Practice Title: Community-based COVID-19 Vaccination Points of Dispensing (POD) Sites: Adapting to Changing Needs
Department: Los Angeles County Department of Public Health
Size: Large (Population of 500,000+ people)
State: California
Summary of Practice:
The Los Angeles County Department of Public Health (LACDPH) serves 86 out of 88 cities and all unincorporated areas. The County spans approximately 4,000 square miles and has the largest population of any county in the United States with nearly 10 million residents. It is also one of the most ethnically and socioeconomically diverse counties in the nation.
During the course of the COVID-19 pandemic, LACDPH Points-of-Dispensing (POD) sites transformed from large drive-through mass vaccination sites that primarily provided COVID-19 vaccinations, to seven community PODs. These sites are focused on how to encourage vaccine uptake via increasing accessibility and establishing trust within the communities the sites serve. Vaccine hesitancy and misinformation, poor public adherence to non-pharmaceutic interventions, and general pandemic fatigue made vaccinations an even more critical tool as the Fall/Winter 2022 possibility of a “tri-demic” (COVID-19, influenza, and respiratory syncytial virus) threatened to overwhelm the health care infrastructures.
The overall goal of the PODs is to provide COVID-19 vaccines rapidly and safely, while ensuring Los Angeles County residents have equitable access to the vaccine. The goal in transforming these larger mega PODs to community PODs was to become a trusted community resource in specific underserved communities and create an accessible “one-stop shop” for nearby residents to receive community health services. The objectives include ensuring accessibility to COVID-19 vaccinations while supplementing additional public health services that respond to the needs of the local community and serving as a trusted source to combat misinformation.
Activities implemented for this practice included:
- Strategic site selection using a health equity lens
- Utilization of real time data and trends to incorporate additional services beyond COVID-19 vaccinations that best catered to the community’s needs
- Community outreach to provide education and increase LACDPH’s visibility in the community
- Deployment of “Vax-on-the-Go” (VOTG) outreach teams that offered vaccines on-the-spot near local businesses and faith-based organizations within five miles of POD locations
Major Process Milestones and Results:
- Community outreach efforts to spread awareness about LACDPH presence in the community and provide health education. Result: Over 28,000 local community venues visited (June 2021 to date).
- Availability of flu and mpox vaccines at PODs. Result: Over 17,000 flu vaccine doses and almost 40,000 JYNNEOS vaccine doses administered.
- VOTG outreach teams established to provide on-the spot vaccinations. Result: Over 3,500 COVID-19 doses and over 1,300 flu doses administered “on-the-go" (February 2022 to date).
- Incorporation “Test to Treat” program. Result: Almost 6,000 rapid COVID-19 antigen tests administered and almost 500 residents referred for therapeutics (April 2022 to date).
- Produce pick-up program established. Result: Over 7,200 households served (June 2022 to date).
With the available resources, LACDPH was able to ensure accessibility to COVID-19 vaccinations despite fluctuating vaccine demand by continuing to remain in the community with consistent days and hours of operation, including offering evening hours and weekends coupled with walk-in availability. VOTG was designed as a “hub and spoke” model - with the PODs serving as the community hub and outreach efforts as the spoke. VOTG teams offered vaccines on-the-spot to capture hard to reach and vaccine hesitant populations. Supplemental services were incorporated including flu and mpox vaccinations, COVID-19 test kit distributions, rapid COVID-19 onsite testing and therapeutics referrals, a produce pick-up program, and additional psychosocial resources such as on-site mental health workshops and other enrollment services.
Factors that led to the success of this practice include the high level of community engagement through LACDPH’s strong community partnerships and commitment to immerse within the local community via extensive outreach. Community outreach teams were deployed for targeted outreach and dissemination of health education materials. Supportive partners, such as the LA County Department of Parks and Recreation and local cities, provided facility space free of charge. LACDPH utilized staff subsidized from the State of California Medical Health Operational Area Coordination (MHOAC) Program to supplement DPH staff. These collaborations minimized the logistical hardships that would have occurred while attempting to expediently expand or contract the POD footprint based on rapidly changing community demands.
LACDPH’s consistent presence for over 18 months helped strengthen community trust, especially through the changing phases of the pandemic, from various COVID-19 surges to the emergence of mpox. The continued community visibility also signified the ongoing nature of the pandemic. LACDPH leveraged the existing infrastructure of the PODs to respond swiftly to other unprecedented needs, such as providing mass mpox vaccinations or linking residents directly to COVID-19 therapeutics resources. Building community trust takes time and this approach was respectful and empowering towards the communities that LACDPH hoped to reach.
The locations of the community PODs were strategically chosen through a health equity lens to ensure that the most vulnerable communities in Los Angeles County would easily have access to services. Utilizing the California Healthy Places Index (HPI) indicators, specific cities and communities were identified as harder-to-reach and had historically more challenging barriers to health access. There was also an additional focus on prioritizing trusted locations such as community centers, parks, and recreation sites, as they were conveniently accessible to the public.
Program website: http://publichealth.lacounty.gov/media/Coronavirus/vaccine/sites.htm
Community-based COVID-19 Vaccination Points of Dispensing (POD) Sites: Adapting to Changing Needs
Category
Immunization
Description