Calling All Social Workers: Exploring the Intersections of API Vaccine Confidence and Professional Values

This final article by the API Social Work Councils (NASW-CA) for NASW Connect to End COVID-19 follows our 2nd webinar on Fall 2023 COVID-19 Boosters where we welcomed Dr. Brandon Yan, MD, MPH, whose groundbreaking research uncovered that Asian Americans in San Francisco and elsewhere suffered the highest Case Fatality Rate/CFR (# of Deaths / # of Cases) from COVID-19 out of any other race/ethnic group. In addition to affording timely insights for Fall 2023 COVID-19 Boosters, Dr. Yan’s presentation and our interview with him also shed light on social determinants/disparities underlying API vaccine confidence. 

Diagnosing Racism

In addition to having higher/highest risk of death from COVID-19 when infected, other key findings of Dr. Yan’s research included evidence of Asians Americans testing less often and later on compared to non-Hispanic whites as well as presenting to care later on/with greater severity of disease during hospitalization. Furthermore, there’s no evidence that higher CFR was attributable to race/ethnicity, especially with CFR rates in Asian countries being substantially lower. 

For many social workers attuned to the experience of Asian Americans, it is not difficult to infer how racism evident in other parts of API experiences contribute to a high CFR. Racist constructs such as the “Model Minority Myth” not only exclude Asian Americans from definitions of “underrepresented minorities” in education and research but also perpetuate cycles of oppression through the false narrative that they do not experience disparities and are unworthy of resources to begin with. 

Working Across Systems of Care

While COVID-19 vaccine confidence is often regarded as an issue isolated to medical spheres, the experiences of racism/traumas/traumatic growth that inform API vaccine confidence spans many ecological systems beyond the constructs of healthcare and the response to injustice needs to be proportional. Through the webinar interview, we discussed Dr. Yan’s own examples of advocacy across multiple systems( e.g. taking time to meet individually with patients, outreach via professional social media and local ethnic television, and writing letters to local legislators). Similarly, it is incumbent upon all social workers to consider how we might best utilize our knowledge, skills, and abilities (KSA’s) to advocate within our roles given our foundational awareness of Systems Theory and the professional reach to support around a confluence of complex factors. Trauma-informed vaccine dialogues can and should take place with social workers of all specializations so that vulnerable clients are not lost to care, whether that is within more immediate micro/mezzo systems(e.g. individuals, families, schools, etc.) and/or larger exo/macro systems (e.g. policy, social media, attitudes, ideologies) –  especially as many of us work within the ethnic enclaves that can serve as protective factors. 

Applying Core Social Work Values to Shape a Narrative of Resilience

Regardless of which system(s) and/or KSA’s social workers are specialized in, this final publication of our campaign encourages all social work professionals to contemplate familiar ethical values in relation to API vaccine dialogues. Our professional core values of service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence outlined in the NASW Code of Ethics serve as a common denominator for promoting vaccine confidence in any setting. 

To name just a few examples: 

• Our value for Service compels social workers to elevate the cause of vaccine dialogues above personal bias.
• Our value for social justice compels us to understand COVID-19 vaccine apathy as a symptom of oppression  toward the most vulnerable populations. 
• Our value for the Dignity and Worth of the Person compels us to form a rapport with our clients, in which they are the indisputable experts in their well-being. 
• Our value for the Importance of Human Relationships compels us to pursue rapport/therapeutic alliances critical to shared decision-making processes that ambivalent clients must go through. Many social workers already have the added advantage of being embedded in the ethnic enclaves that serve as protective factors for API clients.
• Our value for Integrity compels us to act with honesty and to share from reliable sources of information in supporting informed decision-making. 
• Our value for Competence compels us towards a researched-informed awareness of harms both measurable (e.g. CFR) and  immeasurable(depths of suffering). By continually cultivating the cultural humility needed to empathize more deeply with those who remain most vulnerable to COVID-19, we can enhance our professional awareness of why continued broad-based support is needed for our initiative. 

Three years into the pandemic, the question/focus is no longer about ending COVID-19 as a virus, but whether we will remain committed to promoting equity and build on the progress achieved through highly safe and effective vaccines. While not minimizing the very real tragedies of COVID-19 covered in our webinar, we hope that in supporting informed decision-making, social workers can help shape the relationship between API communities and COVID-19 so that narratives of resilience can co-exist. 

Continued Social Work Education and COVID-19

As social work consultants, we recognize that the fight against COVID-19 through vaccine confidence is one that must continue far beyond our time-limited campaign.To explore how you can continue fostering vaccine confidence, our free resources remain available to all. 

NASW National Resources

The national campaign website can be conveniently explored via the Campaign Overview Toolkit, which covers topics such as applying MI/SBIRT to vaccine dialogues,

NASW-CA Resources

In addition to the many resources available via NASW-CA’s campaign website, you can also visit NASW-CA’s Youtube page, where you’ll find both of the following webinars specific to API

• API SW Council Webinar 1: What Social Workers Can Learn From AANHPI Community Leaders 
• API SW Council Webinar Webinar 2: Fall 2023 Covid 19 Boosters Amidst Pandemic Apathy and Fatigue 

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.