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Pastors, Partners and Pop-ups: Report Shows Best Practices for Covid-19 Vaccination, Testing in Underserved Communities

Public health professionals in seven U.S. cities and states share how they increased vaccination and testing rates among their communities where rates were lowest

New York | September 23, 2021 — As more contagious variants become prevalent in the United States, a new report by Duke-Margolis Center for Health Policy gives state and local health officials real-world best practices from seven successful localities, to help increase Covid-19 testing and vaccination rates among hardly-reached communities where vaccination and testing rates are lowest.

Supported by The Rockefeller Foundation, the report – Hyperlocal Covid-19 Testing and Vaccination Strategies to Reach Communities with Low Vaccine Uptake: Considerations for States and Localitiesincludes best practices from state and local health officials in Maryland, Michigan, Minnesota, New Orleans, Utah, Washington, D.C. and North Carolina. These communities are utilizing the Biden Administration’s $6 billion in American Rescue Plan funding to support Covid-19 vaccination, testing, and treatment for populations disproportionately impacted by Covid-19.

“Protecting communities from Covid-19 infection and outbreaks requires vaccination, testing, and other public health initiatives that meet people where they are,” said Mark McClellan, Director, Duke-Margolis. “Hyperlocal strategies that bring together public health, community-based organizations, neighborhood businesses, and other community resources help build engagement and trust that can mitigate challenges and barriers to equitable Covid-19 testing and vaccinations.”

“This pandemic has underscored the consequences of underinvesting in public health capacity, infrastructure, and pandemic preparedness,” said Andrew Sweet, Managing Director of Covid-19 Response and Recovery at The Rockefeller Foundation. “This report can support state and local health officials in continued efforts to respond equitably to the Covid-19 pandemic while informing a paradigm shift in public health practice in the United States.”

The report outlines three guiding principles, with highlighted state and local approaches, to inform tailored testing and vaccination strategies that meet the needs of different communities:

  • Principle 1: Tailor testing and vaccination strategies to overcome community-specific barriers
    • Detroit: Implemented the Community Health Corps Program which connects community members in low-income settings (or experiencing vulnerabilities exacerbated by the pandemic) to critical resources and services relating to food security, utility and water bill assistance, home repair and relocation, and physical and behavioral health
    • New Orleans: Partnered with local organizations to provide behavioral health, pharmaceutical services, cleaning supplies, and food at Covid-19 testing sites
  • Principle 2: Deliver services and communications that are culturally responsive, linguistically accessible, and ADA accessible
    • Minnesota: Published best practices and a checklist for establishing accessible Covid-19 vaccination and testing sites that address different physical, sensory, cognitive, and technological needs
    • Utah: Hired native speakers of many different languages who provided culturally responsive information to community members on where to get tested for Covid-19 or receive a vaccination
    • Washington, D.C.: Implemented door-to-door Covid-19 vaccine outreach campaigns led by bilingual teams
  • Principle 3: Implement community-engaged decision-making and partnerships
    • Maryland: Used vaccination and testing data by zip code to locate pop-up vaccination sites and tailored their outreach to each community. At one site, they partnered with a primarily Black church to administer vaccines and testing. They’ve also developed multilingual vaccine programs for the state’s largely migrant agricultural and aqua-cultural workforces.
    • North Carolina: Hosted weekly meetings with providers, public health officials, and community members to discuss progress on efforts and strategize solutions for emerging challenges

“Community-engaged decision-making is a key factor to advancing more equitable, transparent, and sustainable health policy actions at all times but particularly during a pandemic,” said Andrea Thoumi, Health Equity Policy Fellow, Duke-Margolis. “States and localities should partner with community organizations to understand systemic barriers to access, identify where community members go for health information, and provide platforms for community members to discuss experiences with Covid-19 vaccination or testing.”

The report builds on prior work that provides guidance on implementing equitable Covid-19 testing strategies to reach communities where they live, reducing racial and ethnic disparities in Covid-19 vaccination rates, and building public-private partnerships to support efficient and equitable Covid-19 vaccine distribution.

About the Duke-Margolis Center for Health Policy

The mission of the Robert J. Margolis, MD, Center for Health Policy at Duke University is to improve health, health equity, and the value of health care through practical, innovative, and evidence-based policy solutions. For more information, visit and follow us on Twitter @DukeMargolis.

About The Rockefeller Foundation

The Rockefeller Foundation is a pioneering philanthropy built on collaborative partnerships at the frontiers of science, technology, and innovation to enable individuals, families, and communities to flourish. We work to promote the well-being of humanity and make opportunity universal. Our focus is on scaling renewable energy for all, stimulating economic mobility, and ensuring equitable access to healthy and nutritious food. For more information, sign up for our newsletter at and follow us on Twitter @RockefellerFdn.

Media Contacts:

Patricia Green, Duke-Margolis Center for Health Policy
C: (301) 520-6482

Wyatt Goodwin, The Rockefeller Foundation
C: (212) 852-0000

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