Refugee Health Ed Conference - Question and Answer

April 14, 2021

ID6448

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00:00One issue that has come up in
00:02some of the earlier presentations
00:03this evening has been this issue
00:05of sort of digital literacy ANAN.
00:07Thinking about, you know,
00:09as you brought up Brita,
00:10you know with the on line vaccine scheduling,
00:13that's not necessarily going to be
00:14the ideal mechanism for refugees,
00:16but but for many other populations as
00:18well and in in my work with with sort
00:21of other members of the wine HH team,
00:23I've been really impressed to
00:24hear about what has been done.
00:26Sort of in a granular sense to try
00:29to reach out to folks who maybe.
00:31Not be the most digitally literate,
00:33and I was wondering if you could
00:35give some additional detail just
00:37about the phone
00:38scheduling and how that's been going,
00:40things sure absolutely.
00:41So, in addition to digital literacy,
00:42there's also the issue that
00:44there is a number of people with,
00:46you know where the English is,
00:48not their first language,
00:50and so that would also
00:51be very difficult to map.
00:53To navigate our site so
00:54the phone number to call,
00:56and I can also put it in the chat is 833.
01:00Ask why NHH and through that line.
01:02One people that live in those
01:05highly vulnerable zip codes are
01:07basically can be identified through
01:08our systems that they live in
01:11one of those areas and it can get
01:13prioritized for one of those slots.
01:15We also have a number of
01:17different languages that can be
01:19supported on the phone line,
01:20so that is a great way for folks to schedule.
01:24In addition,
01:25one thing I forgot to mention
01:27was that we have appointments
01:29through Connecticut 211 as well.
01:32And two,
01:32one one has access to not only
01:35only given appointments but a
01:37number of other number of other
01:39providers giving vaccines as well.
01:42And I know they have language services.
01:45Also community health workers
01:46can also schedule directly into
01:48our system and again for those
01:51highly vulnerable patients.
01:52So partnering with whether
01:55it's project access or other.
01:57Navigator Programs is another way that
01:59we can get people directly scheduled.
02:03Wonderful thank you.
02:04I just think it's amazing that
02:06you guys can identify somebody's
02:08location where they're coming
02:10from and actually target them for
02:13specifically reserved appointments.
02:14Technology is amazing.
02:17You know another question too and
02:19this could be for both of you,
02:21and since Jason you're involved at
02:23the state level is just in terms of
02:25thinking about the information that
02:27people need to provide when they
02:29are scheduling their appointments.
02:30I know that through the damn system
02:32on line you know it's it's sort of
02:34date of birth and maybe occupation.
02:36If that's your eligibility and
02:38Anet believe address and email
02:40address are part of that as well.
02:41I understand that when folks are signing
02:43up through the retail pharmacies,
02:45they may also have to provide
02:47some health information in order
02:49to register for the vaccine so.
02:50Just wondering if you guys are getting
02:52any feedback in terms of communities
02:54that may be let more reluctant to
02:56provide this kind of personal data to
02:58either the state or the health system.
03:00An answer.
03:00Any thoughts about that?
03:02Yeah, I'll offer a thought or two
03:04and then breeder can probably
03:06speak with more specificity at yes.
03:08And depending on the system,
03:10depending on how individuals
03:11are accessing vaccines,
03:12whether it's through the pharmacy clinics,
03:14whether it's through a health system,
03:16whether it's through a community clinic,
03:18there are different kinds of
03:19information required in some cases,
03:21part of sort of the medical prescreen
03:23to see whether individuals may be
03:25pregnant or have histories of allergies,
03:27things that help dictate issues
03:29around observation or additional
03:30information that might be shared.
03:31And also again, right.
03:33Some personal information to share,
03:34whether it's registration for email
03:36addresses or even at vaccination sites,
03:38vaccination providers can
03:39ask for identification,
03:40but it's been very clear at the state
03:42level and hopefully diffused all of the
03:44vaccination providers that they have.
03:46An ID can be asked for,
03:48but certainly 1 does not have to be
03:50presented and folks should not be turned
03:53away if they don't present identification.
03:55So really trying very hard to take
03:57down any barriers or concerns that
03:59might keep people away from the
04:01vaccination system even at the.
04:03I guess the theoretical expense
04:04that someone could could could
04:05could misrepresent their identity,
04:07and that's that's a trade off the states.
04:09Happy to make in order to ensure
04:10that folks don't feel concerned about
04:12privacy or personal information
04:13standing in the way of vaccination.
04:17Yeah, exactly, at least it you know Haven.
04:21In the scheduling process, you know
04:23there is some information that is asked,
04:26including insurance information.
04:27You don't need insurance to get a vaccine,
04:30and if people are uninsured like
04:33they absolutely will not get a bill.
04:36But if they are insured then we do billing
04:39administration fee to their to their payer.
04:42But don't ask for any additional
04:44money from the patient themselves.
04:46But yes, we also do have
04:49some information about.
04:51Allergies and other things to let us
04:53know how long the person needs to stay
04:56in the observation period afterwards.
04:58So certainly you know some
05:00of these questions,
05:01may you know may feel personal to some
05:04I have not heard of anyone being too
05:07like so uncomfortable with answering the
05:09questions that they did not schedule.
05:11You know,
05:12at least like to the call center phone line.
05:15Of course I have no idea if
05:18someone felt uncomfortable online
05:20and then decided not to.
05:21Continue on with the process,
05:24but from our listening sessions and
05:26another input from the community.
05:29That's not something that we've heard
05:31has deterred people from getting vaccinated.
05:36Thanks so much for that and I.
05:38I mean, I think it certainly is a
05:40credit that that there are listening
05:42sessions happening that there is
05:44engagement with the community to
05:46try to try to understand this.
05:48I see a question in the chat from Joe
05:50Williams saying I wonder what some of
05:52the educational programming around
05:54vaccination looks like for refugees.
05:56Slash non English speakers, slash,
05:57lower socioeconomic status communities.
05:59Have there been thoughts on digital
06:01videos or narrative storytelling to
06:02help these communities understand the
06:04importance and safety of vaccination?
06:08So I'll say yes, there's been
06:11a lot of thought around that,
06:14and efforts as well.
06:16It is certainly a challenge given the
06:20virtual world where forced to be in.
06:23So for example.
06:26We have developed a very simple like
06:29fact sheet about the vaccines using
06:32kind of the best evidence around
06:35effective communication and messaging
06:37about vaccination that has a version
06:40at like the 6th grade level and also
06:43a third grade level and in multiple
06:46languages that we hope can dispel
06:48some myths and misconceptions about
06:51the vaccine and disseminating that
06:54through community based organizations
06:56through through the state.
06:58Health systems and so on and so forth.
07:02I think the videos and narrative
07:05storing it telling is also really,
07:08really critical and so our communications
07:11Department is certainly developing
07:13some and we try to have clips of
07:16especially of physicians and clinicians
07:19of color providing that information,
07:22and also especially in other
07:24languages besides English.
07:26But there are a number of resources
07:30with that information, you know.
07:32Externally as well, and that is 1.
07:35Nice thing about the Internet and you can be
07:37can be shared widely and disseminated widely.
07:40Whether it was, you know,
07:41homegrown or not.
07:44We've also been holding a
07:45number of town halls again,
07:47so people can kind of ask their
07:49questions and have them addressed.
07:51Although one thing I am starting
07:52to hear is is a lot of people
07:55you know can't can't make those.
07:57I mean, even if they are in the evenings,
07:59you know,
08:00not everyone wants to be on the
08:02same at 7:00 PM on a weekday.
08:04Or,
08:04you know they're tired after after
08:06working or busy on the weekends.
08:08And so that's you, know,
08:09a challenge,
08:10but we're certainly still holding
08:12them and trying both through
08:14the health system and then also.
08:15Through the state there is a program
08:18where clinicians can partner with
08:19leadership from a community based
08:21organization to hold a session
08:23where they can directly address
08:25people's questions about the vaccine.
08:27So those are some of the things
08:30I'm aware of and Jason you may
08:32have others as well.
08:34Yeah,
08:34similar
08:34things happening in terms of town
08:36halls and developing materials and
08:38recognizing the while public service
08:40announcement campaigns and CDC
08:42websites are one way to disseminate
08:44the kind of information that can
08:46correct some misperceptions that.
08:47Has a limited reach and trying to
08:50identify more tailored programs that
08:51are more readily identifiable and
08:53recognizable and and iaccessible to
08:55particular groups and communities
08:57and the concerns they may have.
08:59I think is is one of those really
09:01critical efforts as we move forward,
09:04I'll just add one point.
09:06Just very briefly.
09:07Is that because of the latest
09:09relief bill that passed through
09:11Congress and was signed by President
09:14Biden a week or two ago,
09:15there is a tremendous amount.
09:17Of additional resources flowing to
09:19the states imminently to support both
09:22the vaccination rollout and to support
09:24expanding the public health workforce,
09:26a lot of those efforts will go
09:28towards continuing the this.
09:30This,
09:30I think pretty difficult work that
09:32will lie ahead in terms of reaching
09:35all of our communities of reaching
09:37more broadly and equitable vaccination
09:39program by building the kinds of facilities,
09:42the resources, the staff,
09:44the personnel.
09:44But then I think we'll start seeing
09:47concrete applications of those
09:49additional resources long overdue.
09:51If I could editorialize,
09:52that will help again,
09:53support that at the state level,
09:55recognizing that that's one
09:56piece that can work in a more
09:58comprehensive solution to address
09:59address these challenges ahead.
10:02Wonderful, thanks so much to both of you.
10:05At this point, let me ask all of
10:07our other panelists to go ahead
10:09and turn your video back on.
10:11There's a couple of questions
10:12in the chat that I think would
10:14be good to have some discussion.
10:16You know, one question specifically
10:17to Jenny's if you're hearing
10:19anything about refugees.
10:20Skepticism about the vaccine,
10:21that would be good to share,
10:23but also for all of our panelists,
10:25and certainly for attendees to you
10:26could put answers in the chat you know,
10:29would love to hear more about your
10:31specific experiences with refugees.
10:32Acceptance of the vaccine.
10:33So I don't know if any of our
10:35panelists Jenny would do.
10:36You want to start with some comments?
10:38I yeah, I'm happy to start a
10:41few things that I have heard.
10:44The first being. I actually spoke
10:48with PAMAM our health and Wellness
10:50Manager earlier today about this.
10:53She said, you know,
10:55in outreach to clients about the vaccine.
10:58They were like, well,
10:59you called this a year ago and you
11:01told us to stay home and we've been
11:03staying home and we haven't gone
11:05anywhere and we haven't gotten
11:06covid so we don't need the vaccine.
11:09And so that's been one thing.
11:12An another thing is just like,
11:14yeah, there's some, I think.
11:19Yeah, some some you know.
11:20I don't know if you want to call them
11:23conspiracy theories or what, but.
11:25You know, like I've heard that
11:28this is satanic or like it's,
11:30you know, black magic.
11:32Things like that have come up.
11:36One thing that I haven't
11:39necessarily heard from any of our.
11:43Any of our clients,
11:44but something that kind of like was
11:47sparked by something I heard in the
11:49news recently was the Catholic Church.
11:50Kind of.
11:52Denouncing the Johnson and Johnson
11:54vaccine based on the way that it was
11:57developed and thinking about a lot
11:59of our undocumented clients and,
12:02you know, maybe their their
12:04correlation with Catholicism.
12:06Just being like yeah pre
12:09Emptive thought of mine.
12:11But again, not sure that that
12:13is like I haven't heard that.
12:17Personally.
12:19Silent that gives like a bit of a bit
12:21of a starting point as to what are
12:23some of the things going around, but.
12:26But I see heads nodding,
12:29so that's that's what you're
12:31describing is clearly not uncommon.
12:35Yeah, quickly time and saying I've
12:37definitely heard some of those
12:39things as well. Especially since the
12:41Janssen or JNJ vaccine recently came out.
12:43I guess one one piece of good news is that
12:46we do have really good access to other
12:49types of vaccines here in the states,
12:52so you know someone was
12:54really opposed to Janssen JNJ.
12:56It's easy for them to get Pfizer radar.
12:58No, I do think it's important,
13:01you know, to to counter those things,
13:03but maybe not quite as critical.
13:06As far as the not needing the vaccine,
13:09because you know,
13:10staying at home or you know you've been
13:13asking for so long and haven't gotten that,
13:16that is something that we hear.
13:18Also, there's a contingent of folks
13:20that don't don't believe the severity
13:22of of COVID-19 either as another
13:24key group that doesn't see the
13:26importance of getting vaccinated.
13:28And I think for for those folks,
13:31I think understanding that well,
13:32you don't know what they want
13:34to stay in their homes forever.
13:37Anything for doing it for a year but
13:40but the vaccine is sort of the way out,
13:43kind of back towards normal life
13:46and trying to communicate.
13:47You know the concept of herd immunity
13:50or community immunity as a way that
13:52we can you know collectively kind
13:54of get back towards normal life
13:57is usually fairly effective.
14:00Just very briefly, I'll jump in on that one,
14:02particularly around the
14:03Johnson and Johnson vaccine,
14:04and I'll put it in the chat momentarily.
14:06That issue about about some Catholic
14:07Bishops that have raised concerns
14:09about the the cell lines in which the
14:11vaccines were tested has certainly
14:12created some confusion, but it's been.
14:14It's been quite clearly to the
14:16extent that you may hear this.
14:18Elsewhere that it's been quite
14:20clearly even by the by the Catholic
14:22Bishops of Connecticut released
14:23a statement a few weeks ago from
14:25with respect to Catholic doctrine,
14:27Catholic teaching,
14:27saying that any of the three
14:29vaccines are acceptable in the
14:31Catholics in good faith can choose
14:32any of those available vaccines,
14:34so that's an important message
14:36that absolutely has has gotten,
14:37I think,
14:38confused by some of the voices from
14:40some Catholic leaders in that regard.
14:46Thanks, Jason, that's a really
14:48important important point to bring up.
14:50I'm wondering if if Julia or Trisha,
14:53or certainly Camille Ouranian clinic.
14:55If anybody else has had heard anything
14:58different from what Danny has already shared.
15:02I just wanted to make one point.
15:04I think it's sort of interesting
15:05that you expect refugees who come
15:07some various degrees of you know,
15:09conflict an have often been persecuted
15:11by their own governments, at least from
15:13from the refugees that I have seen.
15:15And it's probably not as broad as what Jenny,
15:17because Jenny works with a lot more people.
15:20I only see my patience,
15:21but I haven't really encountered
15:23this mistrust necessarily.
15:23That, like it's a bad thing and that
15:25like there's something wrong about the
15:27vaccine being developed by the government,
15:29it's more like what Jenny was saying, like.
15:32We're fine, we're healthy,
15:33like why would we need this like
15:35we've been doing fine so long?
15:36I don't think we really need this.
15:38And in general,
15:39refugees do tend to be not that
15:41great about preventive care,
15:42even though they usually majority
15:43of them have had their childhood
15:45vaccinations except travelling.
15:46Typically they're not.
15:47They're not, you know,
15:48the best for preventive care,
15:49and I feel it falls more.
15:51Perhaps under that umbrella.
15:52And like Britta said,
15:53like maybe lack of sort of understanding
15:55of what sort of population helped
15:57us and what like herd immunity's
15:58and those kind of things.
16:00It's just interesting to me that those
16:02are the barriers more than I think like.
16:04Specific mistrust of what's happening.
16:09I would agree with any.
16:11I haven't had a lot of mistrust,
16:13but I think like you know we have such a
16:16variety of families coming in with ideas
16:18that we haven't been able to pinpoint.
16:21Any you know, I don't think we can make
16:24generalizations about the population.
16:25We've had families who very excited
16:27and feel that it's a privilege to have
16:30American health care that they wouldn't
16:32be having at home that they have access to
16:35all these things here that they wouldn't
16:37have at home to families who once again.
16:40I don't want to get anything that
16:42isn't absolutely necessary and
16:44and I think there is.
16:45As everyone has said,
16:47a lot of misunderstanding of
16:48you know that they they are.
16:50They are healthy and that they don't
16:52need to to have the vaccination.
16:55But I would fall away from making
16:57any generalizations because I feel
16:59every family is very different.
17:00When I've been having conversations
17:02with them about the vaccines.
17:08Great, thank you so much chamelon honey.
17:10I see that we are getting to
17:12the end of our of our times.
17:14I just wondering if any of our
17:16panelists had any final comments
17:17that you wanted to share with the
17:19audience before we we end our session.
17:22Yeah, I just wanted to note that.
17:26You know so much for the
17:28refugee of the interventions,
17:29health interventions for our various
17:31refugee populations really turn on.
17:33Volunteer support,
17:33making up for gaps within Systems an
17:36all sorts of systems failures that
17:38an incredible cadre of volunteers and
17:40dedicated staff find a work around
17:42for and it doesn't take that much to
17:44disrupt these very delicate systems.
17:46And then people spend a lot of time
17:49than trying to find new work arounds.
17:51And I think an ongoing question
17:53that I have for this particular
17:55vulnerable population.
17:56Then I'm sure for others,
17:58is what can we do to systematize some
18:01of these will always need creative
18:03problem solving in this work,
18:06but the it's.
18:08I feel like we're not truly
18:10addressing these health disparities
18:12when they fundamentally turn on
18:13people going above and beyond,
18:15or thinking about how to extend
18:17themselves in ways that seems to
18:19me like a very precarious way of
18:21getting access to basic health care.
18:23For a lot of people,
18:25although although I see Jennifer
18:26I see Jennifer pondering that,
18:28maybe that's just the nature of the work.
18:30I I don't know what people think.
18:38I, I think that's a very fitting way to sort
18:41of move towards the end of the discussion.
18:45Why? I think absolutely,
18:46I mean, refugees have just one
18:49group of vulnerable people.
18:50There are so many other groups of
18:53vulnerable people that are, you know,
18:56in very fragile health care systems that
18:58you know when there is something like this.
19:02Like the pandemic,
19:03everything is exacerbated and comes to light.
19:06But they are always there and
19:08always underlying the work we do
19:10and where exactly what you said.
19:12We're always overextending ourselves
19:13trying to individually create solutions,
19:15but I think a lesson we should take away not.
19:18I think everybody here,
19:20I think is well aware of this,
19:22but a lesson just.
19:24For for the larger systems,
19:26I think is just.
19:27How can we improve this going
19:29forward all the time and not
19:30just when there's a pandemic
19:32and when there's emergency?
19:34You know medical care.
19:37That's a great point on it,
19:39so maybe what we can end with is,
19:41you know, the fact that we have so
19:43many folks like like our panelists here
19:45today as well as so many of the people
19:48who joined us for the conversation.
19:50Who really are thinking
19:51deeply about this community?
19:52And then there are others who
19:54are thinking deeply about other
19:55communities that are marginalized
19:56and vulnerable in different ways.
19:58And so as long as there are people who
20:00are continuing to be invested in in
20:02making sure that our most vulnerable
20:04are getting the access that they need.
20:07You know, then.
20:08Then we can.
20:08Then we can continue to work towards
20:11actually fixing this system so we
20:13don't need to keep doing this,
20:14so alright.
20:15So with that I will thank all of our
20:17panelists again for joining us this evening.
20:20This was a wonderful session.
20:22So glad that we were able to
20:24do this this year.
20:25And thank everybody who joined us from
20:27from home or whatever wherever you were.
20:29And for my final slide just to show thank
20:32you so much for joining this conversation.
20:34We look forward to seeing you next year,
20:37hopefully with an even bigger.
20:38Celebration and maybe even
20:40in person at that point.
20:41So thanks so much everybody take
20:43care and have a wonderful evening.