Stories from the Field: Examples of Successful Worker COVID-19 Vaccination Programs

Every year, Maryland’s blue crab processing industry recruits hundreds of migrant workers from Mexico through the H-2B visa seasonal work program to pick, clean, and cook crabs. Following a series of COVID-19 outbreaks, a community-based organization, health department officials, mobile clinics, and employers coordinated with worker representatives to ensure that the nearly 500 crab-processing workers employed on Maryland’s Eastern Shore would be vaccinated against the virus in 2021. By November 2021, all of these workers were vaccinated.

Key components of this effort included:

• Educating workers about COVID-19 vaccination before they traveled to the United States. This was led by the binational organization, Centro de los Derechos del Migrante (CDM), and included providing culturally appropriate information, addressing common questions, and ensuring that workers knew how to access vaccines upon arrival into the U.S.
• Coordinating mobile vaccination clinics through employers to ensure easy access for isolated worker communities.
• Providing paid time off for vaccination and for post-vaccination side effects, which helped workers prioritize COVID-19 safety without fearing loss of income.
• Accompanying workers and providing personalized, confidential assistance to interpret and explain documents, answer common questions, and assuage fears.
• Creating a Worker Advisory Committee, comprised entirely of worker representatives, to provide expertise, updates, and insights to shape vaccine messaging and outreach priorities.

In the rural town of Onley on Virginia’s Eastern Shore, the Legal Aid Justice Center (LAJC) mobilized community leaders and worked with the local health department to vaccinate 50 workers and their family members against COVID-19 during the town’s first free resource fair for Hispanic/Latino community members in June 2021. By leveraging long-standing community relationships, LAJC and their partners aimed to reach Spanish-speaking workers employed in the region’s poultry, seafood, and agricultural industries and their family members.

Key components of this effort included:

• Gathering information about communities’ needs and priorities ahead of the vaccine event.
• Collaborating with community-based partners to offer vaccination information and opportunities alongside other high-demand, free resources like workers’ rights training, domestic violence support, and library services.
• Partnering with local faith and immigrant community leaders to conduct personal outreach ahead of the event.
• Facilitating free transportation to the event.

United Food and Commercial Workers (UFCW) Local 27 union, which represents thousands of workers in the mid-Atlantic region, piloted one of Sussex County, Delaware’s first community vaccination programs from  its offices in Selbyville, Delaware. UFCW Local 27 reached out to state officials beginning in February 2021 to bring vaccination opportunities to their frontline membership, many of whom expressed hesitancy toward government- and employer-provided vaccination programs. Working with community-based organizations and local businesses, UFCW Local 27 hosted multiple vaccination events in Delaware and Maryland focusing on medically underserved workers and their families, including adolescents.

Key components of this effort included:

• Ensuring workers participated in the design and implementation of workplace vaccination programs.
• Collaborating with union leadership, local government officials, and community-based organizations to provide alternatives to workplace vaccinations, including during weekends and at union offices, schools, and community resource fairs.
• Focusing vaccine confidence outreach efforts to union members in counties with low vaccination rates through one-on-one outreach, SMS messaging blasts, and breakroom conversations.
• Complementing vaccination opportunities with other high-demand, free resources like immigration clinics and back-to-school giveaways.
• Disseminating vaccine confidence information in multiple languages and audiovisual formats, pretesting materials, and messaging with worker membership.

The Maryland Lower Shore Vulnerable Populations Task Force convened a network of local organizations, faith leaders, and health departments to provide COVID-19 vaccines and information to community members. These services were delivered at resource fairs held throughout the region. The task force was comprised of elected officials, representatives from local organizations, and volunteers. During the early stages of the pandemic, the task force’s weekly events, dubbed One-Stop Shops, gave communities free COVID-19 testing and multilingual information alongside food aid, immigration law clinics, and other high-demand resources. When COVID-19 vaccines became available, the task force added vaccination opportunities to their events and encouraged attendance through long-standing relationships with the community. To date, the One-Stop Shops have provided vaccines to more than 4,600 individuals from low-income, rural, and under-resourced communities.

Key components of this effort included:

• Using a mobile model that brought resource fairs to the doorsteps of communities that are geographically isolated and medically underserved.
• Designing, with community members, COVID-19 vaccination messaging that was culturally and linguistically tailored for the communities being served.
• Collaborating among diverse, free service providers to ensure community members’ access to COVID-19 vaccination and testing alongside other high-priority services and resources, like food aid.
• Establishing a protocol between task force member organizations and local health department officials to ensure COVID-19 vaccine delivery.
• Consistent, reliable event scheduling.
• Tailoring outreach to the community before events.
• Providing Haitian Creole and Spanish-language interpreters at all events and information in multiple languages through social media and partner networks.
• Incorporating additional resources to overcome language and literacy barriers throughout the vaccination process.

In the Pacific Northwest, a meat-processing company partnered with state and local public health departments to vaccinate its workforce. The company’s previous training on pandemics through a NIOSH-funded Education Resource Center helped the company safety manager  implement controls to reduce infections. By March 2021, 63% of the workforce was fully vaccinated. The workplace-related controls and testing put in place along with the relatively high vaccination rate likely contributed to the company avoiding any shutdown during the pandemic.

Key components of this effort included:

• Connecting early with state and local public health departments to provide COVID-19 testing. This led to mutual respect and a trusted relationship with the company and facilitated early, onsite vaccinations at the facility once vaccine was available.
• Incorporating employee feedback on specific vaccine preference, which led to the original selection of the one-shot Johnson & Johnson Janssen vaccine, and hence, enhanced vaccination coverage.

In August 2021, Duke University and Duke University Health System announced the implementation of requirements for the COVID-19 vaccine primary series for all 47,120 employees by October 1, 2021. The requirement covered all employees, regardless of whether they were fully remote, hybrid, or fully on site, and offered both medical and religious exemptions. As of November 23, 2021, 96.6% of the 23,500 university employees had completed their primary vaccination series, and 2.7% had approved exemptions or deferrals. Among 23,630 health system employees, 93.3% had completed their primary vaccination series, and 6.1% had approved exemptions or deferrals. Employees who had not completed the primary vaccine series participated in a weekly COVID-19 surveillance testing programexternal icon. During the Fall 2021 semester, the cumulative test positivity rate was 0.39%, with 282,358 tests administered to unvaccinated faculty and staff and all students.

Key components of this effort included:

• Holding regular, virtual town hall meetings with experts to discuss vaccine safety and efficacy and options among the approved and authorized vaccines.
• Providing robust reporting mechanisms for tracking compliance with vaccination or obtaining approved exemptions, which allowed managers to have individual conversations to address concerns and encourage vaccination.
• Allowing employees to obtain vaccines at work during work hours and at easily accessible times and locations.
• Providing transportation to vaccination locations on site.
• Providing paid time off for employees with side effects after receiving a COVID-19 vaccine.
• Calling employees and sending personalized notifications of employee vaccine compliance status and scheduling options.