How Springfield’s Hub and Spoke Model is an Example of Vaccine Equity Nationwide

As vaccine inventory becomes available across the United States, healthcare providers like Curative are working to ensure everyone has convenient access to vaccines. This has necessitated meeting people where they are: community centers, churches, shopping malls. As we work to strengthen vaccine confidence, we are bringing vaccine sites to areas that are familiar and easy to access within communities.

Curative employees at the Hub and Spoke location, Bay Area Resident Resource Center, in Springfield, MA.

This has been the backbone of our hub and spoke model, which started in Springfield, Massachusetts. Springfield has had high rates of COVID-19 infection throughout the pandemic and remains one of two counties in Western Massachusetts to be considered ‘high risk’ for COVID-19. During the height of COVID-19 transmission in Springfield, between December 202 and January 2021, positivity rates were as high as 10%. The current national average is 2.2%. Springfield is a young community where the average age is 33, but with disproportionately high poverty rates. The county reports a 28.6% poverty rate, and the median household income is $36,730, a 1% decline from the previous year. Residents in Springfield are diverse — 32% are White, 31% are Latinx, 18% are Black, and 2% are two or more races. The diversity of Springfield coupled with its high vulnerability for COVID-19 makes it a pivotal region to focus on to ensure equitable vaccine distribution.

The hub and spoke model operates like a bicycle wheel, where spokes extend from the center of the wheel, or the hub. A large site provides the staffing and resources needed to operate ‘spoke’ sites, which are mobile vans that venture into at-risk communities. In Springfield, our site at the Eastfield mall allows us to subsidize a van that operates within 30 minutes in every direction. This van takes well-trained and talented staff from the hub and allows them to integrate into the communities they serve.

The ‘spoke’ of the hub and spoke model — a mobile van that brings vaccines into the community, featuring Curative employees.

When we first launched our Springfield hub, we noticed that many of the people getting vaccinated were not from the community or reflective of the community’s diversity. While we encouraged everyone to take advantage of the opportunity, we wanted to ensure that at-risk populations were getting access to vaccines that they needed.

Springfield Health Commissioner Helen Caulton-Harris and Representative Bud Williams supported Curative’s efforts to make vaccine distribution more equitable. Representative Williams asked if we could establish smaller sites, distributing 100 vaccines in the community per day. Health Commissioner Caulton-Harris allocated Curative 500 additional JnJ doses to help distribute. Since launching the spokes, we’ve ramped up vaccines to 400 per day, and continue to find new areas to host our mobile van.

Springfield elected leadership holds a press conference with Curative. 
Left to right: Legislative Aide Darryl Williams, Curative NE Regional Lead Dr. Sly Douglas, Springfield Mayor Domenic Sarno, Curative Community Relations Mgr. Matt Garlo, Springfield Health and Human Services (HHS) Commissioner Helen Caulton-Harris, Community Police Hearing Board Commissioner Robert ‘Cee’ Jackson, State Representative Bud Williams

What makes the spokes so effective is that it brings vaccines away from a mass vaccination site, which can be intimidating and inconvenient. Many of COVID-19’s most vulnerable populations are people of color and essential workers. It is essential to bring healthcare options that are easy, convenient, and reliable. The hub and spoke model allows community members, who both staff and visit our sites, to amplify vaccination efforts by encouraging their family and friends to come get vaccinated. 

We’ve taken extra care to ensure that coming to our sites and getting vaccinated is a positive experience. We have balloons, music playing, and an overall upbeat atmosphere. Doing so diminishes vaccine hesitancy and replaces it with excitement — we are celebrating taking steps to ending the pandemic. Dr. Sly Douglas, our regional lead, remembers specific incidents that made the experience heartwarming — a woman walking out of the vaccination clinic dancing, having just received her shot, and a young man who was hired to staff the Springfield site pointing to his house across the street from Eastfield mall, saying “I grew up there.”

“Curative has been an amazing partner that has resulted in the expansion of our Neighborhood Outreach Strategy. Curative opened a neighborhood site at Home City Housing. That walk-up site has been instrumental in encouraging our residents to get vaccinated. It is also important to acknowledge Dr. Sly Douglas who has integrated the work of Curative into the Springfield community. He listened to our ideas and implemented them using a collaborative model.”

-Springfield Health Commissioner Helen Caulton-Harris
Curative employee welcomes in new appointments demonstrating the positive experience at our sites

Vaccine hesitancy is prevalent in several minority communities. For women, many express fears over unknown lasting impacts on reproductive systems. For older adults, many want more time to see conclusive data. For Black Americans, a history of medical malpractice has caused distrust and reluctance. In general, many Americans see the restoration of social functions and feel that the need to personally be vaccinated has diminished. These reasons and more have amplified the need to fill vaccine appointments. 

In addition to the hub and spoke model, we work to remove the barriers to getting vaccinated. In the early stages of vaccine distribution, the Curative team would find eligible candidates in the Springfield community and present them vouchers to come get vaccinated at a certain date and time. We also had the option to register for a vaccine on the spot, which reduces technical barriers, such as the lack of access to reliable internet, to promote equitable vaccine distribution. Now that the general public is eligible to get vaccinated, we’re targeting our outreach efforts to ensure that vulnerable populations know their options and guide them through the appointment process.

“I want to thank Dr. Sly Douglas and the team at Curative for their continued partnership with my administration’s vaccine distribution operations.  Working with the Baker-Polito Administration, our state delegation, Springfield’s Health and Human Services Commissioner Helen Caulton-Harris, and our local medical institutions we were able to stand up not only a mass vaccination clinic in our city but also numerous strategically located neighborhood vaccination sites in our community. 

Curative played a key and pivotal role in collaborating with my administration’s coordinated efforts of making the COVID-19 vaccine as readily available to our residents as possible, especially for our most vulnerable and underserved populations.”

-Springfield Mayor Sarno

The hub and spoke model can be implemented to serve a range of healthcare needs — testing, new verticals, and antibody detection. Having a strong and cohesive hub can power outreach efforts to hard-to-reach, remote, and underserved areas to help meet patients where they are. We’ve adopted this model to sites across the United States, including Arizona, Michigan, and more. We will continue to pursue operations that allow us to best integrate and serve at-risk communities. 

Curative Inc. and its subsidiary, Curative Management Services LLC, engage with medical entities that provide vaccination services.

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