The Centers for Disease Control and Prevention launched the Partnering for Vaccine Equity (P4VE) program to address racial and ethnic disparities in adult immunization rates, particularly for COVID-19 and influenza. In 2021, the P4VE program allocated $156 million to over 500 national, state, and community-based organizations (CBOs) to improve equitable access to vaccination in underserved communities by promoting vaccine confidence and addressing barriers to vaccination opportunities.

Between April 2021 and April 2024, the Urban Institute (Urban) was one of several national organizations participating in the P4VE program in two major roles, including the following:

(1) Group learning manager of the P4VE learning community: The P4VE learning community comprises over 500 hundred national, tribal, and local organizations nationwide working to build vaccine equity. As the group learning manager, Urban cultivated a collaborative environment and facilitated access to timely information, resources, tools, and subject matter expertise to support participating organizations in their vaccine equity efforts, including the following:

• hosting over 140 virtual live and on-demand educational and training sessions tailored to fit the learning needs and preferences of P4VE-funded organizations
• developing and managing the P4VE Community Connector, a private website that had 1,011 member logins while active, which P4VE partners used to exchange ideas, connect with peers, and register for group learning opportunities and resources
• launching and managing three communities of practice, which brought subgroups of partners (representing 134 learning community member organizations) serving a common priority population together to share ideas, foster community, and collectively increase the impact of their vaccine equity projects
• collecting and disseminating promising practices by funding and providing technical assistance to a select group of partners to implement and study strategies to advance vaccine equity

(2) Subgrant manager: Urban provided subgrants, oversight, and technical assistance to 38 CBOs that implemented vaccine equity projects in underserved communities across the US. During the three years of the P4VE initiative, the Urban team conducted over 600 grant management check-in meetings, conducted 31 site visits, responded to over 370 technical assistance requests, and delivered over 500 resources to its CBO subgrantees, including facilitating two in-person convenings and dozens of peer learning activities and interactive trainings.

With Urban support, these 38 CBOs collectively accomplished the following:

• trained nearly 15,000 community members as vaccine ambassadors
• hosted over 3,500 health promotion events
• developed over 27,000 vaccine-related communication products
• educated more than 30.7 million people through communication campaigns
• established over 4,800 vaccination sites
• vaccinated more than 124,000 people against COVID-19 and influenza

Although racial and ethnic disparities in uptake of the primary COVID-19 immunization series narrowed during the pandemic, the uptake of booster shots has remained low overall, and significant racial and ethnic disparities in receipt of booster doses persist. Factors such as health care provider shortages, lack of health insurance, and inequities in community resources across the US pose barriers to equitable access to immunizations for COVID-19 and other common infectious diseases.

The P4VE program was designed to address these barriers by supporting trusted local CBOs through skilled intermediary organizations, such as Urban, to develop culturally and linguistically effective outreach and organize accessible vaccination clinics. Continued progress toward vaccine equity will likely require sustainable investments in affordable vaccines and community-based outreach in underserved communities.