Important question, the cdc tracks flu every year all i am so pleased to moderate this important session. We are a nonprofit, nonpartisan Public Health policy research and Advocacy Organization based in washington, d. C. The covid19 pandemic is an immense challenge. Envision a nation that values the health and wellbeing of all. Since the spring of this year, we have held a series of webinars focused on the impact protecting older adults from the arm of social isolation. How the pandemic is concentrated in many gaps. We also cohosted a congressional briefing on advancing Racial Equity. It should go without saying that this is an unprecedented pandemic. The likes of which has not been seen in this country. Seenve certainly disparities in past Public Health emergencies. The pandemic has greatly exposed trust for Americas Health has been advocating. Calling for data disaggregation. We are also focusing on other issues. Calling for investment in Public Health infrastructure. This includes increased funding at local levels. As we prepare for a vaccine, it is important to realize that hesitancy and access issues are real. The underlying reasons are many, from higher rates of being uninsured or underinsured to lack of act as to health care to. Istrust as you will hear from our panelists today. Leadingbeen one of the voices advocating for policies that would increase equitable Vaccine Access. We advocate for increased funding for the centers for Disease Control. We have heard many saying that this pandemic should serve as a call for action. Two in systemic inequities. We released a blueprint for the new administration and Congress Focusing on health for all. This report is available on our website. With that background and introduction, im excited to turn to todays discussion. These are the longterm recommendations to build Vaccine Confidence. Remind us to never forget that we are not simply speaking about policies and programs. Lets get started. This is our panel of experts. The president of howard served as previously provost and chief academic officer. He is the author of numerous aerreviewed articles and is widely recognized expert on disparities in health care and medical education. Next is the executive Vice President of the Robert Wood Johnson foundation. She oversees research and communication activities. Before joining the foundation, she led the Chicago Department of health. She led the development and implementation of a fouryear Health Improvement plan focused on equity. She has served on many committees. She has over 13 years of thank you for all of our panelists to are joining us today. Thank you. Grateful that i have been invited to speak today. This has been a movement to deal with centuries old prejudices. Excitedever been more about the direction of our country. The American Society today has problems lying right there on the surface. Public thinking is shifting to more widely acknowledged insperitys for people of color. We have data to prove that these are not groundless or baseless. This is fact. Hardly anyone in the community would have lead to this accelerated timeline. When the world focuses on our communal problem, this is proof of what we can achieve. A vaccine is not a panacea. There is much we need to understand. The realities of the coronavirus pandemic have included deepseated mistrust of the medical system. Africanamerican men and women are twice as likely to die from covid19. The results of these discussed in cr many fold. Independent and interconnected solutions. Is also the simple explanation that black people do not receive equal health care. This is an undeniable truth. Black patients have more medical problems. These continue to do real harm. Pandemic, we have been not admitted to hospitals. Because of income inequalities, we are more likely to work on the front lines. All of this adds up to the black community being the brunt of the pandemic. Problems echoday a disturbing history which were caught in these two films. Black men infected with the disease were lied to. Despite the researchers knowing it was not in the best interest of their health. Her cancer cells were taken and used for Research Without her knowledge. The family received no financial compensation. Her medical information was publicly available. We also have a problem in the opposite direction. Too many Scientific Research opportunities do not involve any black participants. Drugmakers have been slow to relate the breakdown of participants. Dharna moderna reported participants6 of were people of color. A vaccine with limited testing can have negative effects on black bodies. This is even more so impactful. Trials usually have about 30 participants. This problem of trust has been here for the covid19 vaccine. It will not be safe to reopen our country and resume life as normal. Trust can never be restored if we dismiss and ignore. We have to understand where this mistrust comes from. The 6 of participants from communities of color. They should look like the population. Fauci has called for twice that number because of how hard covid19 has hit them. The next step is for the medical establishment to partner with institutions that have high trust within the africanamerican community. Institutions like howard and other historically black colleges and universities should serve as a conduit for bringing in black individuals for trials. Making Great Strides in this area. Howard has been selected by the national covid19 prevention institute. It is vital that we make this as easy as possible for black americans to participate in this clinical research. We must be clear. They should be included in plans to distribute the vaccine. We need to achieve equality in all areas of life. This is being recognized as a problem. The family is now being involved in the research. If we can correct some of these mistakes of our past, we should be able to solve the problems of our present. We understand the magnitude and nuances of these problems. By continuing to place greater emphasis on diversity of representation, i confident that we can in the pandemic on a more equal note. Thank. Thank you very much. You forth that incredibly insightful presentation. We will delve into that more in our q a. You. Ank i was like to start by thanking the team for hosting this important discussion. I am pleased to have the opportunity to join this discussion about Vaccine Access, safety, and utilization. And to share my perspectives. A are focused on building culture of health and advancing Health Equity. ,s a former Health Commissioner i led the 2009 pandemic. I have marveled at the speed at which covid19 vaccine has been developed. I am concerned about the lack of confidence in our Vaccination Program. I would like to share some recommendations. Before i review the recommendations, i want to provide some background information. Rate amonghigher native, black, and latino americans in the united states. This is reflected in this chart. This is not new to any of you. There are structures that are barriers to health. They are exacerbated during Public Health emergencies. We saw this and the h1n1 pandemic in 2009. These graphs have inspired the nation to confront health and Racial Equity more boldly and strongly than other public emergencies. This might not be as familiar to you. Americans are hesitant to get a covid vaccine. The lowest rates of trust lie within the black community. We know coverage will be required to achieve herd immunity. I share this slide with you because it represents the opportunity and responsibility are us to create a Vaccine Program that is equitable. Longommunities that have faced structural barriers to health are the more adversely impacted. It can be challenging to know how to put this into action. Of healthd a set equity principles that can be used as a roadmap. The principles include ,ollecting, analyzing data including those most affected in decisionmaking. Identifying and investigating and investigating in Public Health infrastructure. There have been several sets of investigations. In june, the nih and cdc and the National Academies of sciences, engineering, and Medicine Community committee of experts. They were asked to develop a framework for flexible allocation of the covid19 vaccine. The most attention from the media and policymakers and the public. The Committee Also released seven excellent recommendations. I will be talking about the priority groups. And the other recommendations and highlight their role in Vaccine Confidence. The second and third recommendations are critical components of ensuring an equitable Vaccination Program. The second one is to leverage and expand existing systems and partnerships. I will review why these recommendations are so important. I know firsthand these things need to happen. Vaccine manufacturers, insurance companies, and other federal agencies need to ensure that Vaccine Supplies are widely available. These tap into the existing infrastructure. These are for ongoing stable funding. The cdc works with state, territorial, and local Health Agencies to distribute more than 80 million doses of back scene vaccine annually. This Program Supports other critical elements of the system. Building on this system is efficient and effective. Making a vaccine available will not be enough if no one shows up to get the vaccine. Having ame of you are flashback to 2009. We distributed more than 1. 1 million doses in less than four months. The Health Department collaborated with a few communities and organizations to disseminate vaccine information. And demand from communities of color. Next slide. Chicago learned great lessons from the experience. We needed to earn trust and establish Authentic Communication with communities of color during times of calm. Involvesommunications not just talking but really listening. Next slide. Since 2009, the department of Public Health and many other Public Health agencies have focused on Health Equity and accuracy rigorously developing plans to bring more voices to the table. Chicago 2. 0, that Healthy Chicago 2025 prioritized Health Equity in content and in process. Key pillars of both plans include leveraging disaggregated data for planning and use by the community. And engaging communities of color in the development and Implementation Plan for both. Relationshipshed are key to addressing covid19 when it emerged. Next slide. The city of chicago was able to rely on partnerships when it became clear that a majority of deaths were people of color. The partners helped the city launches its Racial Equity Rapid Response effort, they plan to mitigate covid19 illness and death for black and latino communities. To meet these goals they focused on listening and responding to Community Partners to benefit and not burden communities. And working in partnership with black and Latino Community organizers and leadership to develop a citywide Community Mitigation effort. These relationships will be essential to be as effective as chicagos covid19 Vaccination Program. Next slide. The National Academies recommendations are in building, public confidence, especially among communities of color. They recommended federal agencies lead a court needed response. They recommended hhs create and fund a vaccine risk orientation and Community Engagement program. They have recommended the cdc develop and launch a National Vaccine promotion campaign. They recommended cdc and nih building evidencebased vaccine promotion and acceptance. Emphasizedendation the need to engage with the community to understand the concern, develop appropriate messages, and identify appropriate messengers. More federal coordination reflecting our need for recommendations to be fully implement it and for the full potential of the covid19 Vaccination Program to be realized. 2009, and every large Public Health emergency since then, cdc hosted media briefings and Health Care Provider webinars to provide clear and consistent updates, guidance, and message is. Betweend estimated 6 billion in a billion dollars are needed for vaccination efforts. Without this coordination and support widespread Vaccine Hesitancy will continue. Communities of color be disproportionately impacted by covid19. Next slide. Although federal coordination and funding have been related to date, some has already happened. State Health Officials have begun this work. They submitted to cdc their immunization plan, which included the communication plan and the engagement plan. Other organizations are responding. The National Medical association has scheduled a meeting on october 29 with the goal of developing policy recommendations for ensuring access to and utilization of a safe and effective covid19 vaccine among communities of color. Some academic institutions are putting together initiatives to fill knowledge gaps and help informed decisionmaking about vaccines. Supporting john hopkins an understanding and addressing Vaccine Hesitancy in communities of color. They are also supporting a High Level Panel to make recommendations for managing misinformation related to covid19 vaccines. Next slide. Isritical thing to remember if earning trust for the vaccine and vaccination system is a color is essential the filling the vaccination confidence. When we speak we need to communicate clearly, consistently, and transparently. We need to remember indication is a twoway street. All of us can work on this now, whether you are federal, state, territorial, local, Public Health staff, Health Care Providers, vaccine manufacturers, policymakers. We need to be focusing on earning the trust communities of color and understanding their concerns, determining what messages will address their concerns, and identifying the most appropriate messenger. Next slide. Recommendations and examples i have shared were helpful. The bottom line is this. There are quite a few things we can do now to earn trust and help ensure a more equitable program. Once again, here are the resources i mentioned to help guidance. We have made Health Equity are central aim. The pandemic has made it more clear. This is the work we have to focus on. It is time for all of us to Work Together to dismantle the barriers of structural racism. Together we can set our nation on a course toward a more fair and just society where everyone has the opportunity to thrive. Thank you. Thank you very much for that informative presentation of resources and Lessons Learned from examples from the h1n1 outbreak. I will turn it over to michelle cantu. My first live please. Good afternoon and thank you to trust for Americas Health for inviting me today. Thank you to our previous speaker, dr. Frederick and dr. Marita for providing feedback in your words on the timely and crucial topic related to covid19 Vaccine Access and utilization. Inober 19 has exposed cracks the infrastructure, our department is working in their Diverse Community to share policies associated with this work. The work begins by providing a little more information about the National Association of county and city Health Officials. Next slide please. Nonprofit. We are a leader partner for nearly 3000 local Health Departments and we engage in activities and conduct Research Evaluation on local Health Departments for the National Profile study by advocating for local Health Departments. We aim for optimal Health Equity and security for all people in all communities. Next slide. Naccho has a history of working hard to focus on Health Equity and social justice. Inequity is associated with racism, discrimination and social class. All have implications for our work in Public Health. From developing the roots of the course and advancing public narrative and Health Equity and social justice, naccho is exploiting solutions. Some examples of a worker on this slide. Another important concept in creating a shared understanding of Health Equity as social determinants of health. We work closely with health and Human Services to support the adoption of Healthy People 2030 metrics, including the Healthy People 2030 social determinants Health Framework that identifies five key determinants. Our work and all of our programs at naccho park read it and Health Equity and social justice. Next slide please. Local health apartments on the front lines and we know nearly 90 of local healt departments provide services to youth and children. They play a role in other immunization activities such as conducting valence, providing education, and developing Communication Campaigns to bolster immunization rates in the unity. Local Public Health professionals remain committed and dedicated to addressing coverage, Health Equity, and preparing for the covid19 vaccine. Next slide please. For the National Profile we are able to see how local health , orrtments are governed state, or shared, or mixed. Implementationr and from a federal policy perspective. Policies for the federal level comfy different contacts to get to the local Public Health level and impact that work locally. Next slide please. Local Health Departments service there to Community Health strategist. In this light the Public Health agency sits at the core. They are uniquely positioned to convene and coordinate a multidisciplinary Network Within their community and any Public Health issue. This network of local Health Departments and the Community Partners is critical for reaching and supporting people of color and other parity populations. This is particularly important when we talk about eminis asians at the local level. Local health apartments are working with their Community Partners to disseminate credible respond. On and they are experts on the region and understand the unique needs of their community. Next slide. 2017o has conducted a assessment of local Health Department amortization programs to identify and explore the many facets of the efforts to address eminis asian immunizations. The 2017 assessment highlighted barriers as hesitancy and lack of confidence. It is a significant concern to local Health Departments Immunization Programs. To mobilizeive local Health Departments to combat Vaccine Hesitancy. Next slide please. Hesitancy has drawn the attention of a look Health Providers at all levels. The centers for Disease Control and prevention has designated opportunities for funding to address this Public Health threat so we can vaccinate with confidence. This is afforded naccho to work with demonstration sites, identify pockets of low vaccination within the community, and support local Health Departments in the Communication Campaign to work with their community to improve Vaccine Confidence. It is also to this investment could build local help of our capacity to address helpne confidence and under vaccinated populations by equipping local health apartments to address vaccine hesitant project and continue to identify exemplary practices at the inclusion of communities of color through Community Partnerships and communication. Next slide please. Time naccho explored the impact of covid19 on local eminis asian grams local Immunization Programs. Local Department Program staff were reassigned to respond to covid19 response efforts in the local Health Department. Nearly 90 indicated essential Immunization Program services were impacted. A noticeable decline in Vaccine Coverage rates. They adopted new and Innovative Strategies to provide services for their communities and essential services were provided through extending hours, through telemedicine, providing home visits, and through traffic clinics. Next slide. Drivethru clinics. Local health apartments have worked in the community to Bring Community members to the table their stakeholder meetings and critical events in the community. We have seen local Health Department to engage with influential messengers, community navigators, and Community Health workers to develop appropriate messages, lead community conversations, and conduct training and participate in and recruit for vaccine assistance. The covid19 vaccination distributional plan reviewed by the cdc this past friday. Those that were made publicly available, it is clear they are still in the interim phase given the complexities and unknowns that still exist regarding the upcoming covid19 vaccination. Many of those plans incorporated Community Partners and offices of Health Equity. Thene example here, partnership or health has been working for the past few months to develop guidelines for expanding immunization delivery. They put together recommendations to help implement vaccine delivery efforts and lay the foundation for equitable approach to disseminating a covid19 vaccine when it becomes available. It is based on the colorado offsite clinic operation paper that can be adopted to different circumstances to increase vaccination rates. It addresses populations and partnerships and expanding vaccination services, including comedic asian tips and guidance on specific delivery scenarios. Next slide please. Seen ao covid19 we had decline in workforce and budgets that had not rebounded since the recession. State and local officials reported job losses, resignations, and threats on the public as they recommend a locale to mitigate the threat of covid19 in their community. Regardless, Public Health permits committed and dedicated to addressing Vaccine Coverage, prioritizing Health Equity, providing confidence, and premiering for the upcoming vaccination rollout. During this unprecedented time, in preparation for the covid19 vaccine, we need to ensure all policies have a component that intersects with people in their community. These policy recommendations and continue to work to support the community. Increased workforce and investment is not only there to support vaccine delivery, but to ensure local Health Departments are working closely with their Community Partners. Investment in Infrastructure Systems to ensure sustainability. Ensuring people with lived experience limited experience arms part of the process every step of the way. And authority of Public Health is preserved. Next slide please. To highlight a few congressional bills that incorporate he can honest to access safety, communications, education, and i implement to implications for community appellate. The vaccines act was a bill that required the cdc to take a series of actions related to vaccine rates at awareness, identify pockets of under legalization and low confidence and refusal. Its an opportunity to conduct a National Campaign to increase awareness and identify and prioritize engagement with communities with high rates of unvaccinated individuals. It also looks at the National Vaccine Advisory Committee under the office of Infectious Disease and hivaids policy to address National Confidence in vaccines in a 2015 report. Protecting seniors to the imitation act of 2019 focuses on providing Key Information that seniors regarding vaccines through the medicare and you handbook an increase coverage of vaccines under Medicare Part b pipefitting costsharing. By including costsharing. This bill was introduced into the house and referred to House Committee of energy and commerce. It emphasized the need to increase the rate of recommended immunizations during a Public Health emergency. Health Department Grant funds can be used to develop and distribute culturally, it was link was deeply appropriate messages linguistically appropriate messages. Next slide please. Dedicated dollars were put into vaccine deployment in these bills. One area to highlight is that the cares act passed in march categorizes covid19 vaccine as a Preventable Health service, which means health plans must cover the entire cost. By the political care act and traditional medicare and Medicare Advantage plans. There remains some gaps for shortterm health plans. Next slide. Following has not been passed. The health and economic recovery hasbus Emergency Solutions language to cover those three groups that were left out within the previous bill i mentioned. In september, some of the language was adapted to have a heroes 2. 0 bill that looks at title vii, Vaccine Development, distribution, administration and awareness. It is within the awareness we will literally look at combining this information about vaccine and disseminating scientific evidencebased information. It looks at reducing barriers to accessing vaccines and partnering with organizations to develop and deliver evidencebased intervention. In addition, i highlighted the heroes act introduced by andte republicans in july the Small Businesses act introduced in august. These bills highlight some funding going to enhance seasonal influenza vaccination efforts. Next slide please. Upcoming requests. We have specifically asked for 8. 4 billion for covid19 vaccine distribution, plus 500 million for seasonal influenza. I wanted to highlight the dollars going to outreach the priority population. Communication and educational efforts in combating misinformation. Please. Asking for broader needs related to local Health Departments workforce, including the Public Health Loan Repayment Program and dollars going to poor Public Health infrastructure. Ext slide please i provided a list of resources for things i talked about today and i would be happy to share slides from tatian. Please. Next slide the Economic Impacts of the pandemic or felt nationwide. We have clearly seen evidence of the disproportionate impact of a 19 has had on different racial groups along with different communities. Covid19 vaccination distribution is the largest operational undertaking of anything we have done under covid19 to date. We need coordination and partnership at every level to support those heavily impacted by the pandemic. Any investment put into the effort must consider Public Health and infrastructure in the longterm to get us to the pandemic and look for Better Outcomes for the next Public Health crisis. Thank you. Thank you michelle for helping provide the indepth overview of the function of local Public Health and infrastructure. The funding, which we are hearing is a recurring message with regards to the impacts of the product chronic underfunding of the Health Department at all levels, and the resources you provided to help give us a great legislative and policy overview for this conversation. We willse presentations go to the panel discussion. For audience members, please share your thoughts. There are many questions in the queue already. I will repeat the instructions. We will respond to as many questions as possible during this session. Just open the q a panel by clicking the circle with the three dots at the bottom of your screen. Select all panelists to get your questions sent to the right place. We will go through as many questions as possible. I will start with the audience given the interest and never questions that are being asked to share with our panelists. Colleagues by my cecelia thomas. We will moderate together with regards to questions. If you have a question you can ask our panelists . I want to make sure everyone can hear me. We can hear you. Please go ahead. To all the panelists here is a question. Forou have any resources local Health Departments on developing strong relationships with trusted messengers outside of the Health Department that can reach other communities . This includes young people, people undocumented, and other populations. I will be happy to start. We haved. C. , participated with several community leaders. Especially in the faithbased community. This out of the black coalition against that has proven to be a very vital resource. Engaged theon has community, engaged young people ads on metro buses to talk about social distancing, etc. As we think about vaccination, they have produced psas. We anticipate there will also play significant roles. Help. An example of local the coalition has helped to push the vaccination. They have had federal and local to officials bring people and talk about the vaccine and the process. I guess i would reiterate in terms of thinking broadly and reaching in chicago, we partnered with entities to broaden our reach. We had community and Faith Partners we worked with to extend the reach to others. We partnered with the department of aging, department of Human Services, transportation, housing to identify different organizations to help expand the reach. Communities who have figured to the ground and can understand what their concerns are. It was actually very helpful. Finally just to add on a knew if and Health Departments worked in collaboration with eminis asia immunization action coalitions. They have a list of different coalitions. There have been multiple examples of ways in which local Health Department had engaged the community and Community Partners. I think about Harris County that has extended partnerships well beyond just the traditional historical partners. Whether that is health care. We are looking at influencers in the community. There is also an opportunity to think about ways in which we can also look at linkages to support services. That is something you highlighted a little bit in your comments. The ways in which local Health Departments have engaged with other groups within the Health Department and Community Groups beyond immunization. Time. Ularly during this lets take another question from the audience. This is for each of the panelists. Are there any evidencebased approaches to developing of messages for communities of color . Especially in the area vaccination . The second part is, do the panelists have suggestions for the optimal approaches . The key thing to keep in mind as we have years and years of andrience in Building Confidence forne our childhood Vaccine Program. Over the course of decades there have been challenges to the safety and efficacy of vaccines. The cdc has a wealth of information about how to talk to parents about vaccine. How to talk about vaccine in general. Those are messages that may work with a lot of people. Whether or not they connect with communities of color is not clear. Wes where this concept are identifying Community Groups to work within engage with them in bidirectional communication. The typeconcerns are, of information they need to be reassured about the efficacy, and who are the messengers to convey the information. Andink we have to innovate really work and engage with the partners we have identified in the past and hear from them and understand from the concerns, the answers, and the solutions we can make it build together make and build together. To build on that response, one thing we did not go into great detail about was the spectrum the vaccine and the way we approach Vaccine Hesitancy for each individual person. I think what covid19 does is changes what that looks like related to the Vaccine Hesitancy. This is a new emerging Infectious Disease. A new vaccine. Having those oneonone conversations at the Community Level to really understand what people are thinking, what people are really doing towards the vaccine is needed. So many different groups have doing great surveys. We also know there is the need for the information in order to be able to inform how we talk specifically about covid19 vaccinations. When i think about other Communication Campaigns, there has been some Great Success in other areas of Public Health. Whether that is through the hiv bible hepatitis are, for the Maternal Child Health arm, or even smoking cessation. Delivery methods and how they did that would be incredibly crucial as we are running against the clock. At the same time ensuring we have researched. This will be incredible Research Moving this will be incredible important moving forward. The coalition against covid in d. C. Also had a couple of competitions around the spoken voice and things like that. Things that are culturally appropriate and pull ticipants in and avoid being able to receive those messages. The adolescents are key. When you look at the impact of isolation from their normal socialization has been a challenge. Webinare also put up a i believe is now available on youtube. Kids talk about their challenges along with isolation and the things theyre doing to cope with it. Think the engagement as mentioned by the previous speakers, we have to create these things now and this contemporary circumstance we are in which is very unusual and has such a big impact and influence on social media. Anne ant to speak with little bit more. Isk we need to keep it important have clear, consistent and Transparent Communication from the top down. Starting at the federal level there should be consistent and Clear Communication and transparency about what is going on with the Vaccine Development and the process. What we can expect as the vaccine becomes available. How much vaccine would be available. Not everyone would get the vaccine. The need for prioritization. There are adverse events that might occur that were not previously detected. Millionsbe vaccinating. Clearly communicating the fact of what we know and dont know and setting us vacations. That has to happen across the board. They need to be customization of those messages to the community in a way that makes sense to them and addresses their concerns. The only way we will do that is to work with the community and earn their trust so they can actually engage in a way that allows the to participate in the project. Thank you. Dr. Marita, you touched on a few issues. Both you and dr. Frederick talked about the importance of transparency. Dr. Frederick, you talked about the pace and how the Scientific Community is seeing the Vaccine Development process. Many of us know in this webinar the National Academy has a committee on allocation of the vaccine. In particular emphasizing the importance of transparency. Can you offer some suggestions or recommendations . State, federal, local level . About how we can ensure the transparency is being communicated, especially for communities of color. Where some may fear and think the pace of this is fast and are the truly safety precautions for covid19 vaccines. Its an excellent question. Two things come to mind. The to be clear, when conversation comes up i think people feel the people who may not be interested in doing this may not be highly educated, etc. I live in a house with a 16yearold son and a 14yearold daughter and my wife. Im the only person right now it was willing to participate in a trial and take the vaccine if it becomes available tomorrow. The goes to show the challenge that does exist. There are a few things we must do. I think when we talk about the speed of it, and these are Lessons Learned. Calling it warp speed did not help. Some of what has been done has to be undone. Our Public Health officials have to come out and speak about the collaboration. When i speak publicly i try to andasize in my lifetime, being a Patient First and foremost with sickle cell and type 1 diabetes, and a practicing surgical oncology i have never seen such collaboration. That is the reason for the speed. When we see speed, people here that is if we skip steps. We should speak about the unprecedented collaboration of the Scientific Community. That would help the conversation. The second thing we should do is once the fda has gone through the process there should really explain inffort to as much detail as possible the timeline the people so people can see no steps were omitted. What happened was unprecedented effort to make sure the steps were done as quickly as possible. You have to have people communicating who are trusted partners in the community. That is why i suggested we should mobilize our hbcus throughout the country to really participate in the communication effort to the community of color, as well as faithbased leaders. They are very much connected. I think if you mobilize those forces well, you will get at least a better platform in which to provide a communication. I think dr. Frederick said it right. I think its important to talk about the existing infrastructure for feminizations. For immunizations. Children are protected for more than 17 diseases in the routine vaccinations at childhood. That system has been in place for decades. There are processes in place of the fda level to advise fda. There are processes in place at the cdc level and Advisory Committee that is external, independent, experts in Public Health, pediatrics, adults, adult medicine, immunology, a regarding of advisors whether or not a vaccine should be licensed. In the case of fda or emergency authorization, the cdc makes recommendations about who should get the vaccine. One of the priorities what are the priorities, etc. Working out and actively working now to make sure the vaccines that come out are safe and effective. We need to talk and share that information and assure people all the vaccines the kids get on an annual basis are still being used and being tapped into. If those systems are followed we can be confident with the vaccine becomes available. The are important to share transparency of the process. Just to piggyback more on that. I think that what the previous speakers have really done is talk about the various groups across the federal government who are working in this area and the ability to coordinate at all has been in normas. Enormous. Are so many different facets of groups working on this particularly now. I feel like during your presentation, dr. Marita, you talked about Lessons Learned from h1n1. There are some components there also particular to this particular pandemic and covid19 rollout. Some of that was the ways in which there was more broad communication just ensuring that is the kind of consistent visible communication. Where you could have several groups of hhs experts providing weekly updates to the media on timeline, and emerging information about the dissemination of the vaccination and trying to facilitate that in a way that provides that transparent overby. Overseebeing done to safety and efficacy of the vaccines coming out. Thank you all for those really insightful recommendations and points. Cecelia, lets take another audience question. This is for michelle. Well Public Health departments receive all vaccines for their jurisdiction . Some vaccines go directly to Health Care Providers . Will these decisions be made at the federal, state, or local level . That is a great question. I think those are kind of the nuances we are still exploring. Vaccine that the does come out first. We know this will be a phased approach and they will be a vaccine that will come out in a limited amount in the first phase. That is still being determined at this point in time. What i mentioned a bit earlier in my presentation was that the state Health Department and may be four jurisdictions that are funded through cdc have submitted interim plans to cdc related to vaccination distribution. Plans really are focused on the distribution. Again, they are all very much in draft form in the scenarios that will take place. We are thinking about the first iteration of vaccine coming out. We are focused on the priority population that the National Academy had put out related to the equitable framework. We are thinking about that going directly to Health Care Providers and in some cases the vaccine may come directly to the states and then go to hospitals or Health Care Providers have closed point to distribution. When we look at the second phase or second part of the rollout when we are expanding that on to other priority populations, the vaccine just to be should plan can shift. Those vaccines can come down from the state down to the local level. I think there is a lot of variation. 64 jurisdictions committed plans. Severalterritories, and directly funded cities who we know are working closely with the states. Those plans may look a little different in the ways in which they are rolled out. It is still yet to be seen given the complexities of which vaccine will come out first. Lets take another audience question. This is for all the panelists. If the existing infrastructure that not increase vaccine acceptance, what is going to change on that model for Better Outcomes among black and latino populations . What changes need to happen for success in the Vaccination Campaign . I would say disproportionately the africanamerican population has to be vaccinated. They are two to three times more likely to contract the disease. Twice as likely to die. Its more likely to be a Frontline Worker where the transmission of disease will be high. When we think of distribution and success, remember to get to the type of immunity levels we depending on which study you look at, 60 to 90 of the population would have to have significant immunity. Outside of contracting the virus, which we are fully sure not fully sure everyone has developed immunity. We will really have to have a significant number of those most at risk be vaccinated. I cant give a specific number. What i would say is we have to disproportionately vaccinate the same people who are androportionately affected not be as proportionally given the vaccine as well. Disproportionately be given the vaccine as well. One thing mentioned early on is the baseline. We have disparities in adult Immunization Coverage level. Flu vaccine, shingles vaccine, hepatitis vaccine. Color, have a lower coverage level overall. That is inconsistent funding to support infrastructure over time. [indiscernible] there is a surge of funding and Public Health scrambles to use the funding that becomes available. But there are not sustained levels of support. We are not able to build the address theble to inequities in Vaccine Coverage levels that are baseline. When the next Health Emergency comes, we are not looking at the same problem. In terms of the longterm solution, this is another example of a Public Health emergency were sustained of cal funding over time would have allowed us to be part of prepared so we would not see this disproportionate impact. If we are able to address these inequities in Vaccine Coverage what we see at the baseline, we will not have these problems. We will be better able to respond to the next Public Health emergency. To me the solution is sustained high level funding. Great. I would add that as it relates to that infrastructure and the need for that infrastructure, again, there is still a lot of work that needs to be done. This comes back to echoing but we talked about in Community Engagement and the ways in which we have seen that work in any type of Communication Campaign or immunization campaign. The ways in which local Health Departments or even folks at the local level are just engaging the community to participate in being at the table. A lot of that takes funding and time. Just the kind of echo the continued need for the infrastructure to be built in order to ensure the sustainability of the effort. But knowing we have the opportunity to have people at the table in the communitys most impacted at the table, we are certainly going to be able to help and address some of the andes that folks are facing further understand the best ways to communicate some of these messages. Members youdience are hearing this message of the importance of funding and the chronic underfunding of the Public Health system and the pandemic has exposed that issue with regards to funding shortfalls for Public Health. Q a forput into the those of you looking for resources, whether it is data, specific policy recommendations, we have also produced an annual Public Health funding report that shows as a nation we are spending 3. 5 trillion annual, but less than 3 as that is for Public Health. Is important as we talk about addressing health disparities. Lets turn to another question from the audience. This is for the panel. Before a covid19 vaccine becomes available the flu season what areto be some of the most compelling messages that can be delivered to build trust and the flu vaccine . In the flu vaccine . The has definitely put out messages. I know that currently cdc is working with the racial ethnic approaches to Community Health and funded groups to look at flu vaccine messages specifically focused on adult influenza and those groups that were funded through that project. I think that when we look at those messages ensuring people at the local level can then further take what cdc has put out and look to see what messages resonate with their particular population. Whether that is the ability to have Formative Research or the ability of just knowing your community and your Community Population and the way in which the messages may resonate. People we areny particularly very nervous about this flu season, particularly about what could possibly be a emic. Deming twind flu hospitalizations and covid19 cases increasing and again experiencing pitalization is available and effective and folks should take their flu vaccine starting now and well into december and onward if possible. I agree with michelle. Clear and consistent messaging is important and focusing on the safety and efficacy of the flu vaccine is tickled. In chicago is critical. In chicago, it was an annual process of encouraging folks to get vaccinated. You are not only protecting yourself. You were protecting your loved ones. There are some folks even i choose to get vaccinated to protect themselves because they dont think they would get that sick. Sense of to the responsibility for the young babies at home or Senior Citizens in their lives, appealing to the aspect of the valley of the vaccine. The other thing is helping people understand having influenza it might be difficult to discern between covid and influenza. Healthcare services, you might need to Seek Healthcare Services to increase your chance of getting exposed to covid and flu. And even more burden on the Health Care System. Messages about the safety and efficacy and the benefit to , its beneficial to get the flu vaccine. I think what has been said is those of the primary answers to questions. My secondary answer is ive got my flu vaccine. I think one of the things we have to do as leaders is make sure we do those things and we make it clear. I wore my sticker that i got my flu vaccine on my mask for a couple of weeks until it eventually fell off. I think we have to lead in terms of demonstrating the behavior in the community we want to see as well. Excellent message, dr. Frederick. We should practice what we are preaching, indeed. Another question from the audience . This is also a panels question. Panelists question. How can we be sure the safest vaccine is the most expensive . How can the full Health Departments push that on the communities of color . I will ask for one panelist to answer that question and volunteer for the question. I will try. The u. S. Government has paid for the vaccine so the cost should not bear the burden of any cost for the vaccine itself. What is being negotiated is whether or not there is a cost for the administration of the vaccine. There is usually a Fee Associated with the administration. In 2009, that was waived. Individuals were not charged for the administration. I hope those same kind of protections will be in place. We were able to provide a vaccine free of cost for anyone he wanted the vaccine. We had an expectation they were not charging their patients for the cost of the vaccine. I will have one final question before we get to our closing. All of you has spoken to the importance of partnerships. Authentic partnerships especially in the community. Dr. Frederick, if i can pose this question to you, he spoke on partnerships with historically black colleges and universities. Certainly given there is such growing National Attention to the importance of the historically black colleges and universities broadly, can you talk about the meaningful connection and partnership of the perspective of being a historical black Medical College and university . I think is a very good question. Do and showws us to black physicians and black patients develop a different type of relationship. We dont have black doctors for every black american to have a black physician. Not every single student at our colleges is black. But they do get a significant amount of cultural competency when they come to us regardless of their background. , and we havehere used the word trust several times, but the trust is about building authentic relationship over a long history. While some of our institutions may not be able to do that overnight, one of the things it has done this for all of us to recognize we should be developing those relationships and making that effort now. How graduates are more likely to go back into those communities as well. That is the other thing that raises the trust, when people come back home. The community tends to be very know and trusting and you that persons mom and aunt and grandmother. It is a different dynamic that is set up. We talk a lot about physicians but the reality is the nucleus of our Health Care System is the patient. We should be obsessed about the patient. Physicians, dentists, even with vaccinations. Think about how much time you spent in a dentist chair. If all of us are getting a checkup every year from our dentist, thats another opportunity for us to have a Health Care Professional with a captive audience when you were sitting in that chair to talk to you about vaccinations and about the prevention we should be employing as well. Excellent. Marita, you talked about building those relationships. And michelle, ensuring infrastructure is in place to be able to respond to the growing number of Public Health emergencies. We can certainly continue this conversation for hours but we are at the conclusion of our webinar today. I want to thank again are excellent panelists. Dr. Frederick, dr. Marita, the audienceu, and for engaging in this important conversation and to recognize the work is just beginning. Plus all of us working together we can truly strive to achieve new goals of building Vaccine Confidence had access to a safe covid19 vaccine for communities of color. Building trust in a way in which we can ensure the safety, health, and wellbeing of our entities. If you can go to the next slide, we hope you will join us again next month on november 19. We will be hosting a congressional briefing on the state of the city and better policies for a healthier america. That will take place at 12 30 p. M. Eastern. Ourou are not tapped into weekly or biweekly newsletter, visit our website. You can sign it for our newsletter and get information such as when this briefing announcement comes out, and register for the webinar. Tim hughes will be following up with Additional Information for those of you who have to didnt and registered. Paneliststhank our for an informative discussion. I turn it back to our colleague to close out. Thank you doctor. [indiscernible] a special thank you to our esteemed speakers, dr. Wayne frederick, julie marita and michelle many thanks to our partners who helped organize this webinar. Take you to our audience for joining us today. A recording of todays session along with slides that will be made available next week. As you exit, you will find a brief survey to complete. We will gladly appreciate you all to take a few minutes to fill it out. Thank you again for joining us today. This concludes our webinar. Announcer tonight, cspan will have live coverage of two campaign events. Barack obama campaigning in philadelphia on behalf of joe biden. Watch live at 5 45 p. M. Eastern on cspan. 7 00 p. M. , cspan is live in North Carolina where President Trump is hosting a campaign rally. 2020 Live Campaign coverage on cspan online at cspan. Org, or listen with the free cspan radio app. Senator Kamala Harris visited voters in nashville, North Carolina encouraging them to vote early. Early voting is underway in North Carolina. [applause]
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