Navigators: The Workforce that Can Support Vaccine Education
December 17, 2020 | By Heather Bates and Sara Gleysteen
The vaccines are out. There is now hope on the horizon for what may be the end of this global pandemic. Logistics, trust, time, and education are what remain between vaccines and the public. We know from multiple outreach and enrollment efforts in recent past that trusted messengers are a key part of ensuring sustained community participation. While vaccine-related decision-making is complex– over 27% of adults say they will likely not get the vaccine– it does not require a complex solution. It is proven that education can help overcome vaccine hesitancy which will be crucial to achieve herd immunity and restore our country to a normal operating status..
For the first time nationwide, we are seeing and hearing about how health care workers are getting vaccinated. While we are some months away from the general public having access to the COVID-19 vaccines, when the time comes for everyday citizens to be able to access the vaccine it will likely be close to open enrollment for health coverage made possible by the Affordable Care Act next year. For this reason, it makes sense to leverage enrollment assisters, Navigators, Certified Application Counselors (CACs), Promotores, along with Community Health Workers (CHWs) to educate the general public about the COVID-19 vaccine.
Navigators and CACs know firsthand how important it is that their communities can rely on trusted messengers who are knowledgeable and responsive to consumers’ individual circumstances and how to provide the best possible options to them. Given this critical role that this workforce plays, they are uniquely positioned to become trained and resourced to educate their communities about the COVID-19 vaccine.
Enrollment assisters have strong community ties from years of doing outreach and in-reach to faith-based and school-based partners, as well as food distribution sites and in some cases their local elected officials. They are an incredibly important, and often overlooked, part of the health care delivery system because if people are not enrolled in coverage, they are sicker when they finally do seek use of highly expensive emergency room care. Coupling enrollment expertise with public health is not new but it is under resourced. Historically, through Federally Qualified Health Centers (FQHCs), hospitals, and other provider systems enrollment is included in these settings but to really advance vaccination efforts, we will need an all-hands on deck approach to reaching black, brown, and indigenous communities and this must include support for Navigators and CACs to advance our goals for herd immunity against COVID-19.
During the COVID-19 pandemic, many Navigators and CACs all over the country instituted virtual enrollment workflows in order to maintain relationships with community partners and their clients. This was a lifeline for people who needed to enroll in coverage due to losing their job, needing Medicaid, or a Special Enrollment Period (SEP). In addition to enrollment, Navigators and CACs are very often the frontline for other benefits such as food, income supports, tax credits, and more.
The Department of Health and Human Services has developed a multimillion-dollar national COVID-19 vaccine education that is intended to overcome hesitancy. What is the key point missing from this plan where this workforce can fill in? Trusted messengers in their own communities need to drive this home. We strongly recommend that Navigators and CACs are brought into the public awareness and educational efforts to inform the community about vaccination education and leverage the lead up to open enrollment next year.
To learn more about the year-round critical importance of funding community-based navigation efforts please see our white paper written jointly with Whitman Walker Health in Washington, DC, which highlights the need for this ongoing work.
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 National Association of Community Health Centers, Virtual Outreach and Enrollment Workflow, 2020
 Department of Health and Human Services, “HHS COVID-19 Vaccine Public Education Campaign”, 2020.
 Committee on Public Health Strategies to Improve Health; Institute of Medicine. For the Public’s Health: Investing in a Healthier Future. Washington (DC): National Academies Press (US); 2012 Apr 10. 4, Funding Sources and Structures to Build Public Health.
 World Health Organization, “Behavioral Considerations for Acceptance and Uptake of COVID-19 Vaccines”, October 2020
 Kaiser Family Foundation, “KFF COVID-19 Vaccine Monitor: December 2020”, December 2020.
 Navin MC, Wasserman JA, Ahmad M, Bies S. Vaccine Education, Reasons for Refusal, and Vaccination Behavior. Am J Prev Med. 2019 Mar;56(3):359-367. doi: 10.1016/j.amepre.2018.10.024. PMID: 30777155.