At first glance, North Carolina appears to be conducting a successful COVID-19 vaccination program: More than 41 percent of the state’s population has received at least one dose of vaccine, including almost 80 percent of people age 65 and older, according to the latest data from the North Carolina Department of Health and Human Services (NCDHHS).

However, a closer look reveals some troubling disparities. While nearly 70 percent of the white population has received at least one vaccine dose, the number is only 17.8 percent for blacks and African Americans. Among people who identify as Hispanic only 7.1 percent have been vaccinated and less than 1 percent of Native Americans have received at least one dose of vaccine.

“There’s no single reason why certain communities have lower vaccination rates,” said Mark Blevins, Ph.D., assistant administrator of agriculture and natural resources with Extension at N.C. A&T and head of a new program in which Extension will partner with community-based health organizations to promote vaccinations and combat misinformation about COVID-19 vaccines. “We’re strengthening connections between Extension and partner groups on this topic and creating new pathways for accurate information. This is something we can do within our niche of educational programming while building community connections for future work.”

The new Extension at A&T COVID response program was created when the Centers for Disease Control and Prevention (CDC) reached out to USDA’s National Institute of Food and Agriculture (NIFA) offering to fund innovative Extension education to advance adult immunization in rural, medically underserved, and other hard-to-reach communities. Extension at A&T recieved a grant of $26,000 to work with community organizations and provide educational materials and strategic public messaging to encourage vaccinations in targeted communities. Extension staff will collaborate with five organizations on the effort:

• The N.C. A&T Health Clinic, which serves as a vaccination site for the campus and for communities of color in East Greensboro that lack adequate health services. Michelle Eley, Ph.D., Extension community and economic development specialist, will coordinate work with the health clinic.
• The Association of Mexicans in North Carolina, Inc. (AMEXCAN), a group dedicated to preventing further spread of COVID-19 in Latinx communities in eastern North Carolina. Eley will serve as the Extension liaison with AMEXCAN.
• The North Carolina Farmworker Health Program, which leads efforts to improve the health of migrant and seasonal farmworkers and their families. Beatriz Rodriguez, director of the NC AgrAbility Partnership, will coordinate with the group and its farmworker clinics.
• The Green Rural Redevelopment Organization (GRRO), an organization that addresses critical issues in Henderson, Vance, and nearby rural counties in eastern North Carolina. Morris White, Extension’s regional director for eastern North Carolina, will collaborate on programs with GRRO.
• Feast Down East, a nonprofit focused on creating a healthy, accessible local food system in southeastern North Carolina. Blevins will serve as the Extension connection to the group.
• The General Baptist State Convention (GBSC) of North Carolina, the oldest black Baptist association in the state, which is offering information sessions on COVID-19 as well as testing and vaccination events through black churches. White will be the Extension liaison with the GBSC of NC.

“Our part is to help these groups be more effective and get them science-based information to share from the CDC and other sources,” said Blevins.

Additionally, Shewana Hairston McSwain, coordinator of the Expanded Food and Nutrition Education (EFNEP) program with Extension at A&T, will support the program by using her public health background to develop strategic messages aimed at addressing concerns and questions about vaccines among communities of color, farmworkers and Tribal communities.

Extension staff conducted focus groups and listening sessions with black, Hispanic, farmworker, and rural audiences to get a better understanding of communities with low vaccination rates and learn more about vaccine hesitancy. They also examined data from the NCDHHS on COVID-19 vaccination rates.

“The data was very clear,” said Michelle Eley of Cooperative Extension at N.C. A&T, the co-PI on the project. “It was clear that more outreach was needed for black and Hispanic communities because they were not getting vaccinated as much and they are more likely to have other health issues that put them at risk.” Eley said the data also showed that younger people, ages 18 to 34, and males in general had lower vaccination rates. Young people might be less concerned about the virus because they are less likely to become seriously ill and vaccine hesitancy in males could be rooted in cultural and social norms, she said.

Other reasons for low vaccination rates include a lack of trust in the federal government in black and brown communities, fear of deportation among farmworkers, jobs that provide little time off, a lack of transportation to vaccine sites, and fewer vaccine sites in underserved rural areas.

“There is a vaccine gap between communities and if we understand why, we can address it,” said Eley. “For some it’s a combination of fear and mistrust. Other people have phobias about needles and for some, particularly older people and people in areas with poor internet connectivity, they aren’t able to get online and navigate through the registration process.”

The program begins in June and although it is a relatively small-scale effort, Blevins said it’s an opportunity for Extension to build productive partnerships to address community health issues and the general issue of vaccine hesitancy and misinformation.

“Our job at Extension is to provide the information people need so they can make informed decisions about their health,” he said.