To Boost Vaccination Rates, a Key Funder Channels Millions to Community Groups

Community-based nonprofit Migrant Farmworkers Assistance Fund helps farmworkers in Missouri get COVID-19 vaccinations. PHOTO courtesy of Migrant Farmworkers Assistance Fund

When the FDA announced its full approval of the Pfizer-BioNtech COVID-19 vaccine late last month, public health advocates breathed a cautious sigh of relief: Maybe this would encourage some of the holdouts to get the shots. To some extent, that proved true: an analysis by ABC News showed a modest but welcome 17% increase in the number of Americans getting their first dose of the vaccine following the approval.

But for many people—including those in historically underserved groups who have experienced health disparities of many types—the obstacles to COVID-19 vaccination can be way more complicated. Sometimes, it’s a lack of access to accurate information about the vaccines and fears about side effects. Sometimes it’s a lack of access to healthcare itself, including scheduling and getting the shots. Either way, among the groups best able to help them navigate the barriers to vaccination are community-based organizations with trusted, face-to-face relationships and strong cultural understanding.

Health and equity funders across the country are backing and sometimes leading pooled efforts to boost vaccination rates by supporting organizations rooted in communities rather than in big healthcare institutions. (For a deep dive into this push, check out this informative article by IP’s Katherine Don.) Another funder to go that route is the CDC Foundation, which recently made a wave of grants totaling $30 million, to more than 150 CBOs based in communities particularly hard-hit by COVID-19.

The CDC Foundation is a nonprofit entity, authorized by Congress, that works to advance the mission of the federal CDC agency. It’s funded by organizations, corporations, philanthropic foundations, and individuals, and also sometimes can get federal funding. The foundation has been a major conduit for donations during the COVID pandemic and other health crises, receiving millions from funders like Chan Zuckerberg and Robert Wood Johnson Foundation, and many corporations, including a number of big financial institutions.

For the recent $30 million in funding to CBOs, money came from businesses, foundations and federal funding. The 150 grants were awarded through competitive processes and funded by the CDC Foundation as well as funding provided by the Robert Wood Johnson Foundation, Google.org, Prologis Inc., and others.

Community-based organizations, and community foundations, were actually among the first responders from the nonprofit and philanthropic world to address the COVID-19 pandemic, starting as far back as early 2020. Now, they have become crucial to vaccination efforts in underserved and minority communities nationwide, explained Judy Monroe, president and CEO of the CDC Foundation.

“(The funding) is primarily to make sure community-based organizations had what they needed to answer the questions people had and help folks overcome hesitancy about the vaccines,” Monroe said.

The Utah Health Policy Project is one of the nonprofits supported through the recent CDC Foundation grants. Matt Slonaker, the organization’s executive director, says his colleagues have already developed trust with Hispanic, Asian American and Pacific Islander, and other communities they serve through previous successful efforts to broaden access to healthcare and wellbeing services. And that trust has been the key factor.

“We’re an outreach and enrollment organization, and for decades, our staffers have gone around the state enrolling people in Medicaid, CHIP and in the ACA during open enrollment periods,” said Slonaker. “So we’re reaching out to folks one-by-one in our vaccine outreach, and the CDC Foundation grants have enabled us to expand that work.”

The country’s still-unvaccinated population falls into three general groups, say advocates at nonprofit community organizations: the uninsured and others with limited access to healthcare; those wary of the vaccinations because they lack basic information about their safety and effectiveness; and the diehard anti-vax zealots. Those working at CBOs are more confident about helping the first two groups, less so about the third.

The experience of another CDC Foundation grantee, the Migrant Farmworkers Assistance Fund, which works with migratory fruit pickers in rural parts of Missouri, illustrates how easy it is for certain communities to be cut off from the benefits of the COVID-19 vaccines.

“Ninety-nine percent (of the people we work with) are uninsured,” said Suzanne Gladney, director of the Migrant Farmworkers Assistance Fund. And because migratory farmworkers move from harvest to harvest, both within Missouri and to other states, such as Texas or Florida, many find it difficult to set up insurance coverage or establish connections with primary care physicians. “Some of the children may have Medicaid in some states, but often, that Medicaid won’t work with providers here in this state.”

Because of the peripatetic nature of their work, Gladney said, sometimes the farmworkers will get the first shot of a two-dose vaccine but move to another state before it’s time for the second shot. Some farmworkers—generally unable to miss even a day of work for fear crew leaders on tight schedules will replace them—have concerns about the vaccine’s impact on their ability to work for a day or more, perhaps worried that they’ll feel dizzy up on a ladder, or that sore arms will interfere with their ability to work at full capacity.

“These folks don’t have paid time off for anything, so there’s no option to go for a shot during the day,” Gladney said. They also don’t typically have their own transportation, and are unable to cover the larger distances that are common in rural America to reach locations where vaccines are given. For these reasons, the farmworkers assistance fund generally brings healthcare workers to the farms to administer the shots. Frequently, they opt for the single-dose Johnson & Johnson shot to avoid the problem of moving before receiving the second shot of a two-dose regimen.

Unlike many vocal opponents of the COVID-19 vaccines, the agricultural workers Gladney serves are not espousing wild vaccine conspiracies. “Hey, our farmworkers have often been the only ones wearing masks,” she said. “They’re highly motivated to stay healthy and not miss work.”

The CDC Foundation’s Monroe says she is encouraged that more than half of businesses now require vaccination for employees, and are part of society-wide, multifaceted efforts needed to push up vaccine rates nationwide. “The community-based organizations are part of that larger mix,” she said.