5 Min Inspiration: Trust, Ingenuity, and Vaccines at the Last mile

5 Min Inspiration: Trust, Ingenuity, and Vaccines at the Last mile

You know what inspires me most about CARE’s COVID-19 vaccine work? The number of times I’ve heard someone say that one of the key ways to convince people to get COVID-19 vaccines is to have CARE staff share the message. Here’s what one staff member said recently.
“When people see a CARE vehicle, all their doubts and suspicions are dropped. People say, “If CARE is involved in this, there cannot be any malicious intent. We trust CARE.”” I’ve heard variations of that over and over from so many people in the last year. It makes me so proud to be here. It represents the incredible work that our teams are doing—not just now, but over years and years of investing in communities and building relationships of supporting people who need it most.
In places where CARE has significantly supported COVID-19 vaccine rollout, 102.2 million people have gotten the COVID-19 vaccine. That’s data from public records where governments are tracking COVID-19 vaccination rates.
It’s a tricky conversation. CARE doesn’t usually directly vaccinate people (South Sudan is one exception to this)—so what does it mean to “significantly support vaccines”? What exactly does CARE do that is contributing to these vaccination rates? Let’s take a look at some of the coolest ways teams are making sure that COVID-19 vaccines make it to people at the last mile.
What are we doing?

  • Filling information gaps. CARE Rwanda has trained call center staff at COVID-19 hotlines so those people can provide accurate information to the public who have questions concerning the vaccine. In Jordan, 67% of the people in CARE’s Hygiene and Behavior Change project signed up for vaccines, and they said one reason was because of the information CARE shared with them.
  • Reinforcing data analysis systems: In Zambia, CARE is supporting data entry clerks to access internet so they can add paper vaccination records into the online system (58% of health centers we’re working with have neither power nor internet connections). That accounts for 26% of all vaccinations recorded in the areas where CARE works. Districts where CARE works on COVID-19 vaccines in Zambia have vaccinated 5 times more people since they started working with the CARE team.
  • Helping people navigate online signup and register for vaccines. Bangladesh held 52 training sessions over six months, where they got 1,580 health workers and volunteers set up to register people for COVID-19 vaccines. Those people helped 83,105 people who don’t have smart phone get signed up for vaccines. With more support for registration, the Khulna district went from the second-worst vaccination rate in the country to the second best. The government has asked to scale this support up to vaccination days in many more places, especially as they try to register more people under the age of 18.
  • Advocate for people who might not get the vaccine. In Ecuador, CARE is doing a lot of work to make sure that refugees and migrants can get vaccines, and that they understand how and where to get vaccinated. They especially worked to make sure that health workers were not demanding ID papers for refugees to get vaccinated.
  • Get people talking to leaders and health workers. In the 4 sites in DR Congo that CARE is supporting, vaccination rates are 9%—nearly 12 times higher than the national average for COVID-19 vaccines. That’s partly because of extensive community dialogue sessions, getting local leaders to promote COVID-19 vaccines, and making sure that health centers can solve the problems people raise—like having enough PPE to go around. In Indonesia, CARE and partners engage with Community COVID -19 Task Force, which consists of Health Workers, Village leaders,  religious leader, police and other respected figures-  to communicate the benefit, efficiency  and safety of vaccine.
  • Building on relationships with the private sector to support workers. In Bangladesh, CARE identified that garment workers couldn’t leave work to get vaccines, which meant they weren’t getting vaccinated at all. CARE connected the government to the garment factory owners to extend vaccine training to healthcare staff working at garment factories –and women got vaccines without taking time off. CARE was able to leverage existing relationships with the garment factories, private sector and the government. Now other garment factories are copying this model because it worked so well. 
  • Getting creative in the media. CARE is uses media and radio talk shows to address frequent rumors connected to the vaccine. Overall, 370.2 million people have gotten mass media messages promoting the COVID-19 vaccine.
  • Use social media where it works. CARE’s social media campaigns in 19 countries have reached 476 million people. 8.6 million people are more likely to have a positive attitude towards COVID-19 vaccines of COVID-19 prevention. In Nigeria, the team created a whole Facebook campaign promoting vaccines for pregnant and breastfeeding women. In Haiti, the team used a comic-strip format with local artists. In India, they relied on visuals inspired by traditional local art to promote vaccines.
  • Combining with existing services. In Zambia and Tanzania, the CARE teams found ways to deliver COVID-19 vaccines during regular pre-natal care visits or childhood vaccination programs, making sure that women could get vaccines as often as men.
  • Working with the government.  This is one of CARE’s first priorities in every country where we work. A few examples of what this looks like are that in Rwanda, CARE is collaborating with the Ministry of Health to provide messages on COVID-19 vaccination. In Bangladesh and Zambia, CARE did all of our planning with the government—and the government explicitly asked CARE to take charge of specific technical areas or to support districts that had high need. In Malawi and DRC, the teams are using the Community Score Card to raise community concerns to local and national planning and messaging with the Ministry of Health.
  • Lead with data. CARE has published a variety of studies on vaccines, including one on vaccine hesitancy in Iraq, costing studies in South SudanNepal, and Zambia, updates on Malawi & Bangladesh, and an overall Gender Gap report. Those have helped drive advocacy and planning to improve COVID-19 vaccinations.