Understanding COVID‑19
A quality improvement (QI) project can be undertaken to understand conclusions from COVID-19 incidence, mortality, hospitalization, and vaccination rates.
The QI project might analyze specific documentation, including: weekly number of new COVID-19 cases, hospitalizations, and deaths. The team may also seek to analyze COVID-19 vaccination first doses, second doses, denials, or who is eligible to be vaccinated and has not been.
This can be accomplished by reviewing pertinent COVID-19 data over the course of one week. Data can be disaggregated by race, ethnicity, age, sex, insurance type, etc. to monitor trends.
Example of how COVID-19 Vaccinations Can be Addressed
The Kaiser Family Foundation has been tracking COVID-19 vaccinations by race and ethnicity by extracting data from publicly available COVID-19 datasets on many States’ websites. (Note: NR = Not reported on the State’s website; NA = Data are insufficient for total population comparison.)
These data may help providers in states understand where disparities in vaccination rates exist and point to a need for targeting certain populations.
Additional note: data tables can be constructed based on numerous demographic variables.
| Location | White % of Vaccinations | Black % of Vaccinations | Hispanic % of Vaccinations |
| Alabama | 80% | 17% | 2% |
| Alaska | 30% | 1% | 3% |
| Arizona | 76% | 2% | 13% |
| Arkansas | NR | NR | NR |
| California | 36% | 3% | 18% |
| Colorado | 87% | 2% | 6% |
| Connecticut | NR | NR | NR |
| Delaware | 73% | 9% | 3% |
| District of Columbia | NR | NR | NR |
| Florida | 78% | 6% | 16% |
| Georgia | NR | NR | NR |
| Hawaii | NR | NR | NR |
| Idaho | NR | NR | NR |
“Misunderstanding disparities in [COVID-19] vaccine distribution starts with the misnomer that we are where we were. Too often, government officials inappropriately believed that the level of hesitancy in the African American community remained static and didn’t send vaccines. But, things change, like administrations viewing other [populations] get their shots and survive. Breaking news, African Americans can be flexible, adaptable, and we can change our views based on new information. That’s how we survive. Advancing equity in African American communities during the COVID-19 vaccine effort requires empathy and a commitment to address existing [vaccine hesitancy] longer term.” – Rev. Dr. Terris King, Pastor of Liberty Grace Church of God in Baltimore, MD.
Additional Tactics to Improve COVID-19 Health Outcomes and Vaccinations
There are many tactics the medical staff, beyond the physician, can use to inform and influence patients that will improve their health outcomes and increase vaccination rates. Here are some key approaches:
Patient education
Use patient education tools to encourage mask wearing (single or double), social and physical distancing, hand washing, and the limiting activities of with more than 5 people
Patient surveys
A nurse, medical assistant, patient navigator, or patient educator can survey patients via email before their appointment to understand their feelings, attitudes, and beliefs toward COVID-19 risk reduction tactics and being vaccinated
Health equity strategies
Medical systems and practices may employ health equity strategies that ensure communities hardest hit by COVID-19 are prioritized in the vaccination rollout
Build trust through communication
- Provide culturally appropriate and responsive educational tools that seek to inform patients of the COVID-19 vaccines’ safety, efficacy, and effectiveness. This includes being transparent about current and approved treatments, research, and clinical trials. Patients may also be interested in clinical trial participation
- Patients may also respond to seeing national leaders express their trust in the vaccine by being vaccinated on camera
Proactive activities to improve COVID-19 health outcomes and vaccination rates
- Email patients at regular intervals to remind them of the precautions they should be taking to reduce transmission of the virus and the risk of infection. Include what to do if symptoms arise (testing, isolation, purchasing a pulse oximeter, cleaning recommendations, etc), and when to report to an emergency department for treatment
- Designate personnel (nurse or medical assistant) to answer phone calls related to COVID-19 symptoms
- Show empathy and respect for patient concerns regarding their fears of developing illness and/or fears of death if diagnosed
- Keep patients informed of when and where vaccinations will be available to them and how they may schedule an appointment to be vaccinated
- Prepare your facility for the proper storing, handling, and administration of COVID-19 vaccines using CDC or FDA (Pfizer-BioNTech or Moderna or Johnson & Johnson) guidelines
- Designate staff for scheduling vaccine appointments with eligible patients
- Ensure proper documentation of vaccinated patients to improve follow-up for second dose
- Designate personnel to collect data on adverse events