A 3-Tiered COVID-19 Vaccination Approach to Better Reach the Black Community

Close up of a young African American male patient sitting in a medical clinic and is being given the Covid 19 vaccine in his shoulder by a female African American doctor, both wearing protective face masks
In an effort to better reach the Black community, a university in California developed a 3-tiered approach to establish a mobile vaccination clinic.

Engaging community faith leaders, promoting vaccine education via community healthcare professionals, and establishing mobile vaccination clinics could increase vaccination among Black and Brown communities, according to authors of a commentary, published in Lancet Global Health.

COVID-19 has greatly affected minority communities in the United States. Black individuals represent 14.8% of deaths due to COVID-19, which is greater than the proportion of the Black population living in the United States (13.4%). The study authors note that the increase of ill effects among minority populations is heavily attributed to structural racism and inequities in health care.

It is imperative to increase vaccination within Black and Brown communities. According to the authors, major barriers include decades of institutional distrust among these communities and the current rollout of vaccines leaving disadvantaged areas with lower allocation, which ultimately lead to fewer Black individuals have been vaccinated compared with their non-Hispanic, White counterparts.

Over a 30-day period in San Bernardino County, California, only 3.6% of the adults who received their first vaccine were Black despite making up 7.8% of the local population. In an effort to increase vaccination among the Black population, the Loma Linda University established a 3-tiered approach.

First, the university established a relationship with the Inland Empire Concerned African American Churches and the Congregations Organized for Prophetic Engagement. The university then held a COVID-19 faith summit, during which they educated pastors about the vaccine. After the meeting, the faith leaders promoted educational webinars about COVID-19 vaccines, distributed vaccination registration forms, and managed appointment lists.

Second, to better reach members of the Black community, a Black pharmacist who specialized in infectious diseases facilitated COVID-19 educational webinars for the public. This pharmacist also managed the vaccine distribution during mobile clinic visits.

Lastly, the mobile vaccination clinic primarily used local church parking areas, a familiar setting for community members. The registration process was completely paper-based, such that lack of internet access was not a barrier to receiving the vaccine. During a 24-hour period, the clinic vaccinated 417 people, of whom 84.2% were Black. In the following week, the proportion of Black vaccination recipients increased from 3.0% to 3.6% in the region.

The commentary authors concluded that “the equitable allocation of the COVID-19 vaccines is essential to confronting the racial disparities magnified by the current pandemic” and that their 3-tiered approach increased COVID-19 vaccination among the Black community.


Abdul-Mutakabbir J C, Casey S, Jews V, et al.A three-tiered approach to address barriers to COVID-19 vaccine delivery in the Black community. Lancet Glob Health. 2021;S2214-109X(21)00099-1. doi:10.1016/S2214-109X(21)00099-1