While the Covid-19 public-health emergency officially ends Thursday, the need to vaccinate all people in the United States and prepare for future pandemics must continue. Recognizing this reality, the Biden administration last month announced plans to support ongoing Covid-19 vaccine development and to provide coronavirus vaccines and treatments at no cost to uninsured adults.
But even if these programs come to fruition, the nation’s health defenses are clearly inadequate to prevent both current and future outbreaks of vaccine-preventable diseases — a problem compounded by a sharp decrease in philanthropic support of effective measures put in place during the pandemic.
This is no time to give up on efforts to address what once seemed like intractable public-health challenges. The Covid-19 health emergency offered a glimpse into a world in which vaccines are truly available to everyone. For once health care didn’t seem to have quite as many barriers. No one was denied the vaccine based on their ability to pay. Communities came together to share information about vaccines and create opportunities for people to get the shot. Even the corporate world encouraged and helped employees to get immunized. As a result, more than 90 percent of eligible adults have now received at least one dose of the coronavirus vaccine.
On Friday, we return to a world that is all too familiar to immunization advocates like me — a world in which race, ethnicity, insurance status, and location determine who has access to vaccines.
This is about more than Covid-19. Vaccination rates in general fell sharply for both children and adults during the pandemic, fueled by anti-science disinformation and justifiable mistrust in the medical system stemming from historic and ongoing racism. These factors have led to the re-emergence of fully preventable diseases such as measles, polio, and whooping cough. Influenza vaccination rates among all age groups have also remained alarmingly low, despite an especially severe flu season this winter.
Yet there is no clear path forward to both ensure people get immunized and to prevent potentially catastrophic outbreaks.
The pandemic showed that vaccinating entire communities is possible when enough money is available. Foundations and philanthropists became part of the solution, offering both funding and institutional knowledge to overcome longstanding barriers to health care. The federal government released millions of dollars to community-based organizations to ensure trusted messengers were empowered to discuss vaccines and provide access to immunization clinics.
A report by the organization I lead, Vaccinate Your Family, and Día de la Mujer Latina, or DML, found that these efforts significantly helped boost vaccination rates. DML, for example, was able to train dozens of community health workers, known in Latino communities as promotores de salud. They, in turn, counseled hundreds of people who were either unwilling or unable to get a Covid-19 vaccine.
Similarly, the National Council for Negro Women activated thousands of trusted messengers who were already engrained in their communities working on issues such as civil rights, HIV/AIDs, and improving public education. These efforts succeeded in narrowing and even closing the vaccination gap among Black people and Latinos.
Funds Are Gone
Unfortunately, those funds are now gone, including millions of dollars in philanthropic support. A 2022 report released by Candid and the Center for Disaster Philanthropy found a “concerning decline in giving by large U.S. foundations even as communities face decades-long efforts to recover from the compounding effects of the pandemic.”
The report notes that corporate foundation funding for Covid-19 had already decreased 76 percent in 2021. Overall, pandemic funding fell to just 7 percent in 2021 compared with 12 percent in 2020. Official numbers have yet to roll in for 2022, but anecdotally, our partners across the country report steep declines in philanthropic funding to continue their vaccination efforts.
Vaccine equity is the key to health equity. Vaccinations are often one of the first points of care for infants and are the only medical intervention recommended for nearly every person, in every age group.
But vaccinating the public requires a massive infrastructure to ensure care is available even if a person has no health insurance or primary care provider, and lives hours from the nearest town. Too few traditional medical professionals are available to meet the need, making community health organizations and community health workers essential for filling gaps in vaccine access.
Can’t Count on Government
With Congress in gridlock, philanthropy must step in to help organizations that are tackling multiple public health challenges in their communities on shoestring budgets. Investments in equitable vaccine infrastructure would open up opportunities to provide an array of services beyond coronavirus vaccines to the most underserved populations, including blood pressure screenings and mental health care.
During the pandemic, Vaccinate Your Family, which works to protect people of all ages against vaccine-preventable diseases, created a Vaccination Collaborative, now comprised of 200 groups and individuals. Our goal was to ensure systems put in place during the health crisis continued as the nation battled new rounds of the coronavirus and old nemeses such as polio and measles. We provided expertise to new partners who joined in the fight against Covid-19 and expanded our ability to offer micro-grants so that small but vital community partners received their fair share of funding.
But these groups are now facing a severe lack of funding from philanthropic and business sources. Without such support, this work can’t continue as community-based organizations inevitably follow the limited money available to them. If that happens, many of the critical gains made during the pandemic will be lost, forcing us to start from scratch when the next health crisis hits.
More than three years ago, the worst pandemic in a century came to our shores, killing more than a million people. In the face of such devastation, communities banded together to do heroic work. This is no time to let go of the life-saving infrastructure we built.