For Darol Kukahiko it was all about convenience.
Instead of making an appointment and driving into town, Kukahiko, 59, figured it was easiest to just go to the pop-up COVID-19 vaccine clinic Kaiser offered last month in his neighborhood of Papakolea, a Native Hawaiian homestead mauka of Punchbowl with a population of about 1,800.
Kukahiko said he had made up his mind to get the vaccine a while ago, but at the start of the year, the age eligibility had not dropped below 60, and he was just one year short until it opened to all adults April 19. Traveling interisland more conveniently was one incentive.
He has yet to persuade his mother, in her 80s, to get vaccinated.
She’s stubborn, he said, but after seeing him get his first dose and that he is fine, he thinks she might change her mind.
Kaiser Permanente Hawaii set up the pop-up clinic May 11, and returned to administer second doses of the Pfizer vaccine Tuesday in an effort to get to harder-to-reach communities like Papakolea.
Community nonprofits have been key in the state’s COVID-19 vaccine outreach strategy for disproportionately affected ethnic communities in Hawaii, which include Native Hawaiians, Pacific Islanders and Filipinos, where vaccine rates still remain low.
“Kaiser coming here has been such a blessing,” said Adrienne Dillard, executive director of Kula no na Po‘e Hawaii, a nonprofit serving the community. “They’re making it as convenient as can be.”
Dillard says her group has been working to assist the community throughout the pandemic, whether it’s through food distribution events, assistance applying for the new broadband grants or holding a drive-thru celebration for graduates.
Staff from the nonprofit, founded by kupuna in the community, walked door to door through the neighborhood, offering flyers about the vaccination clinics. For some kupuna it’s just more comfortable to get vaccinated near home than at a large center or a pharmacy.
In April the nonprofit’s Papakolea News offered a special COVID-19 vaccine edition, including answers to frequently asked questions, a list of myths and facts, and what side effects one might expect.
Papakolea is a tightknit community, where kids grow up playing together, according to Dillard, who has been part of it for nearly 30 years.
“When you care about your family and friends, you try to do as much as you can,” she said. “It’s community. You know your neighbors, you know their kids, you just want everybody to be well. That’s what it is.”
Dillard even calls up some kupuna personally to remind them to get their second dose.
Kaiser staff administered the Pfizer vaccine at the May clinic in an organized fashion, with tables and chairs set up at the community park basketball court, and again on Tuesday. There was no line for check-in, and patients sat and talked story in bleachers afterward while under observation for the required 15 to 30 minutes.
Volunteers from Hawaiian Airlines assisted with parking and handed out water and snacks.
For Desiree Terry, born at Papakolea and a resident for 60 years, more convenient interisland travel from Oahu to Maui is a motivation.
“At first I was kind of hesitant,” said Terry, who was receiving her second dose. “After a while I said, ‘Oh, if I want to travel’ … I always go to Maui to see my oldest brother. Usually I fly to Maui three, four, five times a year. … Now I can.”
In addition, Terry said learning of the presence of the UK or B.1.1.7 variant in Hawaii, which is more transmissible, also made her decide to get vaccinated.
“Nowadays you can never tell,” she said.
Matthew Kema, 38, of Papakolea said his whole family was getting vaccinated to keep the household safe. Kema, a lifeguard in Waikiki, also said he looked forward to riding to the beach with friends in the same car again.
So far, some 660 vaccine doses have been administered in Papakolea, representing about 18% of the community, according to Dillard. Fewer showed up Tuesday, but there will be another clinic in three weeks.
Most of the community attending the clinics have been kupuna rather than the younger set, but with the eligibility now open to ages 12 and older, more families with keiki showed up Tuesday. Some residents also got vaccinated through their employers or on their own.
There is a lot of misinformation circulating on social media, she said, and there are some who just are hesitant or waiting for others to get it first, particularly those who are younger.
“They’re waiting,” she said. “We don’t know what they’re waiting for, but they’re waiting.”
Besides Papakolea, Kaiser has also set up vaccination clinics in partnership with the Council for Native Hawaiian Advancement, Kamehameha Schools and Friends of Waimanalo.
Late last week the state Department of Health marked another milestone: More than 1.5 million COVID-19 vaccine doses had been administered in the state, and more than half of the state’s population was fully vaccinated.
As of Tuesday 59% of the state’s population had received at least one dose, and 52% completed vaccinations.
But outreach efforts are now more important than ever in the push to reach remaining pockets of vulnerable communities, and as demand for vaccines declines.
The Health Department in mid-March released a report showing that Native Hawaiian, Pacific Islander and Filipino communities have been hit hardest by the pandemic, and continues to reach out to those disproportionately affected.
Native Hawaiians make up about 21% of the population in Hawaii but 20% of coronavirus cases, 18% of hospitalizations and 12% of deaths due to COVID-19, according to the department’s dashboard.
Pacific Islanders make up only 4% of the population but have accounted for 20% of coronavirus cases, 28% of hospitalizations and 21% of deaths due to COVID-19.
Separate data for the Filipino population was not listed on the dashboard.
As far as vaccinations go, 23% of Native Hawaiian/Pacific Islanders have received at least one COVID-19 vaccine dose, and 19% have been fully vaccinated.
“Generations of compounding health disparities left Native Hawaiians vulnerable to the most severe outcomes of this pandemic,” said DOH Director Dr. Elizabeth Char in a statement. “Therefore, it is critical that we make access to COVID vaccines readily available and provide information about the vaccines to the Native Hawaiian community. Thanks to the efforts of our partners, this work is well underway. But there is always more to be done.”
The NHPI COVID-19 Response, Recovery and Resilience team has been working since May 2020 to address these inequities.
Sheri Daniels, co-lead of the team, said each community is unique, requiring its own strategy for vaccination outreach, considering how data can vary from one geographic area to the next.
“Engagement strategies have to be multipronged,” said Daniels. “We really have to look at these strategies that are community-specific, like Papakolea. Their community health workers are part of the community.”
But that strategy might be different for Waianae or Kau on Hawaii island, and trusted community partners are key.
Messaging is also key, and should be delivered not only in numerous languages, but in more than one way by trusted messengers. She said some groups like COVID Pau and Next Gen Hawai‘i have succeeded at that through creative public service announcements.
Dillard, who serves on NHPI 3R’s social support committee, believes it is about providing education and convenience.
“I think we’re making a small difference, in our small way,” she said. “It’s really about keeping our babies and our kupuna safe. What we want people to understand is it’s not about yourself. It’s about the love you have for others. It’s about keeping safe.”