By: Vineet Singal, CEO & Co-Founder of CareMessage

“Vaccines don’t save lives. Vaccinations save lives.” — Dr. Daniel Salmon, Director of the Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health

In the final months of 2020, we take a moment to reflect on the work achieved by our safety net partners to effectively engage with their patients, while looking ahead to challenges safety net providers will face in delivering COVID-19 vaccine education to patients. We are proud to share our vision for the role CareMessage will play in COVID-19 vaccination education, health center operation logistics for administering the vaccine, vaccine regimen adherence and other critical public health information.

The Past Eight Months:

Since mid-March, our team at CareMessage has facilitated more than 25M messages between our safety-net providers and their patients in 38 states nationally. This has involved supporting our existing, pre-COVID customer base through lifting messaging caps as well as providing tailored COVID-19 related messaging interventions, as well as launching CMLight, our philanthropically-subsidized COVID-19 messaging platform that has now been adopted by nearly 200 safety-net providers nationally.

The biggest areas of utilization that we’ve seen from our full platform and CMLight customers have included: COVID-19 prevention, including symptoms, social distancing, and masks; COVID-19 testing, including informing patients of testing resources, collecting data prior to a test, and communicating test results; Telehealth, including telehealth coordination and patient education for telehealth tools; Clinical Quality, including ensuring that patients come in for important procedures, such as cancer screenings; and supporting Essential Needs, including communicating critical information about food availability, financial assistance programs etc. to underserved patients.

“Without CareMessage, the COVID-19 pandemic would have been even more overwhelming for our staff. Our high-risk patients were able to feel connected with us, and we were able to cut down our workload by notifying negative COVID-19 patients via text message, as well as completing weekly outreach campaigns for preventive care. We could not have worked through the last few months as successfully as we have if we didn’t have CareMessage.”

- A health center in the Midwest

As a consequence of this unprecedented growth, we have more than doubled our active patient users nationally to more than 7M patient users (and growing), solidifying our status as the largest patient engagement platform for underserved populations nationally.

What’s Next:

As the United States enters the third wave of COVID-19 in a period that’s also compounded by rising rates of influenza, we are focusing on driving the adoption of the influenza vaccine, an area where we have historically seen strong results. In addition, the growing amount of misinformation on social media and other sources about COVID-19 has been a troubling development over the past few months. We are redoubling our efforts to curb COVID-19 misinformation regarding mask-wearing, social distancing, testing etc. in order to ensure that low-income patients have a trusted source of COVID-related information i.e. their healthcare provider. And finally, we are launching a major effort focused on driving the adoption of the COVID-19 vaccine, once a safe and effective vaccine is available.

The Challenges with a COVID-19 Vaccine:

A number of barriers will potentially deter or prevent underserved patients from getting vaccinated for COVID-19. Americans in general are increasingly reluctant to receive a vaccine, with about half of US adults saying they definitely or probably would not get vaccinated if one were available today. Common concerns include the safety and effectiveness of a possible vaccine as well as the pace of the approval process. In addition, there are issues tied to systemic racism in healthcare that are driving vaccine aversion within Black patient populations and other communities of color.

Although the recent news about the Pfizer and Moderna vaccine candidates is positive, questions remain regarding the distribution of the vaccine, including but not limited to, (A) the temperature at which the vaccine must be stored and how healthcare providers will be equipped to handle storage requirements, (B) the prioritization of specific patient populations, especially low-income populations, elderly populations and those with severe chronic illnesses, C) the need for multiple doses (vs. a single dose) and D) the timing of vaccine availability for large-scale, widespread adoption.

Regardless of how the above questions get answered, we believe that safety-net providers will play a critical role — engaging and educating underserved patients about the vaccine and driving vaccinations. In particular, given their strong, longstanding ties to local communities, community health centers and free clinics (CareMessage’s core focus) and their providers are in a trusted position to help provide accurate information about the COVID-19 vaccine and help drive adoption, especially when other institutions may struggle to do so.

CareMessage’s Role in Supporting COVID-19 Vaccinations:

When it comes to driving vaccinations generally, previous CareMessage interventions have already proven effective at driving flu vaccinations, pneumonia vaccinations (for seniors) and childhood immunizations. As one example, a safety-net provider in the Midwest used CareMessage to reach 1,900 patients regarding their flu shot clinics, and administered 350 flu shots in just one month versus 200 in a four-month period the year prior, before using CareMessage:

Once a safe and effective vaccine is available, we envision SMS-based interventions delivered via CareMessage falling under three major categories:

• Directing people to COVID-19 vaccine sources: Action-oriented vaccine messaging providing vaccine availability, clinic locations etc., which could be combined with other health outreaches.
• Dispelling myths surrounding the COVID-19 vaccine: Educational messaging to directly and respectfully address myths and misunderstandings, such as facts about the COVID-19 vaccine and its efficacy and reinforcing the importance of getting vaccinated.
• Ensuring adherence with vaccine regimens: Targeted interventions focused on ensuring that patients return for a second vaccine dose and/or subsequent boosters (as needed).

To support the development of the above interventions, we will also be establishing an Advisory Board composed of experts in vaccine aversion within underserved populations, especially low-income communities of color.

Looking Ahead:

CareMessage has the opportunity and responsibility to play a critical role in reaching and protecting at-risk communities, empowering healthcare professionals to have trusted and effective vaccine conversations with patients and families, and battling misinformation and ignorance in order to foster a culture of immunization. We look forward to partnering with our existing customers as well as new organizations, both direct providers in the safety-net as well as payers, government agencies, foundations and other organizations that serve closely with safety-net providers nationally. If you’d like to learn more about working with us, please contact us at covid@caremessage.org.