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Commentary February 25th, 2021
Innovation • Health • Legitimacy
Rebecca Ierardo Senior Associate, North America

Building Trust in Testing & Vaccination

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Since April 2020, @CPI_foundation has been supporting @RockefellerFdn Pandemic Solutions Group of public officials leading efforts to scale #COVID19 testing & vaccination efforts

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.@RebeccaIerardo highlights initiatives from @RockefellerFdn Pandemic Solutions Group that are centering equity, trust & communities in their pandemic response efforts

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From @HealthyBoston @CityofBoston funding community-based orgs, to @CoreResponse in @Oakland; lots of areas are supporting equity in their #COVID19 response

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One month after the first long-awaited vaccine release, the U.S. experienced its deadliest month of the COVID-19 pandemic to date. In January 2021 alone, there were over 95,000 deaths in the country, bringing us past another grim milestone of more than 450,000 total people dead from COVID-19. Getting the vaccine produced, distributed and, most critically, into people’s arms, quickly and equitably has never been more important. Especially as new, potentially more contagious, strains of the virus make their way onto U.S. soil. 

The critical and complex on-the-ground logistics of vaccination has fallen to state and local governments, joining the myriad responsibilities handled at the local level over the past ten months. In April 2020, The Rockefeller Foundation launched the Pandemic Solutions Group (PSG): a peer-learning network of public officials from about 50 U.S. cities, states, and Tribal Nations leading ambitious efforts to scale Covid-19 testing and vaccination efforts in their communities. The Centre for Public Impact provides oversight and support to the group, serving as the PSG Secretariat. Every two weeks, the group convenes virtually to hear from experts and share best practices related to a range of pandemic response topics. 

In April 2020, The Rockefeller Foundation launched the Pandemic Solutions Group (PSG): a peer-learning network of public officials from about 50 U.S. cities, states, and Tribal Nations leading ambitious efforts to scale Covid-19 testing and vaccination efforts in their communities.

Over the last ten months, our sessions have highlighted the hyper-local public health efforts that seek to bring more equitable outcomes to pandemic response, ensuring that those most vulnerable to COVID-19 have equal access to testing and vaccines. 

Through the PSG, city and public health officials, non-profit organizations, and community leaders have shared how they are actively working to build trust and legitimacy in the eyes of residents as part of a more equitable public health response. Below, we highlight two initiatives from PSG members that are centering equity, trust, and communities in their pandemic response efforts:

Taking the Lead from Community-Based Organizations in Boston

In Boston, as with many other localities, community based organizations (CBOs) have been essential to pandemic response, keeping the most vulnerable populations fed and housed throughout this crisis. Recognizing their central role in the community, and also how overburdened these organizations have been over the last ten months, the Boston Public Health Commission and City of Boston have provided funding to over 200 community-based organizations to support vaccine efforts. Alongside this, they are also convening learning and sharing opportunities that provide CBOs with consistent, accurate, and effective COVID-19 messaging they can share with their communities. 

To be successful in their efforts, Interim Chief of Staff, Margaret Reid, shared how important it is to acknowledge the legitimacy of CBOs perspectives about the vaccine. According to Reid, CBOs often represent populations for whom years of historical health inequities have fueled mistrust of the COVID-19 vaccine, and they cannot be “coerced” into touting a vaccination vision that they do not support. Reid recognizes the importance of treating CBOs as full partners and experts in their community and notes that, in some cases, “we have to recognize ‘wait and see’ as an option...if we can move an organization from sharing negative information to feeling comfortable being silent on it, that’s progress.” 

Pairing “hardware” and “software” with Community Organized Relief Effort in California

Community Organized Relief Effort (CORE) is a nonprofit disaster relief organization that has been partnering with community-based organizations and local governments since March 2020 to ensure equitable access to COVID-19 testing, supported services, and vaccination. Ann Lee, co-founder and CEO, described how CORE works with local partners to design the physical “hardware” of their response to reach hard hit communities and the most vulnerable populations by locating walk-up and mass vaccination sites in COVID hotspots and low-income neighborhoods.

However, even at these sites, CORE has reported low uptake among Latinx and Black residents, reinforcing the need for the equally critical “software” of making the sites more accessible, while also partnering with and empowering community leaders to act as trusted messengers. “Even though our walk-up sites are located in underserved neighborhoods, it doesn’t mean you’re still getting the right people onto the sites … It’s not just the messaging; it’s about accessibility. We have a team of community mobilizers working with trusted community-based organizations to get the message out and we offer on-site registration to make this critical relief more accessible,” Lee shared. In Oakland, for example, CORE partnered with a local pastor, who led a door-knocking and phone campaign to spread awareness about testing. This strategy increased testing in the area from about 60 tests per day to 500-1,500.

Moving forward: Supporting equity in COVID-19 response

Testing and vaccinating vulnerable populations quickly and equitably will, quite simply, save lives. As the COVID-19 Tracking Project has repeatedly shown, Black, Indigenous, Latinx, and other people of color are disproportionately affected by COVID-19. Latinx Americans have contracted COVID-19 at 1.3 times the rate of White Americans, while Black Americans have died at 1.5 times the rate of White Americans.

Americans trust their ministers, their local principals, and their mayors; they trust figures of authority that they can see in person, that they can talk to, that they can reach out and touch.

These populations, who are the most at risk of contracting and dying from COVID-19, are also those least likely to have trust in a vaccine or public health systems more generally. Countering this mistrust is a challenge that city and state officials have to overcome. Time and time again, research shows that Americans of all stripes have the most faith in local government, in local institutions, and in local leaders. Americans trust their ministers, their local principals, and their mayors; they trust figures of authority that they can see in person, that they can talk to, that they can reach out and touch. It is these figures that individuals, organizations, and governments alike must partner with to lead more equitable testing and vaccination efforts.

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The CPI team in North America is committed to strengthening the relationship between people and government. Learn more about our work and get in touch if your organization is interested in building more legitimate, effective governments.

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Written by:

Rebecca Ierardo Senior Associate, North America
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