Many refugee, immigrant, and migrant (RIM) community members experience significant cultural, linguistic, and logistical barriers to COVID-19 vaccination. Accessing the COVID-19 vaccine presents several challenges, including digital literacy, transportation, and navigating unfamiliar vaccination sites. When eligible children and their adult relatives have opportunities to get vaccinated at pediatric clinics and children’s hospitals, some of the barriers to vaccinating the whole family are reduced.
Young children see their pediatricians relatively frequently for wellness visits, or regular check-ups. Although children under 5 are not currently eligible for the COVID-19 vaccine, these visits are an opportunity for pediatricians to talk to the parents about getting vaccinated. Visits for adolescents and children aged 5 or older are an opportunity to talk to the whole family about getting the COVID-19 vaccine.
Pediatricians and other healthcare workers might consider implementing the following strategies:
- Make time in clinic schedules for vaccine conversations.
- At the time of scheduling, let families know they will have an opportunity to talk about the vaccine and get vaccinated, so they have time to think about it before the visit.
- Engage in conversations about vaccination as part of a continuing conversation. This strategy lowers the stakes for individual conversations and lets families know that the quality of their relationship with a pediatrician or with the health care system will not depend on their decision to vaccinate or not vaccinate. Some families are deciding to get vaccinated after the third or fourth conversation.
- Approach conversations with an attitude of respectful listening. It’s a good practice to begin conversations by asking or inviting young people and families to talk and ask questions. Families may find the idea of listening to a prepared list of talking points off-putting, but if the interaction is framed as sharing information, with back-and-forth communication, then families are more likely to voice their real concerns and questions.
- Offer and administer vaccines on site, if possible. This strategy eliminates any barriers that might arise between the family’s decision to get vaccinated and the administration of the vaccine.
- Be prepared to vaccinate children for COVID-19 regardless of the reason for their visit.
- Be prepared to vaccinate other family members who need the COVID-19 vaccine, even if they are not pediatric patients.
- Allow some flexibility in where the second dose is administered. For example, if a patient is more likely to follow through with a second dose at a pharmacy near their home, then consider using that accessible location.
Engaging with Families in Louisiana
The New Orleans Children’s Health Project, a group comprised of a pediatrician, case manager, behavioral health specialist and immigration attorney at Tulane University, provides a specialized clinic for immigrant and refugee children in collaboration with a local FQHC, Children’s Hospital New Orleans and the Children’s Health Fund. In this setting, families are regularly invited to have conversations about getting the COVID-19 vaccine. Dr. Kim Mukerjee, the group’s Medical Director, says, “There’s nothing that beats the face-to-face conversation you can have with every single family, and so I’ve been doing that just on a personal, clinical level with every single family I see for a few months now. Even if I’m seeing a younger child, I still have the conversation with the parent to see if they’ve been vaccinated, and then of course, when I have older children, it’s with the child and the parent to see if we can get everyone vaccinated.”
