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Rural COVID-19 Innovations: COVID-19 Vaccination

Examples of how rural communities and healthcare providers are innovating to provide COVID-19 vaccinations in rural areas.

  • Bringing vaccines into hard-to-reach communities
    Alabama
    June 30, 2021 - Hill Hospital of Sumter County takes vaccines to surrounding communities without doctors or clinics. The hospital has staff who live in these communities and commute, so community members already know and trust the people working at the vaccination clinics. The hospital advertises its vaccination clinics through newspapers; social media; and local leaders like pastors, teachers, county commissioners, and the city council. Vaccination clinics are held at churches, fire departments, and local businesses. Hill Hospital provides transportation to those who can't get to a clinic on their own and brings vaccines to people who are homebound. About 70 to 80 people have attended each clinic. So far, 4,372 people have received at least one shot, and 40-50% of county residents are fully vaccinated.
    Source: Loretta Wilson, CEO, Hill Hospital of Sumter County
  • Drive-thru vaccination clinic and door-to-door vaccinations
    Virginia
    May 14, 2021 - The Health Wagon, a mobile clinic in Wise County, hosts a drive-thru vaccination clinic and goes door-to-door to businesses (to vaccinate employees) and to houses (to vaccinate homebound people and their caregivers). The organization has completed 2,500 vaccinations so far. The Health Wagon has a 99% vaccination rate among employees, thanks to employee culture and buy-in from leadership, and posts videos about these vaccinations to encourage community members.
    Source: Dr. Teresa Tyson, President and CEO, The Health Wagon, via the National Rural Health Association
  • Vaccinating homebound individuals
    Vermont
    May 14, 2021 - The Vermont Department of Health worked with local stakeholder groups to identify homebound individuals who need to be vaccinated and created a call center to find any individuals they missed. The State Health Operations Center worked with emergency medical services and home health agencies to deliver vaccines to homebound individuals. EMS agencies additionally provided vaccinations in long-term care facilities to support and augment gaps in the federal pharmacy program. In the first month, EMS vaccinated 2,625 homebound individuals and have since delivered homebound vaccine to over 4,500 individuals.
    Source: Dan Batsie, Director, Vermont Department of Health, Division of Emergency Preparedness, Response & Injury Prevention, via the National Rural Health Association
  • Helping older adults schedule and access the vaccine
    Vermont
    March 29, 2021 - Support and Services at Home (SASH) is an organization that works with affordable-housing organizations across the state to help older adults live independently. SASH staff reach out to individual residents to inform them about the vaccine and help them schedule and get to appointments. Staff has reached 90% of SASH participants in affordable-housing buildings in two communities, providing these residents information, helping them schedule appointments, and making sure they attend both appointments at an in-house vaccination clinic. For SASH participants who don't live in affordable-housing buildings, SASH staff use a newsletter and prerecorded phone calls to reach every participant and then help them schedule appointments and any needed transportation. This approach has helped 95% of these participants receive at least one shot of the vaccine. One SASH provider has hosted 9 clinics at small low-income independent senior housing sites, resulting in about 152 people receiving both shots.
    Source: Casey Doerner, Health Systems Educator/Wellness Nurse Lead, Support and Services at Home, via the National Rural Health Association
  • Vaccine registration system, weekly vaccination clinic, and task force
    West Virginia
    March 29, 2021 - The Greater Greenbrier COVID-19 Task Force holds a virtual meeting at least once per week (since March 2020) to coordinate, collaborate, and communicate local COVID-19 response efforts across governmental, nonprofit, business, and grassroots organizations; this "task force" model has been replicated in nearby counties. The Greenbrier County Health Department — with support from many community organizations and 50-60 weekly volunteers — administers a large-scale, weekly vaccination clinic at the State Fair of West Virginia with capacity to vaccinate 75 people per 1/2 hour. The West Virginia School of Osteopathic Medicine Center for Rural and Community Health assists the Health Department with information and data management linked to evolving vaccine response needs including: hotline and database management system for scheduling and coordinating vaccination appointments, onsite clinic information management, and online map data integration to assist with building routes to coordinate vaccinations for homebound people throughout the county.
    Source: Courtney Hereford, Executive Director, West Virginia School of Osteopathic Medicine Center for Rural and Community Health, via the National Rural Health Association
  • Vaccination clinics and "vaccine swat teams"
    Colorado
    March 23, 2021 - Southwest Health System has vaccination clinics in which it's able to seat, vaccinate, and monitor 25 people every 30 minutes. In addition, Southwest Health System has "vaccine swat teams" that travel throughout its service area to deliver vaccines to long-term care facilities and to people who are homebound or who are experiencing homelessness. Southwest Health System has administered 7,500 shots of the COVID-19 vaccine since December 15, 2020.
    Source: Marc Meyer, Retail Pharmacy Director, Southwest Health System
  • In-person scheduling of vaccination appointments and transportation
    Oregon, Washington
    March 9, 2021 - The Gorge Native American Collaborative and the Gorge TransLink Alliance are hosting vaccination clinics at a shared tribal longhouse in Celilo Village. Outreach teams visit individuals in person to schedule a vaccination appointment and arrange transportation. The first event led to 104 people getting vaccinated, with transit picking up people as far away as 70 miles from the event site.
    Source: Covid-19 Resource Center, National Center for Mobility Management
  • Mobile vaccine clinics and appointment scheduling hotline
    Washington
    March 9, 2021 - Twin Transit, Lewis County Public Health and Social Services, Bird's Eye Medical, and United Way of Lewis County are providing mobile vaccine clinics. Twin Transit manages a hotline so people can schedule vaccination appointments over the phone. This approach reaches people who don't have transportation to attend a mass vaccination event, are homebound, and cannot or struggle to access an online scheduling portal.
    Source: Covid-19 Resource Center, National Center for Mobility Management
  • Mobile health unit for testing and vaccines
    Pennsylvania, Ohio
    March 3, 2021 - Primary Health Network, an FQHC serving 16 counties in Pennsylvania and one in Ohio, purchased a mobile health system where healthcare staff can travel to underserved communities and provide COVID-19 testing or vaccines. The mobile unit can be set up in about 45 minutes; this process includes powering up generators for the freezers that house the vaccines and creating negative air flow to prevent airborne spreading of the virus. Primary Health Network plans to mobilize their COVID-19 vaccination efforts, once adequate supply of vaccine is available. Additionally, the FQHC is performing COVID testing from the mobile unit 3-4 days per week for Mercer County, PA, residents. To address any misinformation and encourage community members to get the vaccine, Primary Health Network's Chief Medical Officer, George Garrow, MD, talks to organizations like farmers' groups, trade unions, and church groups.
    Source: Sara Rupp, Marketing Director, Primary Health Network
  • Increasing vaccine compliance rate among healthcare workers
    Tennessee
    February 24, 2021 - Bolivar General Hospital is at an 86% compliance rate with healthcare staff receiving the vaccine. Executive leaders had one-on-one conversations with employees, board members, and community members who were hesitant about getting the vaccine and answering any questions or concerns they had. The hospital leadership team and department heads were the first to get vaccinated and talked about their experiences so employees could learn more about potential side effects. In addition, the hospital offered vaccine appointments at times that better accommodated people working nights or weekends.
    Source: Ruby Kirby, CEO, Bolivar General Hospital
  • Prisma Health launches mobile vaccination units
    South Carolina
    February 24, 2021 - To help vaccination efforts reach rural and underserved communities, Prisma Health in Greenville, South Carolina, has created mobile vaccination units. The vehicles, staffed with medical professionals, will be hosted in target areas chosen in collaboration with their community partners. The mobile vaccination units will distribute vaccines to eligible members of the community by appointment, following up three weeks later with the second dose. The community partners help spread the word, even going as far as helping people make appointments for the clinic. After completing these pilot events, the goal is to have seven mobile units (three working in the Upstate and three in the Midlands service area) available by the end of this spring.
  • Calling veterans to schedule vaccination appointments and answering questions
    Montana
    February 19, 2021 - The Merril Lundman VA Outpatient Clinic called every patient in its service area, which includes two American Indian reservations, to schedule a vaccination. When some patients were hesitant in getting the vaccine, a nurse called each of these patients back to answer any questions they had. This second phone call led to 10 more veterans agreeing to be vaccinated.
  • Reaching out to Black preachers and leaders to encourage vaccination
    Louisiana
    February 17, 2021 - St. James Parish Hospital staff noticed that the majority of people choosing to get vaccinated after seeing the hospital's online and social media advertising were White ― in a parish in which almost 49% of the population is Black. Hospital staff reached out to Black preachers and local leaders (including a state representative) and established a phone line to spread the word about getting vaccinated. The next week, vaccination among Black community members increased from 9% of the total number of people vaccinated to 30%.
  • Using phone trees and regional transit systems to reach individuals
    North Carolina
    February 10, 2021 - When CommWell Health in Brunswick County had 200 vaccine doses available, the NAACP county branch president organized a phone tree so that the vaccination event held the next day would have enough attendees. This method of communication was important in reaching individuals unable to access their usual sources of information, like churches or senior centers. In Jackson County, the regional transit system is picking up older adults and driving them to vaccination sites. These rides (in vans and small buses) are free, a small number of passengers can ride at any given time, and plexiglass separates passengers from one another.
  • Virtual town hall for informed discussions about vaccines and health equity
    North Carolina
    February 4, 2021 - Buncombe County Health & Human Services, in partnership with the YWCA of Asheville & WNC, is hosting a two-part virtual town hall to discuss the COVID-19 pandemic and vaccine distribution. The first part, held on January 27, discussed historical and ongoing reasons that BIPOC (Black, indigenous, and people of color) populations tend to mistrust medical systems. The second part will be held in early February and will discuss the science of vaccines. In addition, Buncombe County Health & Human Services is creating a Community Vaccine Conversation Toolkit to help faith organizations, civic groups, and community members have fact-based, informed conversations about vaccines.
    Source: Zo Mpofu, Public Health Program Consultant, Buncombe County Health & Human Services
  • Information website and vaccine priority mapping tool
    North Carolina
    February 1, 2021 - East Carolina University (ECU) Brody School of Medicine and Vidant Health created an information website called COVID-19 and Eastern North Carolina to provide COVID-19 and vaccine distribution information for healthcare providers, health departments, and community members in the 41-county service area. ECU also developed a Vaccine Priority Index Tool so that groups like health departments could identify populations and high-risk facilities (like nursing homes and meat packing plants) that are of high priority to receive the vaccine. In addition, a team led by the ECU Department of Bioethics is creating an ethical framework to address questions such as vaccine hesitancy.
    Source: Greg Kearney, Associate Professor, East Carolina University Department of Public Health
  • 1,232 doses of Pfizer COVID-19 vaccine distributed
    Texas
    January 28, 2021 - In Dalhart, Texas, a team of nurses, volunteer police, and volunteer firefighters converted the town's event space, the coliseum, into a vaccine clinic. The police and firefighters helped direct the crowd, each person given a number and set up in the socially-distanced waiting area. Once given the vaccine, they were kept for 15 minutes of observation before getting checked out and given instructions on how to schedule their second dose in approximately 21 days. The clinic was targeted at residents in the counties of Dallam, Hartley, and Sherman, although no one was turned away. Senior citizens and essential workers were given priority, but ultimately 1,232 Pfizer vaccines were distributed, making the clinic an overwhelming success. The community plans to continue its vaccination clinics in the same manner. For more on this event, see 1,232 Doses of Pfizer COVID-19 Vaccine Distributed at Coliseum in Dalhart, Texas in the Rural Monitor.
    Source: Joyce Bezner, Dallam Hartley Counties Healthcare Foundation
  • Community health centers work with local organizations to distribute COVID-19 vaccine
    Wisconsin
    January 28, 2021 - Scenic Bluffs Community Health Centers, a rural community health center in western Wisconsin, reached out beyond its own frontline healthcare staff in order to distribute the COVID-19 vaccine to as many eligible Phase 1a individuals in the community as possible. They contacted independent healthcare providers, faith-based organizations, and local rural emergency services, such as first responders, EMTs, fire departments, and small municipal police departments ― who all play an integral part in rural communities, and could face potential COVID-19 exposure. Because vaccine delivery often came at short notice, Scenic Bluffs collected contact information from these groups ahead of time, to quickly direct them to online registration for a vaccine appointment when the health center had vaccine in-hand. They also work with other community organizations, such as local school districts, to ensure COVID-19 vaccine educational resources are available, questions are answered, and preparation is made for the organizations in phase 1b.
    Source: Samantha Knutson, Scenic Bluffs Community Health Centers
  • Book club pivots to vaccination effort
    New Mexico
    January 26, 2021 - The Fabulous Ladies Book Club in Ruidoso, New Mexico began coordinating local COVID-19 vaccination efforts when they learned that their state department of health needed help with distribution in their area. The book club networked with the local community and the state department of health, even setting up a hotline for questions. They helped people register for the clinic, providing technical assistance and walking participants through the process. Once the clinic began, the women volunteered their time at the site, doing everything from managing the vaccine stock to shoveling snow so the clinic was accessible. Some book club members volunteered up to 50 hours a week. Their efforts paid off, with more than 2,417 vaccine doses administered so far – estimated to be a little over 30% of the area's population.
  • Addressing vaccine hesitancy through social media and graphics
    North Carolina
    January 22, 2021 - Roanoke Chowan Community Health Center is using social media to address vaccine hesitancy with patients. The center posted videos of trusted providers talking about why they received the vaccine. In addition, the center created graphics that address common questions about vaccines and have photos of staff members getting vaccinated. For examples, see Community Health Center Addresses Vaccine Hesitancy through Social Media in the Rural Monitor.
    Source: Erin Storie, Communications & Advocacy Coordinator, Roanoke Chowan Community Health Center
  • Grassroots education to encourage acceptance of COVID-19 vaccination
    Arkansas
    January 21, 2021 - Dr. Jason Lofton, a family physician who practices in the rural community of De Queen, AR, has noticed a trend of vaccine hesitancy in his community, which was hit especially hard by COVID-19 in June and July. To combat the issues of mistrust and lack of understanding, Dr. Lofton has taken a grassroots approach to educate his patients and members of the community, using various media and meeting with local leaders. Dr. Lofton provides education on the COVID-19 vaccine as part of every patient encounter. He has discussed current issues about both the virus and vaccine on local radio, along with presenting to the area's police department, Rotary and Lion's Club, and public school administration ― who used their new video department to record and broadcast a video. Dr. Lofton also records Facebook videos in order to inform the public, sometimes collaborating with another local physician, Dr. Randy Walker. Additionally, to aid in education of the community's Hispanic and Marshallese populations, they have worked on bringing in Spanish and Marshallese interpreters on some of their videos.
    Source: Dr. Jason Lofton, De Queen, Arkansas
  • Holding a vaccine town hall
    Texas
    January 20, 2021 - Titus Regional Medical Center in Mount Pleasant held a virtual COVID-19 Vaccine Town Hall. Two doctors and the CEO answered community members' questions (submitted ahead of the event and during the event) about the vaccine. In addition, the medical center created an online waiting list for receiving the vaccine, and over 4,500 community members have signed up so far.
    Source: Terry Scoggin, Chief Executive Officer, Titus Regional Medical Center
  • Delivering vaccines to remote villages by plane, water taxi, or sled
    Alaska
    January 8, 2021 - To reach remote Alaska villages, tribal healthcare providers have delivered vaccines via chartered planes, water taxis, and sleds pulled by snow machines (what people in other states and regions call "snowmobiles"). One group of providers administered the shots in village clinics and made home visits to elders who weren't able to travel. Another team asked anyone eligible to receive the vaccine to meet on the tarmac so vaccines could be administered as soon as the plane landed. After administering the shots, these providers waited 20 minutes (to make sure no one had an allergic reaction) before flying to the next village. Thousands of doses have been delivered so far.
  • Pueblos of Acoma, Laguna team up with New Mexico Department of Health and EMS to deliver COVID-19 vaccine
    New Mexico
    January 7, 2021 - The Pueblo of Acoma and the Pueblo of Laguna have partnered with the New Mexico Department of Health in order to distribute the Pfizer COVID-19 vaccine to reservation residents. The EMS services of both Pueblos provide a key role in the vaccination efforts, mobilizing to administer the vaccine in drive-through sites. The first events focused on those who are at higher risk of infection, such as the elderly and front-line workers, with both locations vaccinating over 200 residents. Vaccination efforts are currently ongoing, with pre-registration open to tribal members who live within the reservations. To date, more than 800 people in each area have received the vaccine, with the goal of vaccinating all of the roughly 4,000 members who reside in both locations. For photos and more information, see the Pueblo of Laguna Covid-19 Facebook page and the POA Health & Human Services Division Facebook page.
    Source: Chelsea White IV, University of New Mexico Center for Rural and Tribal EMS
  • Using existing relationships between pharmacies and long-term care facilities
    West Virginia
    January 7, 2021 - Since West Virginia has few chain pharmacies, it did not sign on with a federal program using two nationwide chains to distribute the vaccine in long-term care and assisted living facilities. Instead, West Virginia created a plan to deliver the vaccine to 250 pharmacies, many of which are small and independent. Many long-term care facilities in the state already have a relationship with these pharmacies, so these pharmacies already had patient data. Thus, pharmacies were able to schedule appointments, secure consent forms, and match doses to eligible patients before vaccine doses even arrived in the state. When the vaccines arrived, pharmacists already knew how many doses they'd need. West Virginia has completed a first round of shots at all long-term care facilities in the state and has begun administering second doses.
  • After freezer failure, hospital must distribute vaccines on a wide scale
    California
    January 5, 2021 - In the rural community of Ukiah, California, health professionals at Adventist Health Ukiah Valley Medical Center found themselves with only two hours to distribute 830 doses of the new Moderna COVID-19 vaccine after their freezer failed. Staff quickly mobilized and coordinated with the county and an eldercare facility, getting doses to frontline workers at the county jail, as well as the eldercare staff. Hospital staff networked with other medical professionals and members of the community and were able to get four vaccination sites established, and word spread quickly in the isolated community. All remaining doses were administered within the time frame due to this impressive coordinated effort. This provides an example with lessons learned of how mass distribution of COVID-19 vaccines may work in the near future.
  • Buying specialized freezers for vaccine
    Washington
    December 3, 2020 - Ferry County Health built two outbuildings and bought specialized freezers cold enough to store one type of COVID-19 vaccines. Coordinators purchased these freezers before the vaccine had received FDA emergency use authorization because they knew the freezers would be in short supply once a vaccine was approved.