On July 24 in downtown Lowell, Massachusetts, a group of city officials, community leaders and public health workers, of which I was a part, accomplished something many of us had feared would be impossible: We vaccinated nearly 10 times more people at a single community clinic than we had at our mobile clinics. And we did it thanks to a block party.
On the green beside a STEM academy, dozens of resource tables, a DJ booth, a team of food trucks and an enthusiastic army of volunteers convened, eager to greet any community member interested in dancing, mingling and grabbing some free swag. Families were invited to peek inside an ambulance at Touch-A-Truck, or try their luck on the cornhole boards. An outreach team made sure to walk to the nearby park to let folks know that they could join us, get free water and hygiene kits and sit in the shade. And at the center of it all, a small crowd gathered to wait in line for a coronavirus vaccine, a grocery gift card and a ticket for a free empanada.
Throughout the day I watched as vaccinators stayed busy and took note of who hopped in line. A mother was able to get her vaccine thanks to the many youth volunteers available to entertain her four young children while she sat in the observation area. A couple who were concerned they didn’t have the right documents to qualify were escorted by an interpreter who helped explain every step of the process. An elderly woman with her two adult children with special needs was able to bring them all together at the same time, which had been challenging for her to schedule via the online system. The flow never ebbed.
The block party model of public health work is not new. Historically, block parties have cultivated community bonding, identity and solidarity, especially in low-income and urban neighborhoods. Designed as by-the-community, for-the-community spaces, block parties have been particularly effective vectors for public engagement efforts for everything from violence prevention to voter registration.
In mid-June, our community, like many across the United States, reached a stagnation point in our vaccination rate. Even after we had spent months building out walk-in clinics, offering multilingual vaccine materials and organizing neighborhood-based mobile clinics, we hit a wall: Our community was 52% vaccinated, well below the Massachusetts state average of 64%. Our neighborhood-based mobile clinics were seeing as few as three people a day despite outreach teams knocking on doors and staffing phone banks.
Health disparities are not uncommon in Lowell. In our city of 100,000, approximately 1 in 5 community members live below the federal poverty line. Less than 49% of community members are white, nearly one-third were born outside the United States, and more than 40% of households are multilingual. This diversity has yielded huge community assets, as well as challenges in ensuring equitable access to health resources. After a year of convening to strategize around protecting our community, it was a blow to see the needle stay in the same spot, week after week. We had reached the point where, it seemed, demand was no longer outpacing supply.
At the time, the prevailing wisdom held that the remaining unvaccinated were staying that way due to some intractable resistance to vaccination itself, not lack of access. But at only 52% vaccinated, could we really accept that the remaining 48% of our community members were unreachable? Or that they all were intractably opposed to vaccination? Did we truly succeed in making sure everyone who needed child care had received it? That everyone who was worried about side effects affecting their ability to work had been given resources? That every person without documents was met with open arms rather than turned away from a vaccine site? That everyone who doesn’t read English found a way to navigate the scheduling site? Could we truly say to ourselves, “We have done everything possible here; there is no more to do?”
We needed a new model for access, one in which support and education happened at the same site — and at the same time — as vaccine access.
When the city presented its block party model, the response from community public health leaders was immediate and enthusiastic. A planning committee convened; sponsorships were secured; community organizations signed on to host resource tables; and food trucks were commissioned so that anyone with a vaccine card — either months old or brand-new — could get a free treat.
We were not sure what to expect on July 24. It was possible we were wrong about our community and that we truly had reached the end our of vaccination efforts.
Instead we were greeted with a line around the block before we had even opened. Families laid out blankets to share their empanadas and egg rolls. Parents showed their children signature moves to bachata, and then children showed their parents the latest dances they learned from TikTok.
At resource tables, connections flourished: People registered to vote, informational flyers about eviction protections were scooped up and referrals to substance use recovery homes were secured for community members in need. And occasionally I would catch a glimpse of a Band-Aid on someone’s upper arm, indicating they had been vaccinated. Throughout the course of the day, 64 people got a coronavirus vaccine, a marked increase from recent mobile efforts.
We learned many lessons from our block party — that people are eager to feel joy again, that the right DJ is critical for setting the vibe and that few people can resist the promise of a free empanada or egg roll.
But the most critical lesson is that, despite the valiant efforts by many to eliminate barriers to vaccine access, some remain. The city’s vaccine block party was successful because it was a family event that functioned as free child care; because nearly every organization that sponsored a table also brought along multilingual staff who were happy to interpret for people who needed help; because people felt comforted seeing their co-workers, neighbors and friends sitting in the vaccine tent alongside them; because there were no complicated booking systems to navigate to secure a vaccine appointment; and because interpreters and advocates were available to help with registration so people felt reassured that it was OK that they did not have health insurance or an ID card.
The remaining people who are not vaccinated in our communities are not a monolithic group, homogenous in their experiences and values, unchangeable in their positions and unreachable through our efforts. Some people just need more or different support than what we have done so far. And as recent vaccination gains in so-called intractable states like Louisiana and Arkansas show us, there is still hope going forward.
Since people who are unvaccinated are not a homogenous group, there is no silver-bullet strategy for vaccination efforts. Our duty as public health stewards is to provide as diverse an array of opportunities for vaccination as we possibly can. We need mass vaccination sites, in-office vaccination, neighborhood mobile clinics, county fairs or church picnics where vaccines are available. And, yes, we could probably stand to hold more block parties.
Hannah Tello is a data analyst and project manager for the Greater Lowell Health Alliance in Lowell, Mass. She coordinates a range of community public health efforts including COVID-19 response and vaccination.
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