Restaurant discounts and free karaoke songs at pop-up clinics, extended walk-in hours at pharmacies and door-to-door visits by community representatives armed with facts about the COVID-19 vaccine.

After five months of having patients line up in limited locations to get shots, public health workers and even local business owners are getting creative as they face a new challenge of waning interest in the vaccines and supply begins to outpace demand.

“There’s definitely a little bit of a slow down,” said Kerri Okamura, the director of pharmacy operations for KTA Super Stores on the Big Island. “The next step is to get into the community and make sure people understand that the vaccine is safe and effective and it’s what is going to let us gather and get back to normal.”

Zinfandel Josiah receives the Moderna COVID-19 vaccine from Registered Nurse Janet Sinclair at the Waimanalo Health Center.
Zinfandel Josiah receives the Moderna COVID-19 vaccine from registered nurse Janet Sinclair at the Waimanalo Health Center. Cory Lum/Civil Beat/2021

That’s why clinics and pharmacies like KTA’s have expanded their vaccine walk-in hours, Okamura said.

Okamura said being a local company, with pharmacies in Hilo, Waimea, Waikoloa and Kona, has been an advantage as they conduct more outreach vaccine events.

After a slow start and initial glitches in distribution, officials have expressed concern that most people in Hawaii who wanted the vaccine have received it while others have refused or delayed getting a shot.

Declining Demand

Approximately 44.6% of Hawaii’s adult population is fully vaccinated, state Department of Health spokesman Brooks Baehr said Friday. But the momentum of the campaign has slowed, particularly on neighbor islands.

Health advocates are eager to persuade as many people as possible to get the vaccine to stop the spread of the coronavirus so life can return to normal.

Dr. Damien Kapono Chong-Hanssen, the medical director of Hoʽōla Lāhui Hawaii, the community health center on Kauai, said he first noticed the drop in interest on the Garden Island in mid-April.

“We made it as accessible as possible to people who strongly desired it, and we just got through them all,” said Chong-Hanssen.

He said he has been pleased with the local businesses joining the effort to reach out to those who are hesitating.

Take Kauai’s popular poke spot, The Fish Express. They’re offering 5% discounts for customers who received a COVID-19 vaccine.

Two restaurants that temporarily shut down after the DOH found evidence of virus transmission are now working with Chong-Hanssen’s health center to plan pop-up vaccine clinics.

The owners of Rob’s Good Times Grill, which recently reopened after two of its employees contracted COVID-19, are considering offering a gift card to fully vaccinated patrons, he said. And Troy’s Bar, another Lihue spot that was affected by COVID-19, is planning to offer five free karaoke songs at another pop-up vaccine clinic tentatively planned for June.

“These were two bars where local people tend to frequent,” Chong-Hanssen said. “Kauai is a nice size for this stuff. We’re small enough to play along with each other and we can make things like this happen.”

Next Up, Youth

The declines in turnout span all ages, but as the state launches clinics for children as young as 12, some local health leaders say concerns about the vaccines have become more noticeable.

“We knew at some point we’d have to switch from making the vaccine available to actively going out to try and convince people to come in and describe the benefits of vaccination,” said Waianae Coast Comprehensive Health Center’s Director of Infection Control Jacob Schafer, who has overseen clinics on West Oahu.

As vaccine eligibility expands, the center is working with its school-based clinics to engage with a younger crowd.

Three vaccines — Pfizer, Moderna and Johnson & Johnson — have received emergency authorization from the Food and Drug Administration, but only Pfizer has been approved for ages 12 to 15.

“We had higher demand in older age groups and it seems as we moved to younger and younger age groups they seemed less interested,” Schafer said.

In the beginning of the pandemic, most cases were among older adults, but the ages of people infected have shot down in the past month. Most of the recent COVID-19 cases in Waianae have been among people younger than 20, he said.

“Just today there are 64 active cases in Waianae that we know of, and the vast majority are 17-, 11-, and 13-year-olds,” he said.

Some community health centers haven’t been able to get the Pfizer vaccine because they’re unable to place a minimum order of the vaccine. The health center has a steady supply of Moderna and Johnson & Johnson vaccines but would like to reach more kids.

Mary Oneha, CEO of the Waimanalo Health Center on Oahu, said she is working with other health centers on the island to put in a joint order for Pfizer vaccines.

Kimo Alameda, the CEO of the Big Island’s Bay Clinic, agrees addressing vaccine hesitancy among a younger crowd will be the next challenge in the vaccine rollout.

Waimanalo Health Center.
Waimanalo Health Center is among many clinics that has seen interest in vaccines decline. It used to accommodate an average of 40 patients a day at its COVID-19 vaccine clinic and now accommodates 20 to 30 daily. Cory Lum/Civil Beat/2021

Alameda said the discussions he’s had with his own children about the vaccine have helped him shape the clinic’s messaging around COVID-19 vaccines. He hopes to put a public service announcement on the local radio station soon.

“It’s my son and his friends who think they’re invincible and they think they are not going to get sick,” he said. “We had a nice conversation. I want to replicate the conversation I had with my son on the radio.”

Alameda said he is floating the idea of holding a concert that provides free admission to people who are fully vaccinated.

“The next phase in my mind is door to door and make it even easier for people to take the vaccine while simultaneously incentivizing the 12- to 30-year-olds,” he said. “They’ve got to be incentivized.”

Approaching Rural Communities

Clinical leaders at neighbor island health centers say their most successful approaches are tailored to the community.

On Hawaii island, West Hawaii Community Health Center’s Dr. Lee Ann Heely-Rolston oversees a team of community health workers that has engaged with migrant and seasonal farm workers who work on Kona coffee farms, Pacific Islander migrants and the Native Hawaiian community.

They meet with community leaders prior to clinics. Answering questions about side effects and addressing concerns in peoples’ native language helps a lot, Heely-Rolston said.

When they approached the community leaders of the Hawaiian homestead community of Laʻi ʻŌpua Village, Heely-Rolston’s team worked with community representatives who later canvassed their own neighborhoods, knocking on doors and engaging in conversations about the COVID-19 vaccines.

Kauai, meanwhile, leads all counties in terms of the number of people fully vaccinated.

Blanca Gil Lopez, who manages Kauai District Health Office’s multilingual team of community health workers, said her team’s efforts have been a big part of that success. She gave a recent example.

“We had scheduled meetings with eight Thai-speaking farmers and a Thai-speaking volunteer at different times through the morning,” she said. “More than 18 farmers came and more continued to come on the following days. Coconut wireless never fails.”

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