Lessons From an Implementation Evaluation of a Real-World Multi-City Initiative to Address COVID-19 Vaccination Inequities

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Community health equity research & policy


The COVID-19 pandemic shed light on stark racial and ethnic inequities in access to care and accurate health information in the U.S. When COVID-19 vaccines became available, communities of color faced multiple barriers that contributed to low vaccine rates. To address this gap, the Equity-First Vaccination Initiative supported community organizations in five demonstration cities to plan and implement hyper-local strategies to increase COVID-19 vaccine access and uptake among communities of color. To draw learnings from the experiences of the participating organizations, we applied a framework that integrated implementation science and health equity principles. In this commentary, we describe how we used this framework to guide qualitative interviews with community organizations, focusing on insights across five implementation elements (reach, design, implementation, adaptation, implementation outcomes). Learnings from this evaluation may help guide future implementation of similarly complex initiatives involving multiple organizations and sites to advance health equity during a public health crisis.

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