North Sound ACH Board Message: Equitable Access to COVID Vaccines

From Kim Williams, Board Chair (on behalf of the North Sound ACH Board of Directors)

North Sound Accountable Community of Health (North Sound ACH) strives to be a champion for equity and well-being in the region, and across the state of Washington. Our purpose, adopted by the Board, is to create a just and inclusive culture and the necessary conditions required for all community members to thrive. 

We have now lived with COVID in our communities for more than a year, and continue to see signs of exacerbated systemic and structural racism exposed every day. A year later, we still don’t have consistent access to COVID testing in communities disparately impacted by COVID, and now we face unprecedented challenges to equitable access to COVID vaccines.

Around the country – and here in our own region – we have seen conscious and unconscious mistakes and missteps, as providers struggle to manage unpredictable vaccine supply, refrigeration challenges, and vial expirations. Decisions are being made under extreme pressure to assure no vaccine is wasted, while depending on traditional methods of scheduling patients for first and second doses. In our region and beyond, we have seen those with access, money, and privilege have better paths to the vaccine than community members most impacted by the disease, especially communities of color.

The Board of North Sound ACH believes our systems and organizations must do better. Board members committed to a learning journey, encouraging each other to lean in and take risks, even if it means that sometimes the steps will be the wrong ones. Our intention, in the midst of this health crisis and pandemic, resonates with Maya Angelou’s wisdom when she says: “Do the best you can until you know better. Then when you know better, do better.” We recognize that individuals, especially those in communities heavily impacted by COVID, are doing the best they can under unimaginable pressures; institutions must lean in and improve strategies to reach and protect those same communities.

The Board of North Sound ACH is calling upon all North Sound partners, including those represented on our Board of Directors, to embed Targeted Universalism into their vaccine planning. All partner organizations have received information about targeted universalism, which puts the onus on us to identify the universal goal, then find ways that all community members can achieve it.  If the universal goal is to get all those in eligible tiers scheduled for vaccine appointments, we know that one single strategy will not reach everyone. We need multiple and targeted strategies based on what we know about sub-populations that we serve. However, investment in targeted strategies seems to elude us when we are under enormous pressure.

As examples, we are asking North Sound ACH’s CEO to advocate for, support, and assist in setting up: 

• Sites and appointment slots specifically ready for community members where English is not their first language, with interpreters, friendly and welcoming faces who will communicate a sense of belonging.
  
• Alternative ways to schedule appointments, recognizing that some community members have limited or no access to broadband or a device that can track all the possible websites claiming to find appointments.
  
• Transportation assistance, for those who want a vaccine but can’t physically get there.
  
• Designated slots at every appointment site for essential workers in our communities – including grocery workers, field and farm workers, utility workers and others.
  
• Creating mobile vaccine distribution to go where community members gather, bringing vaccines to them. 

Getting to this universal goal will require we all do our part, including having hard and uncomfortable conversations with partners who misstep in operationalizing their approach.

The Board has charged the North Sound team with leading discussions and supporting decisions that will assure all community members can find their way to the vaccine, to expand its work with local health departments, and to reach out to all ACH partners to expand the staffing capacity of vaccine clinics, mobile clinics, and pop-up sites. We are also asking the same of ourselves as Board members, and the of organizations that we work for.

The Board recognizes that while there have been challenges and insurmountable odds to conquer in this process, there has also been heroic, inspiring, and strong community-building efforts and resources currently innovating the way we ensure access and equity for such a vital need in our region.