Navigating Vaccination Efforts: Lessons Learned and New Challenges

This episode and blog post are Part 1 of the first special report of our Vaccine Confidence Special Reports series on At the Core of Care. Over the course of 6 episodes, we'll do a deep dive on three different facets of the COVID-19 vaccination effort. Stay tuned for new episodes in the coming weeks by following us on Twitter and subscribing to our newsletter. 

­­In this episode, we hear from Carl Hinson, the Director of Workforce Development for Hawaii Pacific Health. He explains that his organization has enlisted high school students to help vaccinate community members and converted motor coach buses into mobile vaccine clinics.

Hawaii has unique challenges to healthcare delivery. Most of the islands of Hawaii are considered rural, due to their physical distance and lack of specialty care providers. Recruiting healthcare staff proved challenging before the pandemic. As Carl explains, “our challenge is that we have 2,500 miles of water between us and the nearest landmass.” The pandemic only exacerbated workforce shortages. Several training programs shut down, reducing the number of medical assistant graduates from over 400 to under 100. 

Carl had begun piloting high-school-based medical system training programs prior to the pandemic. Nursing training programs, surgical instrument processing tech programs, and patient service representative programs have been placed into high schools to develop Hawaii’s healthcare workforce. The program has been highly successful; 18 high schools in Hawaii now offer the program, and 100% of the program’s graduates receive national certification as medical assistants.

When the Department of Health asked Pacific Health to help with vaccine distribution, Carl quickly turned to his school partners for help. Principals and school staff were supportive of hosting high-school-based vaccination sites. Carl ensured that students of the medical system training programs were taught how to provide IM injections. Then students were staffed alongside nurses and medical assistants to administer vaccinations. “These were seniors in high school that were not only vaccinating their peers in school, but then their parents would come,” says Carl. It was a win-win for the medical assistant program and for the community.

But Carl and his team acknowledged barriers to vaccine access, and wanted to improve vaccine distribution to hard-to-reach populations. Hawaii has many transportation services to accommodate tourism. He contacted a bus company that had offered transportation services to Pacific Health. “Why not try to see if we can't retrofit a bus or two, make it a vaccination center, and then it carries all the supplies from one location to the other?” The bus partner agreed to provide a bus, and just two weeks later the first mobile vaccination bus “Vax Squad” launched. The bus was staffed with both experienced and new medical assistants, including students who had recently finished the medical assistant program. To date, three buses have delivered 40,000 vaccinations to communities around Hawaii. 

This project was successful because of pre-existing partnerships, according to Carl.

Later in the episode, we hear from Maria Saldiva in Texas. Maria is currently a clinical assistant professor at UT Health San Antonio School of Nursing, and a family nurse practitioner at the college’s Wellness 360 Clinic. Maria is also a member of the National Nurse-Led Care Consortium’s Vaccine Confidence Advisory Committee. She describes the services that Wellness 360 Clinic offers, and the diverse community of students she serves. She also shares how UT Health San Antonio managed testing, vaccinations and most recently the latest isolation guidelines. She also talks about the uptick in provider visits when patients test positive and navigating when it’s safe to return to school or work on campus. 

Nurses and other health professionals across the country are using innovative methods to vaccinate their communities against COVID-19. Follow along as we explore their stories in depth as part of our Vaccine Confidence Special Reports. 

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This project was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number NU50CK000580). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The contents of this resource center do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.