On May 25, the House Energy and Commerce Subcommittee on Oversight and Investigations—presided over by Chair Diana DeGette (D-CO)—held a hearing entitled “A Shot at Normalcy: Building COVID-19 Vaccine Confidence.”
For the first time since the start of the COVID-19 pandemic, the Energy and Commerce Committee included a hearing witness from a local health department. In coordination with NACCHO, Karen Shelton, M.D.; NACCHO member; Director of Mount Rogers Health District, Virginia Department of Health was invited to speak before the subcommittee. The jurisdictions she serves are part of Virginia’s 9th Congressional district, represented by subcommittee Ranking Member Morgan Griffith (R-VA). Rep. Griffith introduced Dr. Shelton and thanked her for protecting the residents of the 9th district.
Additional witnesses included the following:
- Nick Offerman, Actor and Woodworker
- Saad Omer, MBBS, PhD, MPH, FIDSA, Director of the Yale Institute for Global Health
- J. Nadine Gracia, MD, MSCE, Executive Vice President and Chief Operating Officer, Trust for America’s Health
- Amy Pisani, MS, Executive Director of Vaccinate Your Family
During her testimony, Dr. Shelton outlined multiple factors to overcoming the declining pace of COVID-19 vaccinations. Dr. Shelton stated that while barriers differ between regions, all local health departments have a “shared goal of protecting and promoting the health of our communities.” She noted that local health officials have a keen understanding of the communities they serve, and the distinct local cultures inherent to their populations.
Dr. Shelton noted that vaccination demand has declined —despite the recent surge in supplies—as cited by Dr. Omer in his testimony—stating “many [individuals] labeled as hesitant have simply not had access to the vaccine or the opportunity to have their questions answered.” She cautioned against labeling people as hesitant or resistant, when some individuals may have access barriers, such as needing more time to travel to get the vaccine and conflicting work commitments or lack of child care supports.
The other witnesses echoed these concerns and addressed additional challenges that populations may face due to inequities based on race or ethnicity or socioeconomic status.
Dr. Shelton also outlined some of the challenges rural health departments face when conducting community outreach and education. She noted that much of the region she serves lacks access to broadband and cell service, and the health districts have a smaller workforce that has been stretched thin from the pandemic. In response to a question from Rep. Buddy Carter (R-GA), Dr. Shelton stated that although broadband access is a long-term infrastructure goal, it currently can hamper the ability to address constituent concerns and conduct community outreach.
In her written testimony, Dr. Shelton cited NACCHO’s 2019 National Profile of Local Health Departments, noting that the local public health workforce has been chronically underfunded and under-resourced since the financial crisis of 2008. Dr. Shelton noted that many communities never recovered, and at the onset of the pandemic, workforce capacity was down 21% in local health departments nationally.
