[House Hearing, 117 Congress]
[From the U.S. Government Publishing Office]


                      BUILDING VACCINE CONFIDENCE:
                          OUR SHOT AT CURBING
                        THE PANDEMIC IN CHICAGO
                               AND BEYOND

=======================================================================

                                HEARING

                               BEFORE THE

             SELECT SUBCOMMITTEE ON THE CORONAVIRUS CRISIS

                                 OF THE

                   COMMITTEE ON OVERSIGHT AND REFORM

                        HOUSE OF REPRESENTATIVES

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             FIRST SESSION

                               __________

                           NOVEMBER 10, 2021

                               __________

                           Serial No. 117-51

                               __________

      Printed for the use of the Committee on Oversight and Reform
      
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]    

                       Available on: govinfo.gov,
                         oversight.house.gov or
                             docs.house.gov                            
                                __________

                    U.S. GOVERNMENT PUBLISHING OFFICE                    
46-258 PDF                 WASHINGTON : 2022                     
          
-----------------------------------------------------------------------------------   
                            
                   COMMITTEE ON OVERSIGHT AND REFORM

                CAROLYN B. MALONEY, New York, Chairwoman

Eleanor Holmes Norton, District of   James Comer, Kentucky, Ranking 
    Columbia                             Minority Member
Stephen F. Lynch, Massachusetts      Jim Jordan, Ohio
Jim Cooper, Tennessee                Paul A. Gosar, Arizona
Gerald E. Connolly, Virginia         Virginia Foxx, North Carolina
Raja Krishnamoorthi, Illinois        Jody B. Hice, Georgia
Jamie Raskin, Maryland               Glenn Grothman, Wisconsin
Ro Khanna, California                Michael Cloud, Texas
Kweisi Mfume, Maryland               Bob Gibbs, Ohio
Alexandria Ocasio-Cortez, New York   Clay Higgins, Louisiana
Rashida Tlaib, Michigan              Ralph Norman, South Carolina
Katie Porter, California             Pete Sessions, Texas
Cori Bush, Missouri                  Fred Keller, Pennsylvania
Danny K. Davis, Illinois             Andy Biggs, Arizona
Debbie Wasserman Schultz, Florida    Andrew Clyde, Georgia
Peter Welch, Vermont                 Nancy Mace, South Carolina
Henry C. ``Hank'' Johnson, Jr.,      Scott Franklin, Florida
    Georgia                          Jake LaTurner, Kansas
John P. Sarbanes, Maryland           Pat Fallon, Texas
Jackie Speier, California            Yvette Herrell, New Mexico
Robin L. Kelly, Illinois             Byron Donalds, Florida
Brenda L. Lawrence, Michigan
Mark DeSaulnier, California
Jimmy Gomez, California
Ayanna Pressley, Massachusetts
Mike Quigley, Illinois

         Jenifer Gaspar, Deputy Staff Director & Chief Counsel
                         Beth Mueller, Counsel
                        Yusra Abdelmeguid, Clerk
                      Contact Number: 202-225-5051

                  Mark Marin, Minority Staff Director

             Select Subcommittee On The Coronavirus Crisis

               James E. Clyburn, South Carolina, Chairman
Maxine Waters, California            Steve Scalise, Louisiana, Ranking 
Carolyn B. Maloney, New York             Minority Member
Nydia M. Velazquez, New York         Jim Jordan, Ohio
Bill Foster, Illinois                Mark E. Green, Tennessee
Jamie Raskin, Maryland               Nicole Malliotakis, New York
Raja Krishnamoorthi, Illinois        Mariannette Miller-Meeks, Iowa
                         
                         
                         C  O  N  T  E  N  T  S

                              ----------                              
                                                                   Page
Hearing held on November 10, 2021................................     1

                               Witnesses

Panel 1

Lori Lightfoot, Mayor, City of Chicago
    Oral Statement...............................................     5
Ngozi Ezike, M.D., Director, Illinois Department of Public Health
    Oral Statement...............................................     6

Panel 2

Helene D. Gayle, M.D., President and CEO, The Chicago Community 
  Trust
    Oral Statement...............................................    16
Omar Khan, M.D., Co-Chair, Muslim Community Center's Health & 
  Awareness Committee
    Oral Statement...............................................    18
Martha Martinez, Manager, Pandemic Health Navigator Program (Gail 
  Borden Public Library District)
    Oral Statement...............................................    19
Don Abram, Program Manager, Interfaith Youth Core
    Oral Statement...............................................    20
Ben O'Donnell, Coronavirus Survivor
    Oral Statement...............................................    22
Dr. Joseph Kanter, State Health Officer and Medical Director 
  Louisiana Department of Health
    No Oral Statement............................................

Written opening statements and the written statements of the 
  witnesses are available on the U.S. House of Representatives 
  Document Repository at: docs.house.gov.

                           Index of Documents

                              ----------                              

Documents entered into the record for this hearing are listed 
  below.

  * ``Getting to Yes: Increasing Equitable Outcomes in COVID 
  Vaccinations- Reaching underserved communities 
  disproportionatle impacted by COVID-19,'' report, by Advocate 
  Aurora Health.

  * Letter to Reps. Krishnamoorthi and Foster, from Advocate 
  Aurora Health.

Documents are available at: docs.house.gov.

 
                      BUILDING VACCINE CONFIDENCE:
                          OUR SHOT AT CURBING
                        THE PANDEMIC IN CHICAGO
                               AND BEYOND

                              ----------                              


                      Wednesday, November 10, 2021

                   House of Representatives
                  Committee on Oversight and Reform
              Select Subcommittee on the Coronavirus Crisis
                                                   Washington, D.C.
    The subcommittee met, pursuant to notice, at 1:08 p.m., in 
Conference Room C, Malcolm X College, 1900 W. Jackson Blvd., 
Chicago, IL, and via Zoom. The Hon. Raja Krishnamoorthi 
presiding.
    Present: Representatives Krishnamoorthi and Foster.
    Mr. Krishnamoorthi. The subcommittee will come to order.
    The title of today's hearing is ``Building Vaccine 
Confidence: Our Shot at Curbing the Pandemic in Chicago and 
Beyond.''
    Without objection, the presiding member is authorized to 
declare a recess of the committee at any time.
    I now recognize myself for an opening statement.
    I would, first of all, like to thank Congressman Foster, my 
fellow subcommittee member, for joining me today, and all of 
today's witnesses for taking the time to testify about the 
critical issue of building vaccine confidence.
    I would also like to thank Chairman Clyburn of the Select 
Subcommittee on the Coronavirus Crisis for his strong 
leadership and for lending us the resources for this important 
hearing today.
    President Biden, Governor Pritzker, and Mayor Lightfoot 
have successfully vaccinated millions of Americans, over 222 
million in total, including 8.3 million here in Illinois and 
1.6 million in Chicago. That is over 75 percent of all 
Americans, Illinoisans, and Chicagoans over the age of 12 who 
have received at least one dose of vaccine.
    In just five months, the vaccine prevented 140,000 deaths 
across the country.
    We know that the vaccine is effective. We know that it is 
safe. And we also know that widespread vaccination is the way 
to end this pandemic. So, why aren't more people getting 
vaccinated?
    After all, without the vaccine, people are six times more 
likely to get coronavirus, and 11 times more likely to die from 
it. And vaccinations offer better protection against the 
coronavirus than immunity from a prior infection. Unvaccinated 
people who had recovered from a prior COVID infection are five 
times more likely to get COVID again than those who are 
vaccinated who had a prior infection.
    With the vaccine, families can confidently gather for the 
holidays. Kids can see their grandparents. Children can spend 
more time in school and less time quarantining.
    The Federal Government has provided millions of dollars in 
aid to end this scourge. The American Rescue Plan provided $350 
billion across the country, including about $275 million here 
in Illinois. Chicago's vaccination efforts were fueled by 
almost $100 million in Federal funding.
    Yet, many Americans remain unvaccinated. Nationwide, more 
than 20 percent of all adults and children over the age of 12 
have not yet received even one dose of vaccine. Illinois has 
done better than the rest, and Chicago the same. Yet among 
adults and children over the age of 12, 23 percent have not 
started a vaccine series here in Illinois.
    We now have an unprecedented opportunity to increase 
vaccine uptake here in Chicago and across the country. Just 
last week, Federal regulators approved the vaccine for children 
ages 5 to 11. I should say that my own five-year-old got 
vaccinated last week, and she got a poke present in return.
    We owe it to our children to get shots in their arms 
quickly and equitably. They will spend more time learning, and, 
importantly, they will be able to get back to playing sports 
and socializing. They will have access to reduced-price 
nutritional meals, we well as other important social services.
    President Biden, Governor Pritzker, and Mayor Lightfoot are 
all working hard to get shots to our kids. They are ensuring 
that vaccines are readily available at locations parents know 
and trust, like doctor's offices, children's hospitals, and 
schools.
    Chicago is closing its public schools this Friday so 
parents can get their children vaccinated, and they are 
offering a small monetary award for children who get 
vaccinated.
    As we vaccinate young children, we must continue to address 
vaccine hesitancy in historically underserved communities. We 
must continue the hyperlocal outreach that is working in 
Chicago. That means sending trusted messengers into their 
communities, and it means overall building vaccine confidence.
    We are going to hear from many people today about how well 
this approach works.
    We are going to hear from Mayor Lightfoot, who spearheaded 
the Protect Chicago 77 program, a community engagement program 
working to ensure 77 percent of Chicagoans 12 and older, across 
all 77 Chicago communities, have started their vaccinations by 
year's end.
    Chicago is getting close; it is at 75 percent, and 
climbing. To help get to 77 percent, every Chicagoan can talk 
to friends and loved ones about the vaccine. Businesses can 
require vaccinations for their staff and patrons.
    And we don't want to just hear from government leaders. We 
will be hearing from people who are out in their communities, 
doing the hard work of on-the-ground outreach.
    Ms. Martha Martinez, the supervisor at an outreach program 
at a public library in Elgin, will tell you about how she and 
her team talk to community members every day. Dr. Omar Khan is 
both a medical doctor and a Muslim-American community leader. 
He will tell us how he has tailored his work to those in his 
community. Mr. Don Abram works for the Interfaith Youth Core, 
which funds local groups that are working to increase vaccine 
uptake.
    They all agree on one thing: hyperlocal, on-the-ground 
outreach works. And the empirical evidence supports this 
approach.
    Financial incentives are great, and they do a great job of 
ensuring a large number of people get vaccinated when they 
become eligible. But they don't work for everyone.
    Employer vaccine requirements can also help fill the gaps. 
At United Airlines, implementing vaccine requirements increased 
the vaccination rate to 99 percent. Chicago and Illinois have 
both implemented vaccine requirements for public employees, 
keeping children and others in the care of public workers safe. 
And we are looking forward to hearing what Dr. Ezike has to say 
about this, as well.
    Among the vaccine hesitant, many more want time to wait and 
see if the vaccine works. And many just want to talk to someone 
who can answer their questions. By funding and empowering 
hyperlocal outreach on-the-ground efforts, Chicago and Illinois 
are helping residents get the answers they need from the people 
they trust. And that is going to be an ongoing theme, I think, 
of today's hearing, which is finding trusted messengers to do 
that hyperlocal, on-the-ground outreach.
    With hard work in the weeks ahead, we will keep children in 
schools and let families come together for Thanksgiving and the 
Christmas and winter holidays. I look forward to hearing from 
our witnesses how to meet those goals by building vaccine 
confidence in Chicago and beyond.
    Now I would like to recognize Congressman Foster for his 
statement.
    Mr. Foster. Thank you to the committee and to my friend, 
Congressman Krishnamoorthi, for convening this hearing, and to 
both panels of witnesses for their participation. I would also 
like to thank several organizations in attendance that have 
been critical to the COVID vaccination efforts in my district: 
the Will-Grundy Medical Clinic; VNA Health Care; and Advocate 
Aurora Health.
    As one of two Ph.D. scientists in Congress, I always look 
to the research and data when making decisions, and the 
decision to get vaccinated is one place where the data could 
not be more clear: all three of the FDA-approved vaccines are 
extremely safe and extremely effective.
    We run into two classes of arguments in the discussion over 
vaccinations. One is a scientific one based on pure self-
interest, and a second one less scientific. It is based on your 
duty to your family and your community, and ultimately your 
country and all humanity because of the danger that one person 
being infected presents to eventually all of humanity.
    So how do we know that they are safe and effective? First, 
the vaccines were tested on primates, for whom they were over 
90 percent effective and had no serious side effects. Then we 
moved on to three different phases of human trials.
    Across each of these three phases, the first of these 
phases, between 30,000 and 50,000 people received each vaccine, 
and each person was monitored closely for any adverse reactions 
or COVID infections. Again, the vaccines proved to be up to 95 
percent effective at preventing COVID infections, and even 
better at preventing hospitalizations and deaths. The side 
effects observed were rare and usually minor.
    So, if you want more evidence, then even after the vaccines 
were approved and deployed at massive scales, the FDA and 
pharmaceutical companies continued to closely monitor people's 
reactions, keeping close records of any serious side effects or 
infections that have occurred. To date, 431 million shots have 
been administered in the U.S. If these shots were dangerous, we 
would know it by now. And if they didn't work, we would also 
know that.
    But, in fact, this extensive data has shown the opposite. 
Although it is still possible for someone who is vaccinated to 
catch COVID-19 or to pass it on, unvaccinated people are six 
times more likely to get the disease and, depending on the 
study, 11 to 20 times more likely to die from it than a 
vaccinated person. Many of our hospitals are overwhelmed with 
COVID patients right now, and more than 95 percent of those 
patients are unvaccinated.
    And as far as safety, after tracking millions of 
vaccination outcomes, the only common side effect is a sore arm 
and perhaps a day of flu symptoms. This certainly isn't fun, 
but neither is spending a month on a ventilator.
    But everyone on the two panels before us today already 
agrees with these conclusions. So, what we are here to do today 
is to figure out how to effectively communicate these data and 
statistics and ultimately get shots in arms.
    Our local health departments and their partner 
organizations in the southwest suburbs have been working around 
the clock to get our neighbors vaccinated. We have seen the 
Will County and DuPage County Health Departments, among many 
others, run highly successful vaccination campaigns for our 
communities of color. I am incredibly grateful for their 
dedication, and I look forward to hearing what further support 
we can give them to get us across the finish line.
    Thank you, and I yield back.
    Mr. Krishnamoorthi. Thank you, Congressman Foster.
    Now I would like to begin by introducing our first two 
panelists.
    Chicago Mayor Lori Lightfoot has led an impressive campaign 
to vaccinate Chicagoans quickly and equitably.
    Mayor, thank you for everything you have done and 
everything that you are doing to build vaccine confidence in 
Chicago.
    Our second witness is Dr. Ngozi Ezike, Director of the 
Illinois Department of Public Health, who has been a constant 
advocate and a steady voice for our state's public health and 
for children's health.
    Director, thank you for all that you are doing for our 
residents in Illinois.
    I will begin by swearing in the witnesses.
    If you would please rise and raise your right hand?
    [Witnesses sworn.]
    Mr. Krishnamoorthi. Thank you.
    Let the record show that the witnesses answered in the 
affirmative.
    Thank you and please be seated.
    Without objection, your written statements will be made 
part of the record.
    With that, Mayor Lightfoot, you are now recognized to 
provide your testimony.

     STATEMENT OF LORI E. LIGHTFOOT, MAYOR, CITY OF CHICAGO

    Ms. Lightfoot. Thank you, Congressman Krishnamoorthi and 
Congressman Foster, and members of the Select Subcommittee on 
the Coronavirus Crisis, for holding today's hearing. I applaud 
your work and the unwavering support that you have shown 
municipalities across Illinois.
    Though this journey is far from over, it is an honor to 
appear before you today to share the work that we have 
accomplished thus far and our plans for the future, which would 
not have been possible without cooperation from the government 
at all levels. So, I want to again thank the members of this 
body for the resources that have been provided to 
municipalities like Chicago. I also want to thank our State 
partners represented today by Dr. Ezike, who has been very 
instrumental in making sure that we are focused and coordinated 
in our efforts with the State.
    From the moment COVID-19 hit Chicago, we were determined to 
listen to public health experts on the science and address its 
effects equitably and include our residents in the progress 
that we are making toward mitigating COVID-19. Thanks to this, 
we saw extremely strong rates of residents cooperating with 
public health orders and developed an equally strong community-
led, hyperlocal response. We have been able to build vaccine 
confidence in our city because we started early on working with 
local leaders across disciplines to build a robust, city-wide 
response.
    This started with the recognition that although all of 
Chicago was impacted by COVID-19, our Black and brown 
communities really bore the brunt.
    For example, in April 2020, despite making up only 29 
percent of Chicagoans, Black residents accounted for 75 percent 
of COVID-related deaths. That was seven times the rate of any 
other demographic.
    To address this glaring and unacceptable disparity, my 
team, alongside community partners, created the Racial Equity 
Rapid Response Team, or RERRT, which forged partnerships with 
trusted community messengers across disciplines and utilized 
trusted locations to provide residents with information, 
testing, and eventually vaccine.
    While this started with a focus on deaths in Black Chicago, 
we soon widened our aperture and worked to build the same kind 
of trusting relationships across Latinx Chicago.
    To bolster this data-driven, hyperlocal approach, we 
launched initiatives like Protect Chicago Plus, in which we 
sought to vaccinate multiple generations within the same 
household simultaneously by going deep into these communities 
that were showing sustained rates of high-case infections. Here 
again, we used a network that we had built for testing and 
education to make progress in our hardest-hit zip codes.
    We also then created Protect Chicago at Home, which 
mobilized our paramedics and vaccinators to provide in-home 
vaccinations for homebound or disabled residents and has been 
available to all residents free of charge since June of this 
year.
    To date, more than 15,000 people have been served through 
this Protect Chicago at Home program. It is very, very popular.
    And as of the last four weeks, 54.6 percent of the 
participants in this program were Black, and 18 percent were 
Latinx.
    We also created a 600-strong work force of contact tracers, 
and we specifically targeted the underemployed with an earn-as-
you-learn approach. Not only have they been doing contact 
tracing, but they have also been deployed to be vaccine 
Ambassadors in their communities.
    Recently, as you mentioned, we launched Protect Chicago 77, 
which engages individuals in every single one of our 77 
communities to ensure that at least 77 percent of residents 
aged 12 and over have received at least one dose of COVID-19 
vaccine by the end of the year. These efforts have helped to 
save countless lives, including Marie Ann Jesus, parents of 
Portage Park resident Cessi. Cessi and her parents were 
desperate for a vaccine appointment when they met Brianna, who 
volunteered to connect them with vaccine appointments for 
residents after losing her grandfather to COVID-19. Twenty-four 
hours later, Cessi secured an appointment to protect her 
parents. Cessi's story and the story of countless others were 
made possible for the many volunteers, community leaders, and 
organizations who continue to pull their time, talents, and 
resources together to protect our most vulnerable communities 
and have allowed Chicago to retain its reputation as having the 
most equitable vaccine distribution strategy in the country.
    I want to emphasize a couple of data points in my closing 
seconds. Ninety-nine percent of fully vaccinated Chicagoans 
have not tested positive for COVID-19, whereas 99.9 percent 
have not been hospitalized, and 99.9 percent have not died due 
to COVID. These numbers are pretty remarkable, but the flipside 
is the case for folks who remain unvaccinated.
    My time is up, but I appreciate the opportunity to speak 
with you here today. Thank you.
    Mr. Krishnamoorthi. Thank you, Mayor.
    Now I would like to recognize Director Ezike for your 
testimony.

 STATEMENT OF NGOZI EZIKE, M.D., DIRECTOR, ILLINOIS DEPARTMENT 
                        OF PUBLIC HEALTH

    Dr. Ezike. Congressman Krishnamoorthi and Congressman 
Foster, thank you so much for inviting me to be here today to 
speak about our vaccination efforts to protect all of Illinois 
from COVID-19. And thank you for your leadership at the Federal 
level to promote these life-saving efforts to keep our country 
safe.
    As of November 9, 2021, more than 16 million vaccines have 
been administered in Illinois, leading to about 62 percent of 
the population with at least one dose. And more importantly, 57 
percent of the total population is fully vaccinated against 
COVID-19.
    By age, the share of Illinoisans who are fully vaccinated 
is about 84 percent for individuals over the age of 65; 66 
percent for adults aged 18 to 64; and 54 percent for youth age 
12 to 17. Following the authorization of vaccine for children 
age 5 to 11, just on October 29, younger children have started 
to get vaccinated. As of November 7, over 15,000 doses have 
been administered to children age 5 to 11, including your own.
    Mr. Krishnamoorthi. Thank you.
    Dr. Ezike. We are currently averaging more than 53,000 
doses administered per day Statewide, and the seven-day rolling 
average of doses administered in Illinois is more than twice as 
high as our most recent lull, at roughly 19,000 doses per day, 
back in mid-September. There is no doubt that the local health 
departments, health care providers, retail pharmacy partners, 
employers, and so many other partners across Illinois have 
worked tirelessly together to implement a very successful 
Statewide vaccination effort, and we are celebrating this 
achievement thus far, but still understanding that there is a 
lot more work to do.
    We know that there is a wide variance in vaccination rates 
across the State, so the numbers can sometimes hide the 
details. For example, about 95 percent of seniors in Kendall 
County are fully vaccinated, and that compares to 34 percent of 
seniors being vaccinated in Alexander County. For youths age 12 
to 17, 70 percent are fully vaccinated in DuPage County, while 
two percent are fully vaccinated in Harden County.
    Racial differences have also persisted, including for young 
children just beginning to be vaccinated. Among those 15,000 
doses administered through November 7, [inaudible] percent were 
administered to white children, and only 12 percent to Hispanic 
children, and three percent to Black children.
    As we prepare to accelerate the next wave of vaccinations 
for children age 5 to 11, now is a good time to take stock of 
exactly what we have learned about strategies to increase those 
vaccination rates for all.
    There was a time when there was incredibly high demand for 
the COVID vaccine before they were approved and as those first 
doses were rolled out in December 2020. But since April 2021, 
when the rate of vaccination actually began to slow in 
Illinois, the population of individuals left to be vaccinated 
is increasingly composed of people hesitant to the COVID-19 
vaccine, in addition to the minority of Illinoisans who could 
be described as anti-vaccine or opposed to any form of 
vaccination.
    In Illinois, those that are most likely to report vaccine 
hesitancy have primarily been younger people, people of color, 
and rural residents. Importantly, we also know that vaccine 
hesitancy and refusal can serve to reinforce social identity, 
in this case often tied to political or partisan and religious 
identities polarized through the pandemic. Research also 
reveals some of the reasons vaccine-hesitant people share for 
not receiving the vaccine include concerns with the speed of 
vaccine development, lower trust in the experts, and fears 
about the safety and effectiveness of the vaccine.
    Our continuing vaccination efforts will rely in part on 
acknowledging and understanding vaccine hesitancy to best 
target remaining vaccine-eligible individuals. Every day we are 
vaccinating individuals who are likely to have expressed some 
hesitancy, otherwise they would have already been vaccinated 
since all adults were eligible in April.
    These individuals are hesitant adopters, people who are 
both vaccinated and yet report some degree of hesitancy. In the 
current phase of the pandemic, addressing vaccine hesitancy 
should focus on creating more hesitant adopters by implementing 
interventions that are tailored to the specific concerns of 
specific populations. This has been our approach in Illinois to 
date, where we have spent a total of $225 million on the 
vaccination effort.
    There is need for urgent action. The highest rates of 
COVID-19 vaccine hesitancy are found in the demographic groups 
that have already been the most severely affected by the 
pandemic. In Chicago, in Cook, for example, COVID-19 vaccine 
hesitancy for children was nearly three times higher among 
Black parents compared to white parents, while Black Chicagoans 
comprise a disproportionately greater number of COVID-19 deaths 
compared to other groups.
    Attitudinal hesitancy may not be the only issue, however. 
Communities with lower rates of COVID-19 vaccination are also 
those with structural inequities and access to health care 
resources. For example, retail pharmacies have been a major 
source of both testing and vaccination, but research has 
persistently found that Black and Hispanic neighborhoods have 
fewer options for pharmacies and have to drive longer distances 
to the closest COVID-19 vaccination.
    All that we have learned to date will inform how we 
implement our ongoing efforts for the 5-to 11-year-olds. We are 
working to reach school-age children. We are going to use our 
pediatricians, our family doctors, our community health 
centers, all these places where parents can receive trusted 
information about the vaccine to reduce hesitancy.
    To date, approximately 2,200 providers in Illinois have 
registered to administer the vaccine, and we plan to continue 
registering the additional providers, especially targeting 
communities where vaccination rates have lagged.
    Federal support could significantly aid Illinois in our 
efforts to facilitate vaccination among hesitant individuals. 
The Federal Government should help mitigate and counter 
misinformation in the ongoing info pandemic that parallels the 
pandemic. This info pandemic fuels hesitancy and public 
confusion through the rapid and widespread dissemination of 
inaccurate messages. Knowing what is being spread and catching 
it early could allow IDPH and our many partners to respond 
swiftly to misinformation with simple, consistent, accurate 
counter-messaging. Unfortunately, current Federal funding is 
often restrictive and lacks the ability to rapidly reallocate 
those funds to address the emerging needs and crisis situations 
as they arise.
    Reorganizing public health funding is one way the Federal 
Government can help us implement the kinds of interventions 
necessary to refute misinformation and continue vaccinating 
hesitant individuals and populations.
    Thank you so much for the opportunity to share Illinois' 
experience, and I am very happy to answer questions.
    Mr. Krishnamoorthi. Thank you so much.
    I should have told you about the timer before, but there is 
a five-minute timer here, and we will try to abide by the time.
    I would like to recognize myself for five minutes of 
questions.
    Mayor Lightfoot, I understand that Chicago has taken a 
data-driven approach to its vaccination program, and I am 
fascinated by this at-home vaccination strategy.
    Can you explain some of the lessons Chicago has learned and 
how it has changed its approach based on what it has learned?
    Ms. Lightfoot. Well, I think one of the biggest things that 
we have learned is that there is not a one-size-fits-all 
approach, particularly when you are dealing with vulnerable 
communities. We have really spent a significant amount of time 
building partnerships, joining tables that have already been 
built, and really then using the data and sharing that data 
with local-based advocacy groups and stakeholders to craft 
really neighborhood-specific interventions.
    One of the ones that really came out of that discussion was 
our at-home program. We started that using Johnson & Johnson to 
go into homes of our seniors. But we have seen such an embrace 
of it across particularly Black Chicago on the South Side, 
where we have seen lower rates of vaccine uptake, that we have 
literally been going door to door with vaccine Ambassadors and 
then signing up whole households for the at-home service. It 
has really been quite tremendous with us.
    But what I would say is, again, one of the things that has 
been most important in our vaccine distribution program is the 
work that we did prior to the time that the vaccine hit by 
building those relationships with trusted community partners 
and messengers, and then using that infrastructure to push out 
vaccines, and then constantly being engaged with them to 
understand what the levels of hesitancy are.
    I think Dr. Ezike got it just right. Based on polling that 
I have seen, both nationally and certainly here locally, there 
is a small percentage that are anti-vax, that are never going 
to reach it. The vast majority of people that remain 
unvaccinated are still vaccine hesitant. So, when we sent out 
those Ambassadors into neighborhoods, going door to door, we 
see the ability to really address people's concerns, make sure 
that we are informing them of the facts because, as you know, 
there is still a persistent drumbeat of misinformation out 
there about the vaccine, about the efficacy of it, the 
ingredients of it, what was used and so forth. When we are able 
to have those kind of one-on-one conversations, we are able to 
break through at remarkable rates.
    Mr. Krishnamoorthi. Thank you.
    Dr. Ezike, rural areas, it seems like this is a really 
tough-to crack. Can you tell us what is working in rural areas, 
and can you give any specific examples?
    Dr. Ezike. You know, we have tried the door-to-door method 
that had worked in some areas, and we had a lot of pushback and 
resistance on that. So, what we have done, we have continued to 
do outreach, we have continued to partner with churches in the 
area, trying to find local people of faith who are willing to 
share the message, allow education to be spread, host events. 
But we have also had to make sure that we give other options, 
and so we have been very diligent about educating about 
monoclonal antibodies. We know that at the end of the day we 
need to save lives, and if we have people who are still on the 
fence, still hesitant, or absolutely not going to get a 
vaccine, part of the approach has to make sure that they do 
understand how they might take another option if they were, in 
fact, to get infected, although we continue to promote an ounce 
of prevention is worth a pound of cure.
    We have also tried to make sure that there is access----
    Mr. Krishnamoorthi. Excuse me. If I could jump in, are 
there any trusted organizations in the rural areas, or trusted 
messengers, that seem to be more effective than others?
    Dr. Ezike. So, we think that using physicians from the 
local area, people who are recognized by people in that area. 
We have a strong rural health department at IDPH, and working 
with those physicians who are in the community, helping to have 
the town halls where people can ask the specific questions that 
are maybe holding them back. And when they see a physician or a 
nurse practitioner, another clinician that is known to them 
that is from the local community, sometimes that correct 
messenger is the person whose message will be received.
    Mr. Krishnamoorthi. Now, Mayor Lightfoot, what do you 
think? Who do you find to be--if there is a group or a class of 
people who are the most trusted messengers that you have found, 
who are they?
    Ms. Lightfoot. I think it is those local health care 
providers, first and foremost. But what we have also been able 
to deploy is people themselves who are vaccine hesitant, who 
then can tell the story to others about what it was that really 
got them to decide, no, the vaccine is something that I need 
for myself and for my family. Those are very powerful 
messengers.
    Mr. Krishnamoorthi. Excellent. Thank you.
    Now I would like to recognize Congressman Foster for your 
questions.
    Mr. Foster. Thank you.
    You know, as a scientist, I am really proud of the work 
that researchers have done to develop and test vaccines to 
provide protection against this virus. In the early days of the 
pandemic, Congresswoman Donna Shalala, the former head of HHS, 
and I led a bipartisan letter urging maximum resources to be 
put into all vaccine manufacturers that had any chance of 
making a workable vaccine. This effort was eventually rebranded 
as Operation Warp Speed, and the Coronavirus Oversight 
Committee that we are convening here, we have been very active 
in overseeing that production effort and also making sure that 
when the first doses were available they were equitably 
distributed, which was not naturally going to happen.
    So, I am very grateful for the work of the Federal, State, 
and local officials, as well as the health care providers and 
other community members who helped get the first millions of 
shots in arms in record time. And now with 423 million doses of 
coronavirus vaccines administered in the U.S. to date, we have 
seen that the vaccines are very safe and effective. The data 
show that the vaccines are literally lifesavers and that 
serious side effects are rare, and yet far too many Americans 
are still placing their lives and the lives of others at risk 
because of vaccine hesitancy.
    So, Dr. Ezike, as a physician, what are the first arguments 
that you find most effective when you recommend that people get 
vaccinated or boosted as soon as they are eligible?
    Dr. Ezike. I continue to share the information about how 
layered approaches are important and how prevention is always 
our first line. I think I try to use the examples of vaccine-
preventable illnesses that we don't see. I have been a 
physician for over 20 years. I have not treated one case of 
measles. But my tennis captain, her brother is deaf from the 
results of measles. So, in that short time, we can see what the 
vaccine has done.
    The example of polio, I don't have children jumping double-
dutch jump rope with braces on their legs from polio. The only 
reason that we don't have polio is because of the vaccine.
    So, just reminding and level-setting about what vaccines 
are.
    I know a big pushback that comes back is when we talk about 
Tuskegee in the African American community. We talk a lot 
about, oh, the Tuskegee experiment where public health 
officials did not do right by people of color. So, even 
understanding that example, acknowledging that something was 
done very wrong during that time, but remembering that in 
Tuskegee, in that instance, we had a situation where treatment 
was withheld. There were available antibiotics that were 
withheld from people who needed it. And in this case, we have 
that available treatment that we don't want to withhold from 
people of color or anyone else.
    Mr. Foster. You are right, that will just compound the 
inequity that has been longstanding in our health care system.
    Actually, you did a good job of answering my next question.
    Mayor Lightfoot, are there other aspects of your city's 
approach that have helped convince Chicagoans that vaccines are 
safe and effective that you have not had a chance to mention 
yet?
    Ms. Lightfoot. Yes. I think, look, at the very beginning it 
was just getting out the basic information about the various 
clinical trials, the results of the effectiveness. That really 
helped to allay a lot of concerns initially. But right now 
where we are, there is really not a one-size-fits-all approach. 
You have got to simply start the conversation by listening and 
really getting an understanding of what the particular person's 
hesitancy is. It is that simple, but that complicated.
    And we have all the data that you want. For example, in our 
city, if you are a person of color 50 years or older, you have 
a 50 times higher likelihood of death if you are unvaccinated. 
When you start talking to people one-on-one about those kinds 
of shocking statistics, that catches their attention.
    But what we also try to do is draw out the misinformation 
that they have taken in so that we can disabuse them with the 
facts. But it really requires a lot of patience, a lot of 
listening, to go directly, and that is a lot of what the 
vaccine Ambassadors, the work that they are doing on a regular 
basis, and that is why I am proud of that program and why I 
think it has been wildly successful in bringing communities 
into care.
    The other thing that we are really avoiding doing is 
shaming people in communities for not being vaccinated. So, we 
are trying to reinforce the Protect Chicago 77 with positive 
messaging. Any time a community makes measureable progress, we 
highlight that on various social media platforms, and I think 
that positive reinforcement is also helping considerably.
    Mr. Foster. Thank you.
    I have five seconds left, so I think I will yield back.
    Mr. Krishnamoorthi. OK. Thank you, Congressman.
    We are going to do one more round of questions.
    So, Mayor, as you were talking, one thing that dawned on me 
is that when you have almost 80 percent of Chicago residents 
now having received their first shot, that has to touch almost 
every family in the city, at least that is what I am assuming.
    Now, let me ask you this. This may be a loaded question, 
but do you find that family members are good Ambassadors to 
other family members? Because I hear the anecdotes both ways.
    Ms. Lightfoot. It really does go both ways. But if we can 
reach someone in that family, and then get them to be the 
Ambassador with their own family, to talk to mom, dad, grandma, 
other siblings, it does make a huge world of difference. That 
is why I think in part our initial push, Protect Chicago Plus, 
was so successful. We really concentrated on getting someone, 
particularly within an intergenerational household, who would 
be the messenger on the vaccine, who would bring the reluctant 
family members to a vaccinationsite. That is what I think made 
it very successful.
    For example, the Belmont Cragin neighborhood, through most 
of 2020, before there was a vaccine, was a neighborhood where 
we saw exploding case rates, percent positivities in the high 
teens, or even higher in some instances. That community now is 
one of the most vaccinated in our city because of the hard work 
that was done through Protect Chicago Plus, working with 
trusted stakeholders, and we held a lot of vaccination 
opportunities all over, in schools, in houses of worship. You 
name it, we were there working with our partners in various 
pharmacies, with various doctors that were from that 
neighborhood. That neighborhood has had a remarkable recovery 
because of the hard work that was done prior to the time that 
we got vaccine, and then pushing it out and highlighting those 
local stakeholders who said, yes, I got the vaccine, and here 
is the reason why.
    Mr. Krishnamoorthi. Got it. Thank you.
    Dr. Ezike, what can the Federal Government do to assist in 
increasing the vaccination rate? You mentioned something about 
disinformation or misinformation and social media. I would be 
curious about what are your observations there and what are you 
doing or what needs to be done by others to control that issue?
    Dr. Ezike. I think the infodemic, if you will, is a very 
powerful tool that is working negatively against the COVID 
response efforts, and I know most public health departments and 
other health partners don't really have the resources or the 
expertise to be able to monitor what the trends are in social 
media. So, by the time we are actually aware of some of these 
ideas that have just permeated and bathed the people, it is a 
very uphill battle to get on top of that because that news 
spreads so quickly.
    So, if there was a way that the Federal Government could 
assist with monitoring the information that is out there so 
that we can jump and seize hold of some of these mistruths and 
disinformation earlier on, before it has had such a chance to 
percolate throughout society, we could probably avert many 
people from hearing the wrong news, or at least having the 
counter-message be ready.
    Mr. Krishnamoorthi. Getting in front of it.
    Dr. Ezike. Exactly.
    Mr. Krishnamoorthi. Mayor, what do you think about the 
challenge with regard to youth? I see it has risen, the 
percentage has gone above 50 percent, and Dr. Ezike said this 
about Illinois as a whole. What strategies seem to be working 
with our youth? I am talking about 12 to 18 for right now.
    Ms. Lightfoot. Well, first of all, we have to get the 
parents. In that age cohort, you have to get the parents on 
board. Fundamentally, that is what it is really about. You have 
to make sure that young people are connected up with a 
pediatrician, because that is going to be the most likely place 
that you are going to see. And then for the older end of the 
teenage years into the early 20's, we have done a number of 
different things. We have popular influencers who are going 
directly to those young people talking about the vaccine. We 
have done D.J. radio takeovers where there is messaging through 
the whole program on popular radio sites in a variety of 
languages all talking about the safety of the vaccine. Of 
course, we have to get those people vaccinated first, but we 
have had a lot of success with that.
    We have done a lot of digital assets deployed on social 
media platforms and elsewhere to really reach young people with 
the kind of messaging and imagery that is going to make a 
difference for them.
    So, we have really been focused on that cohort, I would say 
initially 18 to 39, and now more recently 12 to 18, and we are 
doing the same thing, frankly, that marketers are doing, what 
works, how do you reach them, and that is where we are going.
    Mr. Krishnamoorthi. Thank you.
    Congressman Foster?
    Mr. Foster. Thank you. Back to the pure science for a 
moment.
    Viruses constantly change through mutation, and new 
variants of a virus can spread more easily or make viruses 
resistant to treatments or other vaccines. One of the strongest 
arguments for getting yourself vaccinated is to reduce the 
number of chances the virus has to incubate a new variant, a 
new and dangerous variant of itself. The most prominent of 
these is currently the Delta variant, which is thought to be 
twice as contagious as the original virus. In fact, studies 
have shown that people infected with the Delta variant carry 
about 1,000 times more copies of the virus in their respiratory 
tract than those infected with the original strain.
    Dr. Ezike, how has your department responded to the 
challenges from the onset of the Delta variant?
    Dr. Ezike. So, we obviously had a heads-up because we saw 
the information coming from around the world, and so we knew 
that this virus will find its way, this variant will find its 
way to us. So, we continued the messaging. Masking became 
another important tool on top of the vaccination, and just 
trying to spread through our community Ambassadors as well the 
information that this was a different virus. I kept using the 
line you are talking about COVID-19; we are dealing with COVID-
21 right now. So, you have to understand that this virus has 
changed. It has newer properties, and they are not properties 
that work in our favor, and that is why we had to go back to 
the masking for all, and that is why we had to double our 
efforts for vaccination, understanding that this vaccine, we 
are fortunate that it also still offered protection even 
against this new variant and that the sooner we got as many 
people vaccinated--and, of course, we know this is a global 
issue in terms of vaccination--the sooner we would be able to 
slow the continued mutation and development of new variants.
    Mr. Foster. So it may, in fact, be Aaron Rodgers who is 
that one-in-a-billion person who incubates through his selfish 
decisions, incubates a new variant that could put billions of 
people at risk.
    Ms. Lightfoot. I would be happy to talk about Aaron Rodgers 
all day long.
    [Laughter.]
    Mr. Foster. Really? OK.
    [Laughter.]
    Mr. Foster. That is a little bit outside--let's leave 
Chicago for a moment here.
    Illinois has worked hard to increase the vaccine uptake, 
and to do so equitably. Earlier this year Illinois Governor 
Pritzker launched a $10 million campaign to tackle vaccine 
hesitancy and spread awareness about coronavirus vaccines, and 
although more than 77 percent of Illinoisans over the age of 12 
have now received at least one dose of the vaccine, vaccination 
rates are lagging behind in some parts of the state, and 
particularly the rural areas. This is not unique to Illinois. 
We are seeing it across the country. A recent study found that 
close to 40 percent of rural respondents nationwide were not 
vaccinated or eager to get vaccinated, compared to almost a 
quarter of suburban residents and a little over 20 percent of 
urban residents.
    Dr. Ezike, how will the low vaccination rates in rural 
areas make your job difficult throughout the state?
    Dr. Ezike. Well, we have already seen the effects of the 
low vaccination as we have come off of this Delta surge. The 
area that was hit the hardest was the region that was the least 
vaccinated. We got to the extent in southern Illinois where 
there are literally no more ICU beds--not for COVID patients 
but for any patient. We were interfacing with our Federal VA 
partners, begging for beds that we could transfer patients to. 
We were asking hospital partners in other parts of the state to 
please allow us to transport patients.
    So, we have already seen the effects of the low vaccination 
rates. In fact, when we looked at where we had limited ICU 
capacity, it matched in order--1, 2, 3--in terms of lowest 
vaccinated regions were the areas that had the lowest amount of 
beds and the highest rates, case rates of COVID.
    Mr. Foster. This is a tragedy. Are there any states you are 
aware of that have been more successful at getting their rural 
populations vaccinated, any success stories at all, or is this 
just a problem with where rural areas get their information 
from?
    Dr. Ezike. It has been a very consistent problem, 
unfortunately. When I talk with my colleagues around the 
country that have similar rural populations, part of it is the 
demographic, some of it is politics. We know that everything is 
political, but it has also become, unfortunately, partisan, and 
that has made some people make a decision against the vaccine.
    Even as people have seen family members become ill 
themselves, seen the head of their nursing department die, we 
have not seen people around them say, oh, I guess I need to get 
the vaccine. So, we continue to work with our partners. We hope 
that every day more and more people will make the choice, 
especially as we are talking about third doses for people. 
Those who haven't gotten their first are way behind, and it is 
still not too late to get started on the effort.
    Mr. Foster. Thank you.
    It appears my time has expired. I will yield back.
    Mr. Krishnamoorthi. Well, thank you so much, Mayor 
Lightfoot and Director Ezike. Thank you for your testimony.
    Panel 1 is now concluded and you are both--I was told here 
to use the word ``released.''
    [Laughter.]
    Mr. Krishnamoorthi. I will just say free to depart. So, 
thank you so much again for your wonderful testimony. Thank 
you.
    Ms. Lightfoot. Thank you.
    Dr. Ezike. Thank you.
    Mr. Foster. Thank you very much for everything you do every 
day.
    Dr. Ezike. Thank you, sir.
    Ms. Lightfoot. Thank you.
    Mr. Krishnamoorthi. I now invite the witnesses on our 
second panel to approach the witness table.
    [Pause.]
    Mr. Krishnamoorthi. OK. We are joined today by five 
witnesses for our second panel.
    Dr. Helene Gayle is the President and CEO of The Chicago 
Community Trust.
    Dr. Omar Khan serves as the Co-Chair of the Muslim 
Community Center's Health and Awareness Committee.
    Ms. Martha Martinez is the Supervisor of the Pandemic 
Health Navigator Program at the Gail Borden Public Library 
District in Elgin.
    Mr. Don Abram is a Program Coordinator at Interfaith Youth 
Core.
    And Mr. Ben O'Donnell is an Ironman athlete and coronavirus 
survivor.
    Thank you all for being with us today. I will begin by 
swearing in the witnesses.
    If you could please rise and raise your right hand?
    [Witnesses sworn.]
    Mr. Krishnamoorthi. Let the record show that the witnesses 
all answered in the affirmative.
    You may be seated.
    Thank you again for joining us.
    I should mention that the microphones are sensitive, but 
please speak directly into them.
    Without objection, your written statements will be made 
part of the record today.
    With that, Dr. Gayle, you are now recognized to provide 
your testimony, and you have five minutes.

  STATEMENT OF HELENE D. GAYLE, M.D., PRESIDENT AND CEO, THE 
                    CHICAGO COMMUNITY TRUST

    Dr. Gayle. Great. Thank you so much. I would really like to 
thank you and Representative Foster, as well as Representative 
Clyburn and the other members of the subcommittee, for holding 
this field hearing.
    This year the Chicago Community Trust partnered with the 
Rockefeller Foundation and local partners to develop the 
Chicagoland Vaccine Partnership, so I am going to focus most of 
my comments around this partnership. This work is coordinated 
with the work that you heard from our public sector, and in 
that vein I want to say how grateful we are to have public-
sector leaders like the ones that you heard from who have done 
so much to protect the health and well-being of our most 
vulnerable residents and communities. They have had to make 
some tough choices in order to keep us all safe and healthy, 
and to make sure that equity was at the center of this 
response.
    However, still, although vaccines are widely available and 
effective, many Chicagoans, as you heard, particularly Black 
and Latinx residents, remain unvaccinated. That is why we 
launched the Chicagoland Vaccine Partnership, which is a 
collaboration of more than 170 organizations dedicated to 
building a healthy and resilient Chicagoland.
    The Partnership recently made over a million dollars in 
grants to community-based organizations who could get the 
people that they work with every day vaccinated. These grants 
supported a diverse range of organizations that are deeply 
rooted in their communities, organizations like food pantries, 
churches, youth boxing programs, and violence prevention 
organizations, organizations that are not often thought about 
as part of the public health response.
    The program has developed things like speakers bureaus and 
an ambassador program to help develop the knowledge base among 
trusted messengers. We have hosted convenings with public 
health departments and community leaders to answer community 
members' questions. We have begun a program to help community 
members gain access to public health careers. And now, with the 
vaccines that we have talked about being available for those 
who are 5 to 11 years old, we have declared November a month of 
action to educate families about vaccines and promote 
vaccinations for all.
    Despite these efforts, we know that disparities in vaccine 
rates persist. To better understand why, we worked with the 
research group Mathematica to conduct a survey to talk to 
people in our communities and hear what they had to say about 
the COVID vaccine. Data from the first wave of this survey have 
had some revealing insights.
    First, most vaccinated responders listed doctors, health 
care providers, scientists, and the CDC as the most trusted 
source of information about the COVID vaccine, and most of 
these who were vaccinated were motivated to get vaccinated to 
prevent death and serious illness within themselves, but also 
to protect their households and family members.
    But for unvaccinated respondents, lack of trust stood out 
as the largest issue. While nearly everyone knew where to go to 
get a vaccine and how to schedule an appointment, most of the 
unvaccinated recipients wanted more time to wait and see if the 
vaccine worked, and many believed it was developed too quickly. 
They also worried about getting sick or experiencing side 
effects, and only about a quarter agreed that the vaccine was 
safe or effective.
    The unvaccinated did not trust vaccine information from 
sources like the CDC, scientists, religious leaders, news 
media, or government officials. Only seven percent reported 
trusting Federal Government officials. Only four percent 
reported trusting state and local officials.
    In communities of color, and for Black Americans in 
particular, we understand why there is that hesitancy, and Dr. 
Ezike referred to generations of discrimination in medical 
research and practices that have caused harm and distrust. So, 
we understand why some of this longstanding hesitancy and 
distrust exists. We also know that there are language and 
technical barriers to accessing vaccines in Black and brown 
communities.
    It is clear that we need more than brochures, public 
service announcements, and financial incentives. But equally 
important, we know that we need trusted messengers, one-to-one 
conversations, and persistence in education and empowering 
hard-to-reach and skeptical populations. We need to ensure that 
issues like childcare and paid leave are addressed so that 
people can get the vaccine and deal with any potential side 
effects. And we have to develop easy-to-understand messages 
that describe how the vaccine testing and production process 
was safely compressed into a shorter timeframe while still 
validating and supporting people who do want and need more 
time.
    There is no silver bullet for building trust and overcoming 
the obstacles that are faced in communities with lower vaccine 
rates. We need to meet people where they are and build 
solutions that meet their needs. We believe this vaccine 
partnership can serve as a model to be scaled and replicated 
more broadly and be an important bridge to building trust in 
communities beyond this crisis.
    At the Chicago Community Trust, we have made closing the 
racial and ethnic wealth gap our highest priority. We cannot 
have a thriving economy on the household, community, or 
regional level if we don't do all we can within our reach to 
prevent further harm from the COVID-19 pandemic. Ensuring the 
equitable uptake of the COVID-19 vaccine is key to achieving 
it. It is both the prudent public health response and a 
critical first step toward a just and inclusive economic 
recovery.
    Thank you.
    Mr. Krishnamoorthi. Thank you, Dr. Gayle.
    Now I would like to recognize Dr. Khan for your five 
minutes of testimony.

   STATEMENT OF OMAR KHAN, M.D., CO-CHAIR, MUSLIM COMMUNITY 
        CENTER'S CENTER'S HEALTH AND AWARENESS COMMITTEE

    Dr. Khan. Thank you. I would like to thank Representative 
Krishnamoorthi and Representative Foster, again, for your time 
and inviting us here to speak with you all and share in our 
experiences on the ground at a hyperlocal level, as 
Representative Krishnamoorthi had mentioned.
    COVID has been an international devastation, and many local 
communities have had to step up to disseminate complex 
information and provide accurate and up-to-date statistics from 
reliable and credible resources. It has been a challenge for 
many, including our own communities at the Muslim Community 
Center and The Douglas Center. I am the Co-Chair of the Health 
and Awareness Committee at the Muslim Community Center, or also 
referred to as MCC, which has locations in the northern Chicago 
suburbs, as well as a location in the city of Chicago. These 
locations include mosques, schools, and, at the core, community 
centers.
    I am also the Director of Health and Wellness, 
Administration, and Development at The Douglas Center, which is 
located in Skokie, Illinois. The Douglas Center provides 
community day services for adults with intellectual and 
developmental disabilities. Both organizations play key roles 
in many people's lives, and both organizations had to 
unfortunately close their doors to their patrons at some point 
during COVID.
    Challenges have been faced within numerous communities in 
regards to comprehension of information, sources of 
information, and hesitancy. Many have expressed concern of side 
effects, long-term effects, and the speed in which vaccines 
were developed. Unique challenges that we have identified 
within the two organizations that I work with are language 
barriers, cultural sensitivities, faith-based concerns, and 
with the special needs population sensory challenges when it 
comes to face masks, adhering to hygiene guidelines, and 
comorbidities and chronic illnesses.
    In both organizations we have built relationships with 
local, state, and national-level clinical personnel and 
entities that are credible and have been providing ongoing 
information and guidance that we have then relayed in relevant 
and consumable manners for the given communities. We have had 
numerous successes over time as we have catered to the needs of 
the various communities, some of which include immigrant and 
refugee populations. The unique challenges we have identified 
with those communities in particular have been trust, language 
barriers, literacy challenges, and cultural nuances.
    The greater successes for both organizations include COVID 
vaccines for qualifying children and adults through MCC has 
been an estimated 2,000 patrons and community members. At The 
Douglas Center, an estimated 98 percent of our participants, 
again that are individuals with special needs, have been fully 
vaccinated against COVID.
    We aim to continue in providing support for our community 
members through information, conversations, and actions. Thank 
you again.
    Mr. Krishnamoorthi. Thank you, Dr. Khan.
    Ms. Martinez, I now recognize you for five minutes of 
testimony.

    STATEMENT OF MARTHA MARTINEZ, MANAGER, PANDEMIC HEALTH 
    NAVIGATOR PROGRAM (GAIL BORDEN PUBLIC LIBRARY DISTRICT)

    Ms. Martinez. OK. Good afternoon and thank you for the 
invitation to both of you for today.
    I supervise the Elgin Area Pandemic Assistance Team at the 
Gail Borden Library in downtown Elgin. My team consists of four 
community health workers: Anamaria Mora, Chas Sirridge, Luz 
Purcell, and Sue Tuominen. We are part of the Illinois Pandemic 
Health Navigator Program that is funded through a grant by the 
Illinois Department of Public Health and administered by the 
Illinois Public Health Association.
    We are charged with helping those that have been impacted 
by COVID, specifically the underserved. That might be the 
elderly or others that lack access to the Internet, a computer, 
or a smart device. We work in a very diverse community in 
Elgin, with significant brown populations. Clients are relieved 
when they are able to come in and speak to us in Spanish. We 
also serve the houseless community that visits the library 
regularly. All of the above are residents that are in need of 
assistance.
    We partner with the local health department to work with 
COVID-positive patients who may need services while they are 
under quarantine. We provide food deliveries, disinfectants, 
diapers, and we have even delivered dog food.
    We can be reached in several ways. We have a published 
number for all to call us. We have an email address and a web 
page. We also staff a table in the library lobby for those that 
prefer to walk in and speak to someone directly. Many are 
looking for financial assistance, and we help to connect them 
with other community-based organizations that have funding for 
such requests.
    Early in the year when vaccine appointments were hard to 
come by, we assisted in scheduling hundreds of appointments. As 
the vaccine requests dwindled, we moved to outreach work by 
participating in local community events and making our 
community aware of our services. We have also hosted many 
vaccine clinics at the library, and we will be hosting one this 
Saturday with DNA Healthcare, and we will be offering the 
boosters as well as the new children's vaccine.
    We have helped with lost vaccine cards. We have answered 
questions about the vaccine, and now the boosters. Our 
availability via multiple channels has allowed us to keep up 
with the pulse of the community, both vaccinated and 
unvaccinated.
    Gail Borden Library is a trusted entity in our community. 
People know to come there when they need help, and the staff is 
great at providing that assistance. Our pandemic team fell 
right into place here. We take a nonjudgmental approach with 
our clients and try to match them with the services that they 
need.
    Through familiarity with our daily presence, we too have 
become trusted advisors in the community. We continue to 
promote vaccination in a respectful, non-confrontational 
manner. We have had many clients stop by to thank us for our 
help.
    I would like to share some experiences.
    We helped an 85-year-old man living by himself who was 
looking for a COVID test. Most appointments are done online, 
and he didn't know how to use a computer or a smart phone. We 
made the appointment for him close to home. He didn't use 
email, but he told us that he could access texting. We took a 
picture of his ticket and sent it to him. He was incredibly 
thankful for the assistance. While that was simple for us, it 
was challenging for him.
    Another case we had was a family of eight that came to us 
in the 11th hour. They were desperate because they were facing 
an eviction notice that very same week. We worked closely with 
them to secure funding and to get them back on track with their 
rental payments. They too were happy to be able to stay in 
their home.
    Our team members have literally driven through tornadic 
winds to deliver medications. They have brought victims of 
abuse to the local crisis center. They have secured temporary 
shelter for a client whose utilities were turned off amid a 
heat wave. They have delivered food to families with empty 
cupboards, and they were welcomed by children peering through 
the window whose faces lit up when they caught a glimpse of the 
ice cream bars at the top of their delivery.
    We know we have helped many people negatively impacted by 
COVID. We hope to continue with this work. We hope that we 
continue to be funded for this work. Special thanks to Denise 
Raleigh and her wonderful team at the library, for they have 
supported us throughout this project. Thank you.
    Mr. Krishnamoorthi. Thank you, Ms. Martinez.
    Mr. Abram, you are now recognized for five minutes of 
testimony.

STATEMENT OF DON ABRAM, PROGRAM MANAGER, INTERFAITH YOUTH CORE; 
          BEN O'DONNELLO'DONNELL, CORONAVIRUS SURVIVOR

    Mr. Abram. Good afternoon. Thank you for the opportunity to 
share my own lived and professional experiences with this 
committee, and for the opportunity to highlight the 
indispensable role that faith-based communities occupy in the 
local response to the ongoing COVID-19 pandemic. My name is Don 
Abram and I am a Black queer minister from the south side of 
Chicago. As a spiritual son of the Black church and a native of 
the far south side Roseland neighborhood, the role of faith is 
central to my own story.
    I grew up in a hand-clapping, toe-tapping Black church only 
minutes from my childhood home. Throughout my life, the church 
has served as a spiritual refugee in times of trouble and as a 
resource in the midst of material and financial need. In 
moments of both crisis and celebration, the church has proved 
itself to be a trustworthy, reliable, and present help to my 
family, my community, and I.
    While the particularities of my story are unique, the 
powerful role of faith-based communities in the lives of 
everyday Americans is not. Across the city of Chicago and this 
country, mosques, churches, synagogues, and temples are more 
than houses of worship. They act as community hubs, daycare 
centers, food banks, and even access points for affordable 
housing, critical social services, and quality health care. 
This is especially true for low-income communities of color.
    The robust safety net created by faith-inspired 
organizations often cultivates pathways by which marginalized 
communities can access life-saving resources. This is most 
salient in the case of the faith-based response to the COVID-19 
pandemic, especially in marginalized communities wherein 
marginalized communities suffer disproportionately. I have seen 
the role that faith-based communities occupy as a program 
manager at Interfaith Youth Core. I have seen it up close and 
personal. Early on in the pandemic, as the need for vaccine 
education, literacy, and access ballooned, IFYC equipped 
Chicago-based faith leaders with the tools to launch vaccine 
education events and vaccine clinics in communities that needed 
it the most. Rabbis, preachers, imams, and spiritual teachers, 
from various faith traditions, came together to share best 
practices and to equip themselves to be vaccine Ambassadors.
    Partnering with medical experts, IFYC offered a six-month 
training program that enabled faith-based communities to 
maximize their impact on the ground. Leveraging decades-long 
relationships within their communities, faith leaders became 
instant trusted messengers, educating their parishioners on the 
efficacy of the vaccine and assuaging legitimate concerns with 
fact-based information. Coupling community events like block 
club parties and Sunday services with vaccine clinics, faith 
leaders were able to increase vaccination rates in their 
communities and ultimately helped to save lives.
    As we consider effective strategies to increase vaccine 
uptick in the near-and long-term future, the role of faith-
based leaders must be centered. Investing in a vibrant 
ecosystem of proximate faith leaders, in the city and across 
the country, will ensure that our response to the ongoing 
pandemic is culturally competent, contextually rooted, and 
grassroots focused. Over and over again, faith leaders have 
been proven to be effective bridge builders between local 
communities and health care providers, ensuring a more 
equitable distribution of vaccine education and vaccines 
themselves.
    While we celebrate the progress made on vaccine adoption, 
particularly in marginalized communities, the need for 
education and the dismantling of access barriers to vaccines 
remains a persistent challenge. As I see it, faith leaders are 
best poised to craft community-based solutions and outreach 
strategies that target those hardest to reach. Sensitive to the 
particular and niche needs of their community, faith leaders 
are equipped to meet people where they are, and to address on-
the-ground barriers to vaccine adoption.
    In my capacity as a Black minister on the south side and as 
a faith-based organizer, I am confident in saying that faith 
communities are critical to us defeating the spread of COVID-19 
and to us healing from the loss of friends and loved ones. It 
is incumbent upon us that we resource, amplify, and coordinate 
with faith communities across lines of difference to further 
our progress on vaccine uptick.
    I would like to thank the committee for your time and for 
the consideration of my testimony. God bless you and all of 
those on the front lines of the ongoing pandemic.
    Mr. Krishnamoorthi. Thank you, Mr. Abram.
    I would like to now recognize Mr. O'Donnell for your five 
minutes of testimony.

        STATEMENT OF BEN O'DONNELL, CORONAVIRUS SURVIVOR

    Mr. O'Donnell. Thank you. I would like to thank the 
committee members for the invitation to this hearing today. To 
be able to tell part of my story to keep others safe is an 
honor. This pandemic and virus are still affecting so many 
people, and if my story and ideas can help others, I am more 
than happy to provide that.
    My story starts in February 2020. I had a two-day physical 
at the Mayo Clinic to ensure I was in good health before I 
started my intensive training for my next Ironman, my second 
Ironman Triathlon. Five days later, I went on a business trip 
where I contracted COVID-19. I started showing symptoms on 
February 29. On that day there were less than 1,000 reported 
cases reported in the United States. I was admitted to the 
hospital on March 9 and spent the next 28 days in the ICU 
before being discharged, and over half of those days were on a 
ventilator. I was the first critical case in the state of 
Minnesota, and I was only 38 years old.
    There are multiple reasons that I have the opportunity to 
be here today. One of those is privilege. I was able to be 
treated at one of the top ECMO centers in the world at M Health 
Fairview at the University of Minnesota. I was privileged to be 
the only COVID-19 patient in the entire hospital for that first 
week and that all of their resources were dedicated to keeping 
me alive. I had the privilege to have a wife who is a Ph.D. 
chemist who could have data-driven discussions with the entire 
health care staff on what treatments they might try for me. I 
had the privilege to have a care team that was willing to take 
chances and experiment. I was also privileged to have a body 
strong enough to survive while they were trying to see what 
could be done. And I was also extremely privileged to have 
insurance and a job with disability pay so I was not affected 
financially. I did not lose my home, I did not lose any income 
due to this, and I know that I speak from a place of privilege 
when I say these words.
    That is the first theme of my story. It is privilege.
    The other main theme of my story is science. When I was put 
on ECMO or ECMO life support, it was thought that ECMO would 
not work for the treatment of COVID-19. However, my doctors 
felt that it was my only shot at survival. There was no known 
treatment for COVID-19 yet, so my care team searched the 
literature and found the best treatments that they could at 
that time. If my family or doctors waited until there was 
something 100 percent effective, I would not be here today. As 
it is, I was the first person in North America to be put on 
ECMO while suffering from COVID and survive. Now there have 
been thousands. Also, I was able to recover and complete 
another Ironman Triathlon last May.
    I could spend long minutes talking about the primal fear I 
had when my intubation tube was blocked and needed to be 
removed and deprived me of oxygen for minutes before it was put 
back in. I could talk about the hallucinations while sedated 
that two years later are still crystal clear in my memory and 
probably will be forever. But fear will not help us in this 
situation. Fear will not help us to get people to get 
vaccinated. We cannot use it as a tactic to persuade people 
that vaccination is necessary.
    What we need is proper discourse without fear. We need to 
address people's concerns with the vaccine, not their decision. 
We need to enter these conversations with empathy and not 
judgment. We should not judge people for the decision they 
made, but rather challenge how they came to that decision. 
There are many reasons for the decisions that have been made. 
There are those that cannot afford to take the time away from 
work to get vaccinated or to deal with the side effects, should 
they have any. When the consequence of vaccination means not 
being able to pay rent or mortgage or put food on your family's 
table, the decision is no longer a simple science and fact-
based decision. These are the impossible decisions. When we 
bring empathy to the table, we discuss the barriers and how to 
overcome them. Some of these barriers have nothing to do with 
hesitation but rather ability. We need a way to combat this 
lack of privilege. Once we do that, we can discuss the next 
steps. And to me, the next step, which has been my message 
since my experience, is to follow the science.
    We have plenty of information and misinformation. We have 
plenty of people blaming or pointing fingers at others in order 
to get their point across. The one phrase we throw around too 
much is to ``do your own research.'' This is dangerous. My 
background is that of a scientist. I have a Master's degree in 
Organic Chemistry from the University of Notre Dame. I know 
science and research very well. I spent the first decade of my 
career developing in-vitro diagnostic tests. I even helped a 
colleague develop one of the tests, IL-6, that helped identify 
the cytokine storm that saved my life. I have spent my entire 
career in science, but I am not a COVID-19 expert. I have no 
qualifications to do any research on this topic, and I have no 
capability to do my own research.
    One thing my background does allow me to do is read and 
understand the research and to put it into a translatable 
format for a general audience. Too often, a single line or a 
research article is taken out of context and used to declare 
the entire article or research study really meant something 
contrary to its findings. The world has a large number of 
people that are creating and sharing misinformation. What we 
don't have is enough people who are translating the research in 
full so that it can be consumed by the general population.
    In order to combat vaccine hesitancy, we cannot push the 
science. We need to bring empathy to the discussion to 
determine a way to allow everyone to follow the science.
    Thank you.
    Mr. Krishnamoorthi. Thank you, Mr. O'Donnell.
    I now recognize myself for five minutes of questions.
    Dr. Gayle, you have made a tremendous number of investments 
during the pandemic. What would you say was the investment with 
the highest ROI, so to speak, especially with regard to 
vaccinations?
    Dr. Gayle. Yes. Well, I think this panel has spoken very 
eloquently to the investment in community-based efforts, and I 
think if I were to say where we could scale up and do more, it 
is in these kinds of efforts where people--again, going back to 
the survey that I talked about, the unvaccinated, the issue of 
trust is the biggest barrier. It is not anymore the access, it 
is not anymore the knowledge of where to get vaccinated. It 
really is this issue of trust. And so I think it is by 
investing in people who know their communities both within the 
health system, public health messengers, community-based care 
providers, but also organizations that help people when they 
are not just focused on COVID, these are the organizations that 
have stood with these populations throughout, and these are the 
organizations that they trust.
    We talked about the role of faith institutions, for 
instance. We are involved with, as I mentioned, food pantries, 
other kinds of community-based organizations. These are the 
organizations that people trust. They know how to speak in ways 
that resonate for those populations. And I think the biggest 
thing is we have to realize that there is no one magic bullet 
and that building trust takes time. But building trust is built 
on meeting people where they are and making sure that we are 
also thinking about the broader ways in which their health, 
their households are affected, and being able to give them a 
sense that they are cared about in a holistic way I think is 
why these community-based efforts have made such a big 
difference.
    Mr. Krishnamoorthi. Got it.
    Mr. Abram, is there something that we have learned in 
talking to people about taking the COVID vaccine that could be 
applicable in any other area where we have trouble 
communicating, whether it is violence prevention or any other 
thing? I am just curious.
    Mr. Abram. I think so, and at the heart of what it is that 
we have done at IFYC is hold space for concerns and to approach 
the conversation with humility, recognizing that community 
members and those who work and live alongside them know more 
about the barriers that exist, know more about the 
particularities of concerns that come up in the community, and 
this is something that can be translated across issues, making 
sure that we create infrastructures wherein community can 
provide feedback to those who have resources, and we can, in 
real time, pivot and adjust as needed, because we created space 
for community partners to really show up and ask questions that 
they need answered.
    Mr. Krishnamoorthi. Got it.
    Ms. Martinez, I am always impressed by Gail Borden Library. 
It is really a gem in terms of our library system. I am 
curious, in your outreach to people, have they also become more 
attached to the library because of your efforts with regard to 
getting them to take the vaccine and doing other things with 
the pandemic?
    Ms. Martinez. I believe so, because many of the people, 
especially early on, when people were on the fence about taking 
or not taking the vaccine, I think just through seeing us there 
day in and day out, we I think inspired some confidence in 
them. We would have discussions, we would answer their 
questions, and I think all of that contributed to getting many 
more people to take the vaccine. And as I mentioned earlier, 
just being able to speak in a language to people also gives 
them a sense of relief and comfort and the ability to be able 
to ask all their questions and get answers.
    Mr. Krishnamoorthi. Yes.
    Dr. Khan, is there anything unique to certain minority 
communities--let's just take the example of the Muslim American 
community--that we should be aware of in terms of vaccine 
confidence or the lack thereof?
    Dr. Khan. Yes. Again, when speaking to a number of the 
barriers that we have been able to identify, language, as was 
mentioned, has been an important factor. When you think about 
some of the conservative aspects, when we created the vaccine 
clinics at the mosques in the gym spaces, we were aware of some 
individuals who may want same-sex individuals providing the 
vaccine for them, creating a privacy space for some individuals 
who may not feel comfortable lifting up their shirts or 
removing their shirts, things like that.
    So, we have had to identify those and address those.
    Again, there are the faith-based concerns, is this 
something permissible within our faith to get, what was used to 
make this, were there animal byproducts that were used, things 
like that. We have had to have conversations with religious 
leaders in collaboration with health care professionals to help 
disseminate some of that information.
    So, it has been very important to identify, again, some of 
these barriers and speak to those things in particular.
    Another challenge that I have come across more recently 
when I spoke about refugee and immigrant populations, things 
like that, something that we are going to have to really work 
hard on is a couple of weeks ago, in having a conversation with 
one of the community centers that we work with, we realized 
that there is no particular written language for one of the 
communities that we work with, one of the refugee communities 
that we work with. How is that communication happening? It is 
not something that they are reading online or within social 
media. A lot of it is that verbal communication, the literacy 
issues.
    So, those are things that we are trying to work on, 
translate that via audio, simplify the language, and make sure 
that people are getting the information that they need.
    Mr. Krishnamoorthi. Thank you.
    Congressman Foster?
    Mr. Foster. Thank you. I guess I would like to start by 
echoing my thanks to Ms. Martinez for everything that Gail 
Borden Library does in the community. I have very fond memories 
from representing Elgin for several years, 10 years ago now. 
You have been a beacon of hope and assistance for people in the 
Elgin community for a long time.
    Ms. Martinez. Thank you, sir.
    Mr. Foster. I would like to speak a little bit about 
vaccine hesitancy among parents of young children. Last week we 
achieved a significant milestone in our Nation's fight against 
the coronavirus when the first coronavirus vaccine was 
authorized for 5-to 11-year-old children. Yet, one recent study 
found that only three out of 10 parents of kids between 5 and 
11 plan to vaccinate their children immediately. Misinformation 
is a problem that can harm children even if it comes through 
their parents.
    Dr. Gayle, is there a misconception among some parents that 
the coronavirus is just like the flu and that their children 
are unlikely to be affected?
    Dr. Gayle. Well, I think a lot of the information that came 
out early on that suggested that children were less likely to 
get sick if they got the coronavirus did make parents think 
that this was a less serious issue for children, and I think 
that has persisted and in some ways remains a barrier. So, I 
think the reason why we have to not have parents' hesitancy 
multiplied through their children, get the information out, 
make it very clear why it is so important. We saw what happened 
to our educational system, where children were not able to have 
the kind of access to education as a result of this. This is 
such a huge, huge step forward to be able to now get children 
vaccinated safely and having the data to show that it is safe, 
that it is effective, and that it can make a huge impact on 
households.
    One of the things parents sometimes are not taking into 
consideration is that the risk of their child is then 
transferred to them and the rest of their household. So, I 
think we have a lot of education to do and a lot of correcting 
of misinformation about the impact both at an individual level 
and, as we were talking about earlier, that this is not just 
about an individual, this is about our communities. This is 
about how do we protect our community more broadly than just 
the impact on the individual. Children have a huge role to play 
in that, and I think we have got to do it, and that is why we 
have dedicated November as vaccination month, to get this 
information out to parents so that they can be part of 
protecting whole communities while they protect their 
children's health, as well.
    Mr. Foster. And this is not only an issue for young kids. 
Also, it is an issue in utero, because there is lots of 
evidence that it is very bad for the mother and the child to 
get COVID, and no evidence at all that the vaccine itself poses 
a risk to a child.
    Dr. Gayle. Pregnant women are going to have more serious 
consequences if they contract COVID. So, it is an incredibly 
important issue.
    Mr. Foster. That is right. So, I understand that anecdotes 
are not data, but I would like to present one anecdote.
    This is my grandson here. I became a grandfather on April 
1. And my grandson, who shares my name, was born of a 
vaccinated mom, and he is healthy and happy. And not only that, 
he sleeps through the night.
    [Laughter.]
    Mr. Foster. So, maybe that is another reason to vaccinate 
here, get mothers to vaccinate their kids.
    [Laughter.]
    Mr. Foster. But, Mr. O'Donnell, as a scientist and a 
coronavirus survivor and a parent of a young daughter, you have 
an important perspective on this. What would you say to a 
parent who said that they didn't need a vaccine, didn't need to 
vaccinate their kids, because the coronavirus is less likely to 
be a big deal for the young and healthy?
    Mr. O'Donnell. I was young and healthy when I caught COVID, 
and I ended up in the hospital for 28 days. I know that my 
five-year-old daughter is excited in asking when she can get 
vaccinated, as well. So for me, we can't get to a normal 
everyday life, and we never know what we have genetic 
predisposition-wise to know if we are going to be completely 
fine or if you will end up getting severe side effects, whether 
you are five years old or you are 50 years old. With that lack 
of knowledge out there, the only way we can combat that is that 
we know the vaccine works, and we have to explain how it works 
for people and for their children.
    Mr. Foster. Thank you.
    I guess I am out of time, so I will yield back.
    Mr. Krishnamoorthi. Thank you, Congressman Foster.
    Mr. O'Donnell, I wanted to ask you about this ECMO 
treatment. Tell us a little bit about that. I think for some 
folks--I have heard of it but I am not terribly familiar, and I 
think others would want to learn more about that.
    Mr. O'Donnell. So, ECMO treatment is extra-corporeal 
membrane oxygenation. It is where they take the blood from your 
body and they pump it through an external machine to put oxygen 
back into it because my lungs were so full of fluid that they 
could not oxygenate my blood itself. It is a tube probably 
about the size of my thumb that gets inserted into your jugular 
to your heart to pump blood through it. All of your blood gets 
pumped through it about every two minutes.
    Mr. Krishnamoorthi. I think this is a treatment that a lot 
of hospitals have provided, but a lot have not, as I understand 
it. Go ahead.
    Mr. O'Donnell. It is a very rare treatment. Right now, I 
have moved to Canada, and the province that I live in only has 
one machine or two machines in the entire province. It is a 
high-risk operation and procedure, and there aren't many 
machines globally. The U.S. has a very large number of them, 
but there aren't very many of them outside of major university 
medical centers.
    Mr. Krishnamoorthi. Got it.
    Mr. Abram, what is the number-one piece of misinformation 
that you deal with, with regard to vaccines, that we should be 
aware of?
    Mr. Abram. Based on my experience particularly with faith-
based communities, one of the primary concerns is that the side 
effects would be really overwhelming and could even lead to 
unexpected illnesses or sicknesses, and that is largely rooted 
in a lack of education around the vaccine and messaging that 
suggests it is not safe or effective, which we know goes 
against science. So, we have been working with faith leaders to 
think about creative, innovative, and ongoing ways that we can 
reiterate the efficacy of the vaccine.
    Mr. Krishnamoorthi. But don't they--I guess in that 
situation--at this point we are reaching 75 to 80 percent of 
adults 12 and over who have received the first dose, so most 
families have at least one person. Do they not see those folks 
and say, OK, that person hasn't gotten sick since they got the 
shot? Or is that not persuasive to them?
    Mr. Abram. It is not persuasive, and I think that is 
largely because of the fact that these folks also perhaps exist 
outside of opportunities and spaces wherein they can ask 
questions around the vaccine with specificity. So, getting 
medical experts or folks who are knowledgeable around the 
efficacy of the vaccine to be in conversation with them becomes 
critically important. In that case, household conversations are 
effective. But what we see is that folks aren't always equipped 
with the specific medical expertise or knowledge to be able to 
articulate the ways in which having the vaccine affects 
ultimately your resistance to COVID-19.
    Mr. Krishnamoorthi. Within the Spanish-speaking community, 
Ms. Martinez, who do you think are the most trusted messengers 
for building vaccine confidence?
    Ms. Martinez. Certainly primary care doctors are.
    Mr. Krishnamoorthi. Who speak Spanish?
    Ms. Martinez. Who speak Spanish, yes, and also the clinics 
that they visit often, because many people don't have primary 
care doctors. So, the local clinics where there are Spanish 
speakers. For us, the VNA, the Greater Health are clinics that 
people trust and go to. And certainly pastors are also 
important in either helping move this forward or in holding 
people back from taking the vaccine.
    Mr. Krishnamoorthi. Are there some pastors who hold people 
back?
    Ms. Martinez. Well, in specific, I don't know of specific 
ones. I have heard that there are people or pastors that have 
not promoted it, and I think that is just as bad as not pushing 
it, when you just hold back and don't talk about it, and then 
it seems that it is unacceptable to go ahead and get 
vaccinated.
    Mr. Krishnamoorthi. Dr. Khan, the imams, how important are 
they in spreading the message; and, as Ms. Martinez said, is 
there a concerted effort to make sure they are vaccinated and 
that they spread the message?
    Dr. Khan. Yes, I think those are challenges that a number 
of communities have faced, as well. Not all imams, a majority 
of imams, have a medical or health care background to 
understand a lot of the specifics. So, we had challenges in the 
beginning as well of imams being able to share that 
information. But that is also our responsibility, to help 
educate them. As time has gone on, as we have been able to have 
these conversations, as we are learning more, getting more 
data, looking at the statistics and information, we are able to 
educate those community leaders.
    We have Friday prayers. In Friday prayers, it is the imams 
that stand before the entire group that is there and speak to 
them and provide guidance and advice and things along those 
lines. It is complete silence throughout the mosque while they 
are listening to them. So, it has been very important to have 
those religious leaders and faith-based leaders speak to this 
and assure the individuals from a faith-based perspective that 
it is permissible. There are, again, a number of other 
challenges that come after that when we talk about safety, 
efficacy, and things along those lines. But, yes, it has been 
very important for the faith-based leaders to address this 
head-on.
    Mr. Krishnamoorthi. Got it. Thank you.
    Congressman Foster?
    Mr. Foster. Thank you. I guess there is another thing that 
we run into from time to time that is related to the faith-
based community, which is that you will be trying to convince 
someone to get vaccinated and at the end they say, ``I will 
just leave it up to God.''
    Mr. Abram or Mr. Khan, what is the answer to that? It is my 
understanding that there is a strong tradition in the Abrahamic 
religions across the world that you are supposed to take care 
of yourself and it is part of what God expects from you, and 
yet you find people using God as a reason not to get 
vaccinated. What is your best answer to that?
    Dr. Khan. Yes. I think that a deeper understanding of that 
comes with a deeper understanding of faith. We have heard those 
exact phrases from a number of individuals. And when you look 
at actual scripture, and we speak about the Prophet Mohammad, 
peace be upon him, and the things that he has said and shared, 
you see that you are meant to care for yourself and take care 
of yourself and those around you. It is a responsibility of 
ours.
    We also acknowledge and realize that we have been given the 
intellect and opportunity to grow from an intelligence 
perspective, and research has helped with that. So, we are 
meant to acquire knowledge. When you think about the Islamic 
faith, when we talk about the revelations of Islam in 
particular, one of the first things that you look at is we 
believe that the angel Gabriel had come down to the Prophet 
Mohammad, and the first words he said to him were ``Read'' or 
``Aqra.'' So, to pursue knowledge has been from the inception 
of the conversation of faith for us.
    So, it is really important that we help those individuals 
who say let's leave it up to God, because there are a lot of 
things that we don't just leave up to God, right? We take 
action, and then we can leave things up to God after the fact 
and pray for things. But it is important that we take action in 
protecting ourselves, protecting our family, protecting our 
communities, understanding that we are all one big community 
and things that happen overseas will affect us here as well, 
right? If we think about this virus in particular and where it 
may have originated, people are affected across the world. So, 
we are one big community, and it is important that we don't 
just think about ourselves but those around us as well.
    So, yes, it is very important that we continue to gain 
knowledge and then take action off of the knowledge that we 
attain.
    Mr. Foster. Mr. Abram, how do you respond when you 
encounter that?
    Mr. Abram. So, from within my tradition in particular, but 
this is across religious traditions, there is a sort of 
theological framework that is centered on healing and treating 
your neighbor as you would treat yourself. There is a moral and 
spiritual imperative for us to care for the other, and that 
often is an effective theological framework that we have seen 
faith leaders use to advocate vaccine uptake and education, 
saying we have a responsibility to care for our communities, to 
care for ourselves, and the way that we are able to do that in 
this particular instance is to ensure that we are using our 
God-given intellect and ability and power to be able to 
actually encourage the vaccine adoption.
    Mr. Foster. Thank you. This is sort of what I mentioned in 
my opening statement about there is a scientific question of 
what is best for me, all right? And a second question that has 
very little to do with science, which is what is my duty to the 
rest of humanity, and this is crucial.
    Dr. Gayle, the Chicago Community Trust and its partners 
have worked very hard to figure out what will motivate adults 
to get vaccinated, but are there any transferrable lessons on 
how to motivate parents and guardians of children, 5 to 11 
let's say, to get their children vaccinated? Is there a 
difference in the messaging that is best for that?
    Dr. Gayle. No. Actually, I think a lot of the same 
messaging. It is just really focusing it more on tackling some 
of the misconceptions about the importance of getting children 
vaccinated. A lot of it is that this is new and parents just 
have not had the information that they need. I think it is 
really the same messages in many ways, but really tailoring 
them so that people can understand the scientific basis for why 
getting children vaccinated is important as well.
    If I could just go back to your last question just for a 
second, just to say that one of the things that I have seen is 
most helpful with getting clergy to address this issue is other 
clergy talking to their clergy peers. When faith leaders reach 
out to other faith leaders, they can start turning their 
beliefs around, and I think it is an important strategy. We saw 
it work with the HIV pandemic. We are seeing it work with COVID 
as well.
    So, I think this peer-to-peer education is important not 
only for faith communities but it is kind of what we are all 
saying here, is that peer-to-peer, talking to people who you 
trust is the way to really shift those beliefs.
    Mr. Foster. Thank you.
    My time is up and I yield back.
    Mr. Krishnamoorthi. Thank you, Congressman Foster.
    First of all, I would like to thank our witnesses for 
testifying today and coming all the way from different parts of 
the Chicago area. We have really benefited from your insights 
and your answers to our questions.
    Without objection, all members will have five legislative 
days within which to submit additional written questions for 
any of the witnesses, which will be forwarded to the witnesses 
for their responses.
    I want to say thank you again to the audience. Thank you to 
everybody for covering this and for your attention to this very 
important challenge.
    Now this hearing is adjourned.

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