“Are we there yet”? Fall 2023 Covid-19 Boosters Amidst Pandemic Apathy and Fatigue

As a nationwide initiative, NASW Connect to End COVID-19 was borne from the notion that social workers are uniquely poised to promote COVID-19 vaccine among those who are least likely to become vaccinated, yet most vulnerable to severe complications. In our prior articles and webinar, the API Social Work Councils (NASW-CA) have examined the social determinants of pandemic health outcomes for Asian and Pacific Islander(API) populations and how a “one size fits all” approach fails to address the disparities that exist within diverse populations that are not accurately reflected in aggregated data. Thus, the practice of cultural humility by social workers remains critical to vaccine outreach, confidence, access, and informed decision-making around the COVID-19 vaccine.

The COVID-19 Landscape and the Role of Social Workers

The timing of this article coincides with both new variants/surges of COVID-19 cases and hospitalizations, as well as another round of highly safe and effective boosters planned for release in mid-September with CDC recommendations that will also cover influenza and RSV. Prudence by social workers is warranted as vaccine availability lacks meaning in the absence of equitable access and informed decision-making by willing recipients to match. As scientists diligently monitor the changing makeup of the virus to adapt vaccines, it is equally important for social workers to continue monitoring and adapt our response to the social determinants of health that can evolve just as quickly. 

Unfortunately, for the most vulnerable API communities, the promotion of new COVID-19 boosters is contradicted by the undoing of health insurance access afforded through the largest healthcare coverage expansion since the Affordable Care Act. With many millions of Americans being cut from Medicaid at the worst possible time, social workers play a critical role in helping clients navigate a more complex web of vaccine access with prohibitive factors such as the uninsured being unable to access vaccines for free at retail pharmacies until mid-October. Such disparities are concerning for vulnerable API communities, especially when combined with pre-existing mistrust of Western medicine.

In fostering vaccine dialogues with vulnerable API communities, it is important to begin with our own self-awareness as providers through the practice of cultural humility, which the NIH defines as a “process of self-reflection and discovery in order to build honest and trustworthy relationships.” Prior to “meeting clients where they’re at,” social workers must examine our own thoughts, feelings, and attitudes toward COVID-19 that may negatively bias vaccine dialogues. Social workers may be subject to similar apathy and “pandemic fatigue” impacting many of the communities we serve. All-or-nothing narratives, such as the often politicized and ill-defined “end” of the pandemic, can lead many to dismiss the Fall 2023 boosters as irrelevant. While many positive milestones have been achieved, such attitudes not only risk disenfranchising populations at highest risk for COVID-19, but can shift vaccine uptake towards a pre-contemplative stage per the Stages of Change Model – especially when factoring existing drivers of vaccine hesitancy such as unofficial sources of information. 

Social Work Education and COVID-19

There is little room for complacency. COVID-19 is here to stay. Equipped with an understanding of healthcare as a social construct, social workers have the ability to focus on a more meaningful and nuanced awareness of what COVID-19 means to our most vulnerable clients who are marginalized, oppressed, and/or living in poverty. 

A number of trainings and resources from Connect to End COVID-19 remain available to social workers who wish to strengthen their vaccine outreach via knowledge, skills, and values intrinsic to our clinical practice. Furthermore, clinicians are welcome to attend our upcoming webinar that coincides with the release of fall boosters. 

A number of trainings and resources from Connect to End COVID-19 remain available to social workers who wish to strengthen their vaccine outreach via knowledge, skills, and values intrinsic to our clinical practice. Furthermore, clinicians are welcome to register here to attend your upcoming webinar on 9/27/23 from 7:00-8:30pm. This second installation of our two-part series is centered on the rollout of Fall 2023 COVID-19 boosters and will feature Dr. Brandon Yan, MD, MPH, a resident physician in the UCSF Department of Medicine, who has led some of the first work on COVID-19’s impact on Asian Americans that went on to impact public policy at local, state and national levels.

The Connect to End COVID-19 initiative is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $3.3 million with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.