2021 Hero BCBST Vaccine Hesitancy Update COVID-19

Using data to overcome hesitancy and lift hopes for the COVID-19 vaccine

Amid a pandemic that has taken a disproportionately grim toll on communities of color, the promise of life-saving vaccines is cause for optimism. Yet, reluctance shaped by generations of inequitable health treatment is proving hard to overcome: Only 35 percent of Black adults and 42 percent of Hispanics say they will get the COVID-19 vaccine “as soon as they can,” compared with 53 percent of white adults. Blacks and Hispanics also say they are more likely to want to wait and see how the vaccine works for others.

The complex reasons for skepticism range from suspicion about the medical system because of a history of mistreatment and racism, to more immediate barriers, such as concern over long waits that could interfere with work or family responsibilities. Though health experts understand that COVID-19 vaccination acceptance levels will likely vary by demographic and socioeconomic conditions, there has been little effort to test precisely what community and personal factors are in play—and use those learnings to design effective ways to help communities reduce the reluctance in underserved communities. 

Can data help overcome hesitancy and promote hope and healing from COVID-19?

That is the goal of a unique collaboration between BlueCross BlueShield of Tennessee (BCBS TN) and Meharry Medical College, one of the nation’s oldest and largest historically Black academic health science centers.

The program’s approach is driven by the knowledge that existing frameworks for overcoming vaccine hesitancy tend to focus on individuals’ attitudes and beliefs. They frequently fail to incorporate social determinants of health and community-level factors. So besides looking at anonymized medical claims data on patients’ prior refusal to accept vaccines, researchers will identify social determinants that may influence vaccine acceptance; develop strategies to reduce disparities in administering the vaccine; and make recommendations to public health officials and policymakers.

“We are data-driven in our efforts,” said Dr. Bryan Heckman, Director of the Center for the Study of Social Determinants of Health at Meharry. “Data is essential to identify what factors are driving hesitancy; subsequently, we can create more precise programs to meet the needs and positively impact our communities.”

As part of the project, BCBS TN developed a Social Vulnerabilities Index, which looks at 19 vulnerabilities that may put someone at a higher risk, such as income, debt, literacy, language barriers and limited access to health care.

Combining all these data points, and leveraging the power of predictive analytics, the program is mapping communities across the state that are at high-risk for vaccine hesitancy.

This predictive modeling will help identify risks at the individual and community level including food insecurity, lack of transportation and limited access to health care services as well as broader issues such as distrust of the health system and misinformation. The findings will, in turn, help shape messaging tailored to specific communities and delivered by trusted community voices. These could include faith leaders, barbers and community activists. 

“This initiative is bigger than BlueCross BlueShield of Tennessee,” said Sherri Zink, senior vice president and chief data officer at BCBS TN. “We want to move the needle on education and understanding, enabling us to optimize health care for all Tennesseans, and we cannot do that without fully knowing why some populations are more at risk.”

The first phase of the collaboration aims to better understand potential disparities in acceptance of the COVID-19 vaccines, and to raise awareness now that safe and effective vaccines are being distributed and to support this effort, the BlueCross Foundation has issued a $325,000 grant to Meharry. Both BCBS TN and Meharry plan to continue this collaboration beyond COVID-19, expanding the model to other health issues, such as diabetes, that have significant impacts on vulnerable communities. 


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