Mitigation and Prevention
This multidisciplinary vaccine delivery strategy was implemented by the Puget Sound Veterans Affairs (VA) facility to mitigate inequities in COVID-19 vaccination among veterans. The practice, which followed the Equitable Vaccine Framework, was put in place in the VA Puget Sound Health Care System and entailed targeted outreach to individual patients based on a score consisting of the sum of risk factors for severe COVID-19 disease and high-risk race or ethnicity. The strategy included four main domains: allocation, outreach, delivery, and monitoring. The care system conducted sequential outreach using multiple communication modalities, worked with community partners to publicize and deploy mobile clinics to underserved areas, and monitored vaccination coverage rates by age, race, sex, and rural status at prespecified intervals and adjusted operations to ensure equity. During the vaccine drive, vaccination rates were higher among Black, multiracial, and Hispanic veterans, compared with white veterans.