New Paper Identifies ‘Citizen Vaccinators’ As The Solution to Pandemic Challenges in Many Nations

When doctors and nurses are in short supply, who’s qualified to administer the COVID-19 vaccines?

That’s not a question you might often hear in the U.S. or other developed nations. Still, in many parts of Asia and Africa, that question is as common as someone asking when batches of vaccine doses will arrive in their community.

“Doctors and other medical staff are in short supply in many parts of the world,” explains William Crano, a professor of psychology in the university’s Division of Behavioral and Organizational Science (DBOS). “That scarcity doesn’t mean you give up on administering the vaccine there. Instead, you have to find a way around the problem, and that means looking to other people who can fill those roles.”

That solution—which involves training community members as “citizen vaccinators”—has been made possible by developing a COVID-19 training curriculum that prepares these citizens in as little as a week to serve their surrounding communities.

Along with Wired International’s Founding Director Gary Selnow and colleagues Charlotte Ferretti, Maryam Othman, and Gray Maganga, Crano, who was involved in the curriculum’s development, has co-authored a new article on the creation of this program titled “An Innovative Vaccinator Training Program.” The article was recently published in The Medical Journal of Southern California Clinicians. Read the full paper here.

The training program was developed under the auspices of WiRED International, a nonprofit organization founded by Selnow more than two decades ago that employs technology to bring medical and health education to people in underserved regions worldwide.

Last fall, Selnow joined CGU to develop the CGU WiRED International Center of Community and Global Health in collaboration with faculty from the university’s School of Community & Global Health (SCGH) and DBOS. Learn more about the new center here.

For Crano, who ​, along with his wife Suellen, has worked with WiRED International for many years, the organization’s longtime reputation in global health education made it ideally suited to turn this vision into a reality.

“You have an organization here with a long and established track record of helping ​people in places with limited resources,” Crano said.

Confronting Gaping Disparities

The new Vaccinator Train Program (VTP) is modeled on the Community Health Worker (CHW) training program, a larger program developed by WiRED International to train community members in various medical support services to boost the size of healthcare workforces in underserved areas.

Why is it needed? The disparity between such workforces in high-income and low-income countries is severe. According to the newly published article, high-income countries average some 31 doctors per 10,000 people, and that number plunges from 31 to just three per 10,000 in low-income countries. Similar dismal ratios are found in the numbers of available nurses.

That means that despite some very good vaccine news—more than two billion doses will be available globally by the end of 2021, with 1.3 billion going to the neediest regions—there won’t be enough medical support staff in these regions to administer them.

That is where WiRED’S CHW program and new vaccinator training curriculum come in.

“Appropriately training CHWs,” the authors write, “could expand the capacity of local medical teams to move the vaccines more quickly throughout each country, thus multiplying the workforce and dividing the time needed to distribute the shots.”

Fully Trained in a Week

In late 2020, as the world anxiously waited for vaccines to be prepared for public distribution, a curriculum development team (including Selnow and his co-authors) set to work in creating the VTP.

The minimum requirement for a person’s acceptance in the program is a high school diploma. The course material, which takes about one week (or 45 hours) to complete, is available online. Students download the coursework to their laptop or tablet before working with an instructor (typically a trained nurse or a Wired-trained vaccine administrator). In their paper, the authors also note that a test of the VTP was done this February in the city of Kisumu in northwestern Kenya and was highly successful.

Why, one might wonder, does it take 45 hours to learn how to give a shot in someone’s arm?

That’s because the VTP covers multiple aspects of vaccine distribution in addition to how to administer an injection. The training program is organized into seven modules that teach students how to transport vaccines, teach communities about the virus and vaccinations, set up shot clinics, administer the jabs, and monitor patients for AEFI (“adverse effects following immunization”).

As an educator, Crano sees immense value in WiRED’s collaboration with CGU for those grad students interested in careers addressing public health problems.

“Beyond the fact that the VTP curriculum is going to prepare more vaccinators and help so many people, there’s a tremendous advantage in having Gary and his fine organization on our campus,” he said. “Our students can learn from him and his organization not only about the kinds of public health problems that pose the biggest challenges, but what it also takes to find the right solutions, while gaining first-hand experience in dealing with health issues and solutions in some of the world’s most underserved places.”

• “An Innovative Vaccinator Training Program,” The Medical Journal of Southern California Clinicians.
• Learn more about the CGU WiRED International Center of Community and Global Health here