'Trusted Messenger' Outreach; When Will Boosters Be Needed? : Consider This from NPR The Biden administration is emphasizing vaccine outreach by 'trusted messengers' — community volunteers, faith leaders, and primary care providers — who are best-positioned to convince people to get vaccinated.

NPR's Maria Godoy reports on that kind of outreach in Maryland, one of just a handful of states where at least half of the Latino population is vaccinated.

In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.

Email us at considerthis@npr.org.

Latest On Boosters; 'Trusted Messengers' Lead Vaccine Outreach

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In the U.S., something like 90 million adults are completely unvaccinated. Some may never get a shot, but many others just haven't had time or need a little convincing. And the strategy for reaching that group...


PRESIDENT JOE BIDEN: Now we need to go to community by community, neighborhood by neighborhood and ofttimes, door-to-door, literally knocking on doors...

CORNISH: Last week, President Biden said there'd be an increased focus on vaccine outreach by so-called trusted messengers. And that doesn't just mean going door to door. It's more about meeting people where they are.


UNIDENTIFIED REPORTER: They're going to knock on your door. They're going to demand that you take it. It's unbelievable how offensive this administration's getting...

CORNISH: The idea of door-to-door outreach quickly became a talking point on Fox News and among conservative politicians.


UNIDENTIFIED REPORTER: New from overnight, Missouri Governor Mike Parson does not like the idea of federal workers going to homes, encouraging people to get a COVID-19 vaccine.

CORNISH: The Republican governor of Missouri - well, he was quick to say his state's health department would resist the strategy, which the White House said is led by local communities. And just for a snapshot of Missouri, cases there have more than tripled since May. At least one hospital system in Springfield has warned it will soon be overwhelmed, and another ran out of ventilators last week.


UNIDENTIFIED PERSON #1: All of the lifesaving equipment is in use right now at Mercy Hospital in Springfield.

CORNISH: More had to be shipped in from St. Louis. Less than 40% of people in Missouri are fully vaccinated.


JEFF ZIENTS: You know, as we've said from the beginning, all of the studies, all of our experiences - the best people to talk about vaccinations with those who have questions are local trusted messengers.

CORNISH: White House COVID coordinator Jeff Zients responded to criticism about door-to-door outreach late last week. Yes, he said, that's just one way the government is trying to reach people. But they're also focused on workplaces, places where people shop and local doctors' offices - anywhere people can encounter those trusted messengers.


ZIENTS: For those individuals or organizations that are feeding misinformation and trying to mischaracterize this type of trusted messenger work, I believe you are doing a disservice to the country and to the doctors, the faith leaders, community leaders and others who are working to help end this pandemic.

CORNISH: Coming up, what outreach that really works really looks like and the latest on potential booster shots. It's CONSIDER THIS FROM NPR. I'm Audie Cornish. It's Monday, July 12.

It's CONSIDER THIS FROM NPR. Before we get to how public health workers are trying to convince some people to get their first shot, there's been a lot of talk lately about when fully vaccinated people might need another one.


UNIDENTIFIED PERSON #2: Breaking news, very disturbing breaking news - Pfizer now says its vaccine is losing efficacy...

CORNISH: That sounds worse than it is. Late last week, Pfizer cited some data out of Israel that showed its vaccine was somewhat less effective at preventing infection against the Delta variant but still very effective at preventing severe illness and death.


UNIDENTIFIED PERSON #2: Pfizer now says a booster - listen to this - a booster may be needed.

CORNISH: The company said it was seeking regulatory approval for a third COVID-19 shot and working on a new vaccine that would target Delta specifically.


UNIDENTIFIED PERSON #3: However, the CDC just put out this statement. Americans who have been fully vaccinated do not need a booster shot at this time.

CORNISH: And that's what the CDC said hours after the Pfizer news.


ANTHONY FAUCI: If you look at the vaccines that we've been using here - and multiple studies from...

CORNISH: In an interview with NPR, Dr. Anthony Fauci said public health officials were still studying the data out of Israel, which suggested the Pfizer shot was 64% effective against infections from Delta.


FAUCI: The levels that we are getting in other studies seem to be substantially higher than the Israeli level of 64%. So what we really need to do is to get a bit more information from our Israeli colleagues, which we're trying to do.

CORNISH: Fauci suggesting there - basically the limited data might not tell the whole story about vaccines and the Delta variant.


FAUCI: The good news is that no matter what study you look at, the protection against severe disease is always well within the 90%, regardless of the study, regardless of the country.


CORNISH: The fact that vaccines remain extremely effective at preventing death continues to show up in real world data. Here is CDC Director Rochelle Walensky just last week.


ROCHELLE WALENSKY: Preliminary data from several states over the last few months suggests that 99.5% of deaths from COVID-19 in the United States were in unvaccinated people. Those deaths were preventable with a simple, safe shot.

CORNISH: In the U.S., according to CDC data, almost 20,000 people have died from COVID-19 in the last two months.


CORNISH: That brings us back to how public health officials are trying to get more people their first shot with that so-called trusted messenger outreach. And there's evidence it's working to bring up vaccination rates in some Latino communities. In fact, according to government data, while Latinos are 17% of the total population, they accounted for 34% of first shots over the last two weeks.

NPR's Maria Godoy went to Langley Park, Md., to find out what's been working there.



It's a hot day at the busy farmer's market right next to the Mega Mart Latino grocery store in Langley Park, Md.


GODOY: Dolores Fontalvo is scanning the crowd, looking for someone she can help. At 72, Fontalvo is friendly, indefatigable and a foot soldier in the state's effort to fully vaccinate its Latino population.

DOLORES FONTALVO: (Speaking Spanish).

GODOY: Her long braid sways as she bounces up to a woman waiting in line. Even though Fontalvo's wearing a mask, she smiles at the woman with her eyes.

FONTALVO: (Through interpreter) Hi, love. Did you get vaccinated yet? (Laughter) I thought not.

GODOY: The woman tells her she's not sure where to go and hasn't had time to get vaccinated. Fontalvo offers details on nearby vaccine clinics staffed by bilingual workers. Some are open nights and weekends to cater to people who can't get time off work. The woman asks her, do I need an appointment?

FONTALVO: (Through interpreter) Nope. Just give me your name and number, and they'll be expecting you at the clinic. First come, first served.

UNIDENTIFIED PERSON: (Speaking Spanish).

FONTALVO: (Speaking Spanish).

GODOY: Fontalvo is one of dozens of volunteer promotoras - literally, health promoters - who work with CASA, a Latino immigrant aid and advocacy group. Her job is to reach out to Latinos, many of them immigrants, to encourage vaccination. She says these days, most people are eager for the information, or they've already gotten their shot. But occasionally, the job involves countering misinformation.

FONTALVO: (Through interpreter) People hear negative rumors like, oh, the vaccine contains a microchip, or vaccines kill people.

GODOY: Her answer to that?

FONTALVO: (Through interpreter) Well, all of us are vaccinated, and here we are. We're all healthy. Nothing has happened to us.

GODOY: In Maryland, as in the rest of the U.S., vaccination rates for Latinos have lagged behind rates for whites.

Neil Sehgal is an assistant professor of health policy at the University of Maryland School of Public Health. He says there have been many reasons for this lag, including no paid time off from work, lack of access to reliable information in Spanish and lack of transportation. But Sehgal says that vaccination gap is now closing.

NEIL SEHGAL: That trend that we're seeing in Maryland, where a greater proportion of Latinos are making up the state's total share of vaccinations, is a good thing. It's the reason that we're seeing that gap close.

GODOY: He says CASA's promotoras are a big reason behind that success.

SEHGAL: When you can get a vaccine from someone in your community, someone that you know and that you have a prior relationship with, you're more likely to.

GODOY: CASA's promotoras have been seeding that relationship with the Latino community for decades, with outreach on long-term issues like diabetes and HIV. Dr. Michelle LaRue is the director of health and human services at CASA. She says when the pandemic struck, the promotoras were well-positioned to help a community left reeling.

MICHELLE LARUE: Our community has suffered not only from COVID but also all the social consequences that have come with COVID - so housing insecurities, food insecurities, financial insecurities due to job losses or hours cut.

GODOY: She says promotoras help spread the word about how to prevent COVID and where to get tested. They also connected people to desperately needed resources, like food and rent assistance. Early on, CASA also recruited promotoras to participate in COVID vaccine trials.

LARUE: We used that to promote the vaccine, say we know for a fact that this vaccine works on us and to try to bridge some of those trust issues that our community may have.

GODOY: Brigadier General Janeen Birckhead heads the state's vaccine equity task force, which partners with CASA. She says the task force homed in on the greater Langley Park region because it had been hit so badly by COVID. She says promotoras have played a critical role in expanding vaccine access.

JANEEN BIRCKHEAD: Our approach is working, and it is that on-the-ground work that we have to continue to do to get into the community. The trusted voice, the person that you may know or the person that you may trust, they're bringing the message to you about the vaccine.

GODOY: Sehgal of the University of Maryland says the promotora model is also being used increasingly in Southern California.

SEHGAL: But nationally, I think CASA and CASA's partners are really leading the way.


GODOY: Back at the supermarket, Dolores Fontalvo is doing way more than helping people get vaccinated. When shopper Antonia Aquino approaches with a question, the conversation quickly turns personal. Aquino starts crying as she recalls her own bout with COVID last year, which landed her in the hospital.

ANTONIA AQUINO: (Through interpreter, crying) Every time I remember, I cry. I said goodbye to my children. I lost my job.

GODOY: She says she now faces a pile of unpaid bills, and she still has lingering health issues. Fontalvo listens sympathetically and offers Aquino words of comfort before giving her a phone number she can call for financial and mental health assistance. She says she often sees people suffering because they're lonely and don't have support.

FONTALVO: (Through interpreter) Everyone has problems, but you have to find a way to overcome them. You have to find a way to keep going because life goes on, and life is beautiful.

GODOY: Fontalvo has been a promotora for nearly 18 years. When I ask how much longer she can keep going, she says, until my body gives out.


CORNISH: NPR's Maria Godoy.

It's CONSIDER THIS from NPR. I'm Audie Cornish.

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