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Keep it local: How America can meet its vaccine challenge


The COVID-19 pandemic, like many of the greatest challenges facing us today, is a global problem that requires both a coordinated worldwide response and collective and individual action. Vaccines are one of our best tools to fight the spread of disease, a tool developed through a worldwide scientific effort but only useful if delivered and administered to every individual. 

In America today, less than half of all people are fully vaccinated against COVID-19, not primarily because of lack of access, but rather due to hesitancy around side effects and the newness of the vaccine, along with a belief that, for healthy individuals at least, the vaccines are unnecessary. 

No outreach program or vaccine incentive will ever be large enough to overcome that central barrier without concrete data and information about the real dangers that exist to each of us. Broad data and advice, delivered by the latest young celebrity or the president or a government expert on late night TV, will do little to move the needle. But local information tailored to each of us in our own communities can and would.  

I first saw this dynamic at play when I was in my early 20s and I, along with others of my generation, were actively protesting the war in Vietnam. I grew up on a naval weapons base, so when I saw cluster bombs raining down on Vietnamese civilians and soldiers, I knew exactly what they did to a person’s flesh. The danger and suffering was real to me, and I was motivated to act. But for many others, the war was a distant drama, unconnected to their daily lives — until they learned it wasn’t. 

Many activists like myself spent much of our time traveling to communities where U.S. war efforts were taking place — not in the jungles of Khe Sanh or on the front lines, but in the classrooms, campuses and community buildings where bomb casings and ammunitions were being made and where young recruits were being educated in the torturous tactics of the war. It’s one thing to watch despair and destruction on the evening news; it’s another entirely to know your school or your community is directly contributing to it. More often than not, once people knew how close the danger was to their own lives and experience, their desire to act escalated exponentially. 

These same levers of change should be at play today to boost vaccination rates. The government has done a decent job in recent months of gathering data and delivering COVID-19 guidance at the national and state levels (though that has not been without its missteps). But now it’s time to move those messages down to the grassroots, where people live and work. 

First, we must collate local data more effectively, showing new infections, hospitalizations, deaths and vaccinations in every county, city and small town in America every single day. The CDC is theoretically already tracking this data, but even an expert would struggle to drill through the material to find the information and then to put it into context.  

Throughout this pandemic, in absence of clear data, local newspapers and media outlets have tried to deliver in the government’s stead. But while an outlet like the New York Times may have the resources to do it well, a small town or community often does not. Public health data from each state is notoriously inconsistent. In one state the total number of vaccines delivered may refer to the total number of doses ever administered; in another it refers to the number of people who’ve received doses. For cases as well, the numbers often differ between newly confirmed infections and the total number of both probable and confirmed cases.

More than a year and a half into the pandemic, it should not be so hard for people to understand how many people in their neighborhood have been exposed and infected, and may be putting them at risk. Beyond compiling the data, the onus is on the government to deliver that data through more effective means.

Already, the government brings together journalists, national leaders and public health experts to brief them on the latest developments in our national pandemic. They should now be filtering those same briefings down to the community level. Whom do you trust more knocking on your door — a nameless stranger with a pamphlet or your doctor or church leader or local community leader?

If the White House asked me what more we could do, my answer would be clear: Marshal the data at the most local level possible. Pinpoint the local leaders, be they store owners, fire chiefs, school leaders or mayors. Communicate the data. Convince them of the danger. Persuade them to act. If every doctor’s office, community center and even barbershop had access to daily data on local infections, the spread of disease and the risk to every community, I am convinced that more Americans would not stand helpless in the face of it.  

William A. Haseltine is president of ACCESS Health International. An infectious disease expert, Haseltine was formerly a Harvard Medical School professor and founder of the university’s cancer and HIV/AIDS research departments. His latest book is titled “Science As A Superpower: My Lifelong Fight Against Disease and the Heroes Who Made it Possible.”