects of that,” says Krista Hanni, a program manager with the Monterey County Health Department. “We thought what they were doing would work well in Monterey County.”
What Fresno County is doing is called the COVID-19 Equity Project. It’s a joint effort between more than a dozen organizations as well as UCSF Fresno and Fresno State. Thanks to an infusion of more than $12 million from the county, and more from the city, the collaboration has reached tens of thousands of people in disadvantaged neighborhoods and rural areas, and people of color or with disabilities.
One equity project program is located on Fulton Street in downtown Fresno. The old Goodwill building, with its green marble façade, is now a vaccine clinic a few days a week. It’s hosted by the African American Coalition, one of the equity project’s three arms. On their way out the door, patients are offered a t-shirt that reads either “I Got My COVID Vaccine” or “Black and Vaccinated.”
According to equity project leaders, of the 8,700 vaccines administered by the African American Coalition, 38 percent have gone to Blacks, in a county where less than 6 percent of the population is African American. At the equity project’s other clinics, including a drive-through mass vaccination clinic at Fresno City College, nearly three-quarters of vaccine doses have gone to people of color.
With 35 percent of its population fully vaccinated, Fresno also has the highest vaccination rate of any Valley county, and it’s come the furthest toward vaccinating its most disadvantaged census tracts.
Clinic coordinator Patrice Pritchett says none of that could have happened without community health workers. “We all play a big part in this, from Mr. Russell greeting you at the door, to Miss Michaelynn getting you your information in regards of what you're receiving, all the way down to the people setting up the tents and pulling out the chairs,” she says.
Beginning last year, equity project leaders recruited and trained Pritchett and more than 100 other community health workers, then secured city and county contracts to get them paid as trusted messengers. “Even if you're scared, if you see someone else that looks like you and you say man, ‘if they can do it, then maybe I should try.’ And I believe that’s what’s happening for our community to be vaccinated,” Pritchett says.
“What you hear is people saying how pleasant the experience was, how pleasant the people were, how it was an unexpected pleasure to get service in a way that respected them,” says Dr. Venise Curry, a physician and consultant with the African American Coalition. The community health workers running the clinics and distributing community information, she says, “are exceptional and show up and do their work with commitment every day.”
Now, Fresno’s coalition is recognized as a role model statewide, especially for the curriculum Fresno State developed to train its health workers. It’s what both Monterey County and Santa Cruz County relied on to train their workers as well.
A collaboration following a similar health-worker-based model is developing in Sacramento County, where Kaying Hang works with the grant-giving non-profit Sierra Health Foundation. “It is groundbreaking, it is innovative, it is leaning into community assets, so for all of those reasons it is a model that should be closely looked at for spread and scale,” she says.
Hang also says it’s no surprise that such innovation originated right here. “Within the Valley, there are incredible community leaders and advocates who are tackling these inequities, and they are addressing these challenges head on,” she says.
The COVID-19 Equity Project didn’t materialize overnight. Organizers first met last April, and it took until August to secure their first round of funding. But Tania Pacheco-Werner, co-director of the Central Valley Health Policy Institute at Fresno State and one of the equity project’s co-leaders, hopes that doesn’t discourage others from trying. “I hope people can see how community members can be experts in their own healthcare, even with people having a high school education or less than high school education, and it just takes the time and training,” she says.
Pacheco-Werner also asserts that the training can be used to address other community health issues long after COVID is behind us, something Fresno County Interim Health Director Dr. Rais Vohra has spoken about as well. The equity project has “been an investment that’s really paid a lot of dividends through the COVID era,” he said in a recent media call. “As we start to expand now and think about other public health issues that we need to address, we’ll certainly look at that model to say, how can we create an equity project that looks at other diseases that we need to tackle here in Fresno County?”
The equity project’s community health workers hail from all walks of life, including students, grocers, retirees, and auto mechanics. Patrice Pritchett used to be a daycare teacher. But she said that this job, and the gratitude that community members share with her, have changed her life.
“We're all in the same shoes, we all have the same questions, we all have the same fear, and now we’ve created a family in it,” she says. It’s a calling she hopes to stay with even after the pandemic is over.