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“We’re afraid of losing our jobs if we try to make a difference and we’re exhausted!!”

I had the honor to speak at the two AIM (Association of Immunization Managers)  regional conferences last week. The Western Regional Conference was in Denver on April 18 with health leaders from 10 states, Arizona to Texas. The Heartland Regional Conference was in Tulsa on April 21 with health leaders from 5 states,  Missouri to Arkansas. My theme at both conferences was how can we improve COVID-19 Vaccination Rates Among Hispanic/Latino Children? If we continue to see our state vaccination rates drop putting more children at risk of serious illness , even death, why isn’t that prompting us to crisis action? 

Actually we have the strategies to address the health equity crisis now post-Pandemic, of which vaccination is one of the most critical components. But those written strategies are useless sitting on a shelf while we’re not working together without the will and the passion to acquire the needed resources to put the strategies into action. How are we going to move the needle if state and county health organizations aren’t actively talking to each other, focusing on the strategies, ironing out our differences, finding ways to utilize our resources effectively, and taking the risks to do things in a better way than what we did in 2019? Acknowledging that while we work in different environments we still have the same mission with the same goals in addressing this crisis? Protecting all people’s health and lives whether white or BIPOC.

One of the key parts of those strategies, as I have emphasized, is actually getting into the vulnerable communities by finding the resources, reevaluating old protocols/behaviors, cutting red tape and bureaucracy so that our post-Pandemic clinics become more available and are friendly, warm and less confusing/intimidating for people, who we treat as customers now not just patients. 

With that, Public Health should actively partner with cultural brokers and promotoras as well as clinics and other health entities, even pharmacists and health care student programs, to bring the new perspectives and the new resources that we badly need to make a difference. 

That’s the strategy we’ve been testing at school clinics in Aurora and Denver recently.

When I finished this message at the Tulsa conference it was greeted with standing applause from the health leaders there. Several came up afterwards to thank me for pulling back the curtain on one of the most troubling barriers of change-making in their states. “We know change like you describe is needed”, they said, “but we don’t work well together as health communities and we’re afraid of losing our jobs if we try to make a difference and we’re exhausted!! How do you do it??”

My response with a smile, “I’m independent working with the state and our regional health entities. I believe in what I’m doing, and, guided by my faith, I can challenge our health communities with action not only talk. Like you, I’m  exhausted too but my faith keeps me from being overwhelmed.”

One of the participants in Tulsa quietly asked me in confidence, “…can you please come to my state and talk with us about this problem?” Yep, I’ll be at the Kansas Immunization Conference in June and your state will be there. I can talk about the barriers we share. I’ll  bring what we’re learning and doing in Colorado and also learn what other states are attempting in addressing those frustrating barriers.

The next day, Dr. Michelle Fiscus, CMO of AIM, sent this message to AIM’s conference organizer and me:

“We were honored to have Julissa speak to attendees at two of our Vaccine Access Cooperative (VAC) regional meetings. Before an audience of physicians, pharmacists, Medicaid medical directors, immunization program managers, immunization coalitions, and other partners, she told her truth. She said things that made some people a little uncomfortable (which is a good thing!). She helped us understand how to best connect with the Hispanic/Latino community and where we mess up. Most of all, she taught us with passion and laughter! We won’t soon forget her stories and can’t wait to see her at our meeting in New Orleans in May!”

And with that I’m now invited to speak at the AIM Beaches Regional Conference in New Orleans in May. The conference that month will occur between two scheduled Aurora school vaccination clinics, but I have faith that I can be there!

The other highlight of last week was our combined Arapahoe County Public Health Department and CAHEP/Regis University vaccination clinic at Aurora’s East Middle School. As I told those at the AIM conferences, we’re testing in action the strategies that connect with community in a way that reduces complexity and confusion and help people feel valued and appreciated. Lowering the barriers of mistrust that consistently block the equity needle.

The clinic was scheduled to operate from 4PM to 8PM (actually went beyond with late vaccinations and then clean up). When our guest, Ms. Arlen Zamula, Director of the CDPHE Office of Health Equity, arrived at 630PM, the team was heavy into vaccination with lots of people there. She afterwards that evening sent this message to us:

“Over 120 vaccinations in three hours is what happens when clinicians work with the community. At East Middle School in Aurora, some of the most at risk and underserved families lined out the door to get vaccinated and access other health services. This success is due to champions like Julissa Soto of the Health Equity Commission coordinating with clinical partners like the Colorado Alliance for Health Equity and Practice (CAHEP) clinic, Regis University, Arapahoe County Public Health and school leadership. A heartfelt thank you also goes to Principal Brown and Family Liaison Ms. Melendez, who not only opened their school and helped work the clinic, but personally called, texted, and contacted many of the families. This collaboration with the community is a huge win for public health in Colorado.” 

Here’s how East Middle School staff felt about their clinic:

Ms. Linda Melendez, Family and Community Engagement Liaison:

“I’ve known Julissa for over 12 years, and by far this vaccine clinic has been the most meaningful event we have collaborated on so far. I want to thank CAHEP and Regis University for your willingness to come into our community and serve us with such grace and compassion. Families were able to get school and COVID vaccines, masks, COVID tests and get dental screenings. A colleague of mine always says, “our community deserves it, and we owe it to them!” 

Thank you for making health care accessible for our community, they deserve to have equitable access!”

Ms. Jessica Kinzeler, School Nurse:

“It was a pleasure working with Julissa and her team, they were very friendly and efficient throughout the whole process.”

Ms. Jacquelyn Brown, Principal:

“At East Middle School we believe in establishing relationships within the community that can positively impact the welfare and academic trajectory of our students.

Our partnership with Julissa Soto and other health professionals from Regis University and  Colorado Alliance for Health Equity and Practice (CAHEP) assisted our staff with supporting over 130 families during the recent vaccination clinic held on April 20th from 430-8 PM.

The turnout exceeded our expectations, the customer service was exemplary and the health needs of families were met. We look forward to establishing additional access opportunities for our families! Thank you, Ms. Soto for a job well done.”

Thanks to the Regis University team of student pharmacists and nurses supervised by Doctor of Nursing Practice and Associate Professor, Ms. Holly Vali. She brought her dedicated students to vaccinate the many people at East. We missed Regis University Associate Professor Ms. Stephanie James, who couldn’t be at the clinic due to Covid.

Thanks to the Arapahoe County Public Health Department and the Immunization Team who came to provide needed vaccination to the East Middle community. I’m really looking forward to debriefing with them on how things went, where there were glitches, what went well, and how we can continue to work well together addressing the school vaccination crisis. Tackling the challenge of moving that stubborn health equity needle together.

And special thanks to Mr. Alok Sarwal, CEO of CAHEP. He gets it. We in Colorado need to all work together to improve school and Covid vaccinations, especially in vulnerable communities. He’s doing his part with action, bringing a health team and extra vaccines that we would need at East (paid for out of his CAHEP budget). He’s applying for VFC support but still has a ways to go. Ms. Heather Roth, Immunization Branch Chief at CDPHE, thanked Mr. Sarwal for this support:

“I just wanted to reach out and say THANK YOU for assisting with the clinic that Julissa has organized at East Middle School for this Thursday. I understand that your clinic is really stepping in to save the day and ensure that no families are turned away from vaccines. You continue to be a valued partner for ensuring access to vaccines in Colorado. 

Please let us know if you run into any issues getting set up in the Vaccines for Children program. Our staff is here to help.”

So how did  it go at East? I’ll allow these pictures to show you.