To vaccinate thousands, NC turns to volunteers - North Carolina Health News

By Hannah Critchfield

For a rollout large enough to combat the novel coronavirus pandemic, you need volunteers. A lot of them.

Getting shots into millions of arms requires boots on the ground, and to vaccinate a majority of North Carolina’s population – who reside in a nation already experiencing a shortage of health care workers – the state has/providers have turned to members of the public who are willing to lend a helping hand.

At Cape Fear Valley Medical Center in Cumberland County, over 300 volunteers from the United Methodist Church have assisted with vaccines, pushing wheelchairs, assisting with paperwork and monitoring people after they’ve received their dose for anywhere from 15 minutes to half an hour.

“I’ve got 16 new emails since yesterday from people asking if they can be a part of the volunteer program,” said Al Miller, director of disaster ministries for the United Methodist Conference and coordinator of COVID-19 vaccine volunteers. “They’re coming from churches that are maybe 60 or 70 miles away.”

Debbie Gilbert, 64, a semi-retired registered nurse who worked in schools, gives shots to some of the over 500 people who arrive daily at the drive-thru vaccine clinic at Tryon International Equestrian Center in Polk County, an operation she says runs so smoothly it’s “better than a Chick-fil-A drive-thru.”

At the Federal Emergency Management Agency (FEMA)-backed mass vaccination site in Greensboro, volunteers greet soon-to-be-vaccinated patients at the entrance of the Four Seasons Town Centre Shopping Mall and provide Spanish and American Sign Language interpretation.

Ensuring the pool of volunteers is diverse is both a challenge and a priority, vaccine coordinators said.

“If we’re really trying to reach historically marginalized populations, we want the people that are working here to reflect the type of people we’re trying to serve,” said Keith Acree, communications officer at the NC Department of Public Safety, which is facilitating operations at FEMA-backed sites.

Amid a pandemic that has put the nation’s inequalities on display – illuminating disparities along lines of race, socioeconomic status, ability and citizenship – having volunteers who are representative of people within the communities where clinics are located can be a source of ensuring equity in the state’s vaccine rollout. Their presence can also provide a source of reassurance to fellow community members who may be distrustful of the vaccine they’re about to take.

Who are these volunteers, and how do they hear about the opportunity to serve at vaccine clinics?

Benefits for volunteers

In North Carolina, volunteers at vaccine sites have a shot at getting a vaccine, regardless of current eligibility.

At the end of a day, there are typically unused doses at vaccine clinics that will expire if they’re not put into arms. State health officials recommend providers do everything they can to reach out to eligible people when this happens – but emphasize that it’s ultimately more important to inoculate someone who’s available rather than waste vaccine.

For some, volunteering at a vaccine clinic can be a way to give back after an abysmal year, to catch a glimpse of a future that’s seemingly just around the corner – where grandparents can be hugged, meetings with friends aren’t canceled each time it rains, and it’s possible to consume a news story without encountering the word “coronavirus.” But for many, the hope of personally receiving a vaccine looms large – like a carrot at the end of a stick – as well.

“The commitment I have for the volunteers is that if you come and work for the day, you get a vaccine,” said Miller. “We want to get shots into arms and giving people who put themselves out there and help a shot is an incentive to get more people to come.”

Who’s volunteering?

As in other states across the country, North Carolina has struggled with equity in its vaccine rollout.

Trends are improving, but with 75 percent of the total vaccinations, white people still outweigh all other racial groups in the state’s overall doses given so far, surpassing their proportion in the general population.

In contrast, just 4 percent of vaccinations have gone to Latino people, who account for 10 percent of North Carolina’s population, and roughly 17 percent have been given to Black people, who make up 23 percent of the population.

The state has taken a series of actions to combat the disparate number of white people vaccinated. The Department of Health and Human Services is prioritizing a portion of its doses weekly to events that focus on underserved communities, partnering with local faith leaders and organizing groups to hold vaccine awareness events and clinics in areas where many of these community members reside.

Some of these disparities can be credited to mistrust in the safety of the vaccine among communities of color, due to a deeply-entrenched history of racism and xenophobia within the United States medical system and government. But a growing amount of evidence suggests issues of access are partially to blame — meaning people of color who want to get vaccinated are struggling to get an appointment.

It’s nearly impossible to discern if there are similar disparities in the racial and ethnic makeup of volunteers at vaccine sites. Very few county health departments appear to be tracking the racial and ethnic demographics of their volunteers. North Carolina Health News contacted 17 counties who have higher proportions of Black or Latino people than the general state population, as well as NC DHHS – only two counties said they collected demographic information on their volunteers.

Wake County, North Carolina’s largest, has set up three mass vaccination sites and is sending vaccine “strike teams” – mobile clinics set up at various sites  – into communities that are allotted equity doses, with the help of its staff, the National Guard, nearby hospital employees, and volunteers from churches and local organizations for “non-medical” work like greeting and traffic control.

“I reached out and heard back from some [of these groups], but it’s clear no one is clearly tracking the demographics,” Stacy Beard, communications manager for Wake County government, said in an emailed statement.

In Granville County, 30 percent of the population is Black and 8 percent is Hispanic or Latino, according to Census data. Ten to 20 percent of vaccine volunteers are Black and the rest are white, according to Shauna L. Guthrie, medical director for Vance and Granville counties.

Vance County, where just over half of the population is Black and 8 percent are Hispanic or Latino, is relying on employees in the school district and their spouses for volunteers. There, 39 percent of volunteers are Black, 10 percent are Latino and 51 percent are white, according to Aarika Sandlin, public information officer for Vance County Schools.

Anecdotal clues

Volunteer organizers, as well as state background check requirements, provide anecdotal clues about who might be helping at COVID-19 vaccine sites.

“Is [getting a diverse pool of volunteers] a problem?” said Miller. “The answer to that question is yes, yes, and yes.”

Recruiting volunteers who reflect all of the communities within North Carolina is a challenge that’s improving over time, Miller said, much like the effort to encourage and help underserved communities get vaccinated.

“With the volunteers, it’s hard not to see the same thing as we’re seeing with vaccine turnout,” said Miller. “What we found was that reaching out to our minority church pastors and getting them to come forward and be a part of it has been key in getting others to come with them.”

Much of that success has come from word-of-mouth outreach. People often hear about opportunities to volunteer at vaccine sites through friends or family members who have previously spent a day directing traffic or doing data entry.

Miller recalled an early vaccine clinic Cape Fear Valley hosted at a high school in a predominantly Black community.

“The hospital did it there specifically to get into that community and to try to get people in that community to join us – the first day, it was exactly the opposite of that,“ he said. “But the second day, as more people heard about it and saw what was happening, it was phenomenal the number of people from the community that came.”

The state is not tracking volunteer demographics, at the county level or for the federally-backed site in Greensboro. However, Acree from DPS, said the group he’s seen at the site is “fairly diverse.”

“We’ve got English speakers, we’ve got Spanish speakers, able-bodied folks, someone in a wheelchair was here yesterday, people of multiple races – we don’t have a count of any of that, but it appears to be a varied bunch of people,” he said.

The mass vaccination site has recruited many of its volunteers through partner organizations in the community such as La Semilla, Americorps, and Baptists on Mission.

“There really aren’t a lot of unattached local volunteers,” Acree said. “They all seem to be part of another organization that we’ve partnered with.”

Volunteers like Gilbert, who is white, and coordinators all said they saw people of all ages and genders helping at their volunteer sites.

Providing reassurance

Volunteers are more than cogs in an immense logistical machine needed to vaccinate hundreds of people in a given day. For those who may be nervous about getting a shot, they’re often a source of emotional support.

“There’s been a lot of times where our volunteers have been able to talk with people one-on-one about getting a shot, helping to ease that fear, talking about their excitement to get a shot, or how they’ve already had the shot and there’s no need to worry about it,” said Miller.

It’s another reason coordinators said they’re seeking an array of people in their volunteer pools – who’s delivering the message matters, as does ensuring that message is available in a variety of languages.

“The more that we can get people from those communities [we’re in] to come to help, I think the better people from those communities will feel about being there,” said Miller.

Those who are left out

There are two groups who likely cannot participate at most vaccine sites in North Carolina: people who have been convicted of a felony and people who are undocumented.

Many county health departments or vaccine sites, including the federal FEMA site in Greensboro, require potential volunteers to undergo a background check through the state’s Training, Exercise, and Response Management (TERMS) system.

“The TERM application itself does not ask for a social security number, but the background check portion of it does,” said Acree, which would preclude individuals without United States citizenship from participating.

“A felony conviction most likely would be a disqualifier,” he added.

Kelly Morales, executive director of Siembra NC, an organization that advocates for the rights of immigrants, said that while the social security requirement for volunteers is concerning, immigrants within that Latino community face a larger problem — finding out where and how eligible people can get vaccinated at all.

“I think the challenge, no matter how much we want to focus on Latinx or Black working class folks, or how much we reserve a certain percentage of vaccines, is to actually reach these folks – these are people who have two or three jobs, who also have families,” she said.

A recent survey conducted by the organization, which involved 836 members of the Spanish-speaking Latino population in North Carolina, found that over half of the people who responded wanted to get the COVID-19 vaccine. However, a majority of the respondents said they didn’t know how to access a shot.

“The folks who are able to get vaccinated are folks who have access to information, and what we’re seeing is there’s still 70 percent of people who do not know where to go,” said Morales.

Providers are not supposed to be requiring social security numbers or any identification cards for vaccinations, according to Yazmin Garcia Rico, director of Hispanic/Latinx Policy and Strategy at DHHS, as they are not a prerequisite for getting a shot.

The state plans to open up two more mass vaccination clinics in Alamance and Forsyth counties developed with the Latino population in mind in the coming weeks, according to Garcia Rico.

At the Alamance event, which starts this weekend, they will partner with the CityGate Dream Center, a nonprofit that serves the Latino community in Burlington. They’ll likely need more volunteers to do it.

If a provider is requesting you provide an ID to get a shot, call the state’s COVID-19 Vaccine Help Center at 1-888-675-4567.

“If we hear about any sort of incident we address that immediately,” said Garcia Rico. “Vaccine providers are not supposed to tell people that they won’t be able to get an appointment if they don’t have an ID. We have been very clear on that.”