‘Trusted messengers’ distill science, debunk myths about COVID-19 vaccine

VaxUpPhillyFamilies, led by Penn’s School of Nursing, engages Philadelphia parents and caregivers as vaccine ambassadors to identify concerns and provide support related to COVID-19 vaccines, increase vaccine uptake, and address social support needs.

A person, Helaine Heggs, standing outside in front of a tree.
Helaine Heggs is one of 24 ambassadors recruited by VaxUpPhillyFamilies, an initiative spearheaded by Penn’s School of Nursing, in collaboration with the Annenberg School for Communication, Perelman School of Medicine, Children’s Hospital of Philadelphia, Philly Counts, and Konquered Healthcare Solutions. (Image: Linda Jiang)

For Helaine Heggs, her role as a VaxUpPhillyFamilies ambassador coalesced around a rewarding moment with someone in her community. The woman didn’t want to vaccinate her child against COVID-19, convinced by the stories she’d heard that the vaccine was unsafe and unproven. 

“I told her, ‘That’s not real. We have people studying this,’” says Heggs, originally from Brazil but who has lived in Philadelphia for 16 years. “I told her, ‘We know the virus is real. The vaccine can help you.’” They then chatted a few minutes more before parting ways. 

Several weeks later, the woman found Heggs again, this time with two COVID vaccine cards in hand, one for herself, a second for her child. “I am proud of this job we’re doing to get everyone vaccinated,” Heggs says. “We’ve got to believe in science. I believe in science.” 

Heggs is one of 24 ambassadors recruited by VaxUpPhillyFamilies, an initiative spearheaded by Penn’s School of Nursing, in collaboration with the Annenberg School for Communication, the Perelman School of Medicine, the Children’s Hospital of Philadelphia, Philly Counts, and Konquered Healthcare Solutions

The goal is to train community members—parents or caregivers with already vaccinated young children of their own—to get the word out about the COVID-19 vaccine and more. During the first 10-week phase, which ended in mid-June, the ambassadors posted on social media, canvassed at community events, distributed flyers, shared 30-second videos they’d developed, had bi-weekly check-ins with program leaders, and more. Phase 2 is set to begin shortly. 

“There is a perception in the community, that COVID-19 programs are only focused on vaccination. The vaccine is certainly our major goal, but it’s not the only goal,” says Terri Lipman ofPenn Nursing. “We believe that our ambassadors are situated to connect around broader issues. This is an optimal opportunity to address social needs that the pandemic has greatly exacerbated.”

‘Changing the tide toward equity’

VaxUpPhillyFamilies came about as a component of the Community Engagement Alliance (CEAL) Against COVID-19 Disparities program established and funded by the National Institutes of Health in 2020. Philly CEAL started in May 2021, when Penn Nursing joined with the City of Philadelphia and multiple University and community partners to work on COVID-19 outreach.

“One of the aims of CEAL was to mount a coalition to mitigate COVID-19 disparities,” says Lipman. “When reviewing the COVID vaccination rates in Philadelphia of 5- to 11-year-olds at that time, only 22% of children from underrepresented minorities were vaccinated. We wanted to approach vaccine hesitancy differently to try to move the needle.” 

In the past, Philly Counts, a city government initiative created prior to the 2020 Census, had enlisted community members for this kind of role. “That’s always been a core part of our work, bringing in trusted messengers to talk with their neighbors,” says Gabriela Raczka, Philly Counts public affairs manager. “There’s a lot of misinformation and distrust, but, when you hear something from someone who looks and sounds like you, it resonates differently.” 

The team developed a project plan that focused on engaging parents and caregivers as ambassadors. It also enlisted Konquered Healthcare to train participants and lead focus groups that would allow the ambassadors to share the concerns they’d been hearing on the ground. 

“We were trying to create a trusted team of neighbors, mothers and fathers, friends, church members,” says Kevin Ahmaad Jenkins, Konquered CEO and a lecturer in the Department of Medical Ethics and Health Policy at Penn Medicine. “Sometimes changing the tide toward equity begins by deputizing the people who live next door.” 

Information dissemination 

On April 18, two dozen ambassadors officially began their work for VaxUpPhillyFamilies. They received a general COVID-19 training that dispelled myths about the vaccine, plus addressed common concerns and FAQs.

They also received input from the Konquered team on how to distill scientific information into easy-to-grasp tidbits. “We were trying to understand the pain points so we could reverse engineer the problem,” Jenkins says. “We wanted to help them understand what works and what doesn’t.”

Each week, ambassadors received a $50 stipend to complete at least two of five engagement opportunities, which included actions like posting on social media five times per week or having three separate conversations about getting children vaccinated. “We offered a variety of actions to make it really accessible,” Raczka says. 

A flyer called "COVID-19 Vaccines are Safe for Children and Teens." It continues, "Help protect your child, your family, and others," followed by two long boxes of text. One states, "Getting a COVID-19 vaccine can help protect children ages 5 years and older from getting COVID-19." The other states, "Preparing children and teens for vaccination." They both go on to give bulleted lists of information. At the bottom is a statement about the scientific work conducted before vaccine approval.
A flyer provided to VaxUpPhillyFamilies ambassadors that they could hand out to their community. (Image: Courtesy Philly Counts) 

Part of that entailed providing sample social media text, created by a team led by Annenberg Associate Professor of Communication Andy Tan. They drafted posts and messages, generated graphics, even gathered stories from the ambassadors that became part of the overall narrative, what Tan describes as a “bi-directional exchange of resources.” 

The idea was to make the process as welcoming and seamless as possible for folks at every technology and comfort level, Lipman says. “The families that we engaged were not necessarily convinced of the importance of having their children vaccinated from the outset. They had some hesitancy themselves. But, because they had had the experience of wrestling with the decision, they became messengers who could easily relate to the concerns of their neighbors.” Their 10-week commitment ended on June 13, and many are coming back for another round. 

Measuring success

Tracing vaccination numbers directly back to such a campaign is difficult—few places ask for or track why someone gets the COVID-19 vaccine—but Raczka says they have other ways to measure the success of VaxUpPhillyFamilies. For example, participants are extraordinarily connected to the program, with a 90% engagement rate, she says. “We did a mid-session and final evaluation, too, and they all expressed feelings of fulfillment and gratitude for participating.” 

For the second phase of VaxUpPhillyFamilies, the team plans to expand its training, updated with the latest science and public health guidance. Penn Medicine will lead a training about social determinants of health, and Tan, who runs Penn’s Health Communication & Equity Lab, will work with participants on social media dissemination skills. 

“This isn’t the first or last public health crisis,” Tan says. “Investing in this infrastructure of hyperlocal trusted messengers, who are also invested in improving the outcomes of their communities, will go a long way toward making sure we have a resilient infrastructure to face threats like this in the future.”  

Heggs wants to be part of that effort and she plans to continue as a VaxUpPhillyFamilies ambassador. Though she invariably won’t get through to everyone, she says it’s worth it for the moments when she does. 

Helaine Heggs is a parent ambassador in the VaxUpPhillyFamilies program.

Kevin Ahmaad Jenkins is CEO of Konquered Healthcare Solutions and a lecturer in the Department of Medical Ethics and Health Policy at the Perelman School of Medicine at Penn

Terri Lipman is professor emerita and former assistant dean for community engagement at the School of Nursing at the University of Pennsylvania.

Gabriela Raczka is the public affairs manager at Philly Counts, a program of the City of Philadelphia. 

Andy Tan is an associate professor of communication at the Annenberg School for Communication and director of the Health Communication & Equity Lab at Penn.

Other VaxUpPhillyFamilies leaders include Heather Klusaritz, associate director of the Center for Community & Population Health and adjunct assistant professor in the Department of Family Medicine & Community Health at the Perelman School of Medicine; Rachel Feuerstein-Simon, research manager at Penn’s Center for Public Health Initiatives; and Sophia Collins, clinical nurse project manager in the Children’s Hospital of Philadelphia Policy Lab.