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Three key principles for equity-first vaccination are guiding the EVI

• Equity-first programming must be delivered at a hyper-local level.
• It should be led by the communities in which it is implemented.
• It should be holistic, aiming to achieve vaccination equity in the context of equitable outcomes in health, economic opportunity, and other sectors.

CBOs highlighted several types of access barriers

• Information about how to get vaccinated is hard to find.
• Vaccination sites are inconveniently located.
• Institutions and systems administering vaccinations might not be trusted.
• Vaccination access requires internet access and technological literacy.
• Although vaccinations are free, individuals still incur costs related to accessing them.

Organizations are using creative strategies to overcome these barriers and promote vaccination equity

• Organizations are sharing information through trusted messengers about how to access vaccinations through a variety of mechanisms, ranging from neighborhood flyers to social media messaging.
• EVI partners are making vaccines more convenient to access.
• Many EVI partners are helping with registration and providing transportation to and from vaccination events or appointments.
• Some organizations are offering incentives that are meaningful to the population.

EVI partners identified factors that have enabled progress

• Three characteristics of CBOs have been critical to implementation of hyper-local approaches to vaccination: mission-driven, committed staff who reflect or come from the communities they serve; deep knowledge of, and history in, their communities; and agility.
• Partner relationships are essential.
• Four types of external supports were important: policy leadership; adequate and stable funding; technical assistance; and access to high-quality, timely, race/ethnicity–disaggregated data.

The Equity-First Vaccination Initiative (EVI) aims to reduce racial disparities in coronavirus disease 2019 (COVID-19) vaccination rates in the United States and, over the longer term, to strengthen the public health system to achieve more-equitable outcomes. To accomplish these goals, The Rockefeller Foundation has committed $20 million over one year to fund anchor partners in five major cities—the Open Society Institute—Baltimore in Baltimore, Maryland; the Chicago Community Trust in Chicago, Illinois; Houston in Action in Houston, Texas; United Way of Greater Newark in Newark, New Jersey; and Roots Community Health Center in Oakland, California—to plan and implement hyper-local, place-based strategies to increase vaccine confidence and access for communities that identify as Black, Indigenous, and people of color.

This interim report introduces the initiative and the anchor partners in each of the five demonstration sites, highlights the initial work of selected community-based organizations (CBOs) to which the anchor partners are making subgrants, synthesizes lessons learned across the EVI in its first three months, and suggests policy actions for decisionmakers to consider as they seek to support hyper-local, community-driven efforts to reduce inequities in COVID-19 vaccination.

In just the first few months of the EVI initiative, the CBOs in the five demonstration sites held nearly 1,200 vaccine-related events, provided assistance (e.g., transportation, registration) more than 42,000 times to get people vaccinated, made almost 2 million connections with community members through campaigns and information sessions, and administered almost 16,000 COVID-19 vaccinations.

• Chapter One

  Background

• Chapter Two

  The Broader Context: Findings from a National Scan of Access Barriers and Strategies to Address Them

• Chapter Three

  The Equity-First Vaccination Initiative Demonstration Sites

• Chapter Four

  Early Insights from the Equity-First Vaccination Initiative

• Chapter Five

  Recommendations Based on Insights to Date

• Chapter Six

  Summary and Looking Ahead

• Appendix A

  Methods

• Appendix B

  What Do Available Data Tell Us About COVID-19 Impacts and Vaccination Rates in the Five EVI Demonstration Sites?