Harvard Fellow on Vaccine Hesitancy, Messaging in Senior Housing

Regulation | February 08, 2021 | by Juliana Bilowich

On a call with LeadingAge members, Dr. Piltch-Loeb, a Preparedness Fellow at Harvard’s School of Public Health, shared tips on vaccine messaging in senior housing communities.

During the February 8 Housing Advisory Group call, LeadingAge hosted Dr. Rachael Piltch-Loeb to discuss messaging strategies for affordable housing providers navigating the COVID-19 vaccine rollout. As the Preparedness Fellow with the Harvard TH Chan School of Public Health, Dr. Piltch-Loeb worked on infectious disease preparedness before the COVID-19 pandemic, including the Ebola, Zika, and H1N1.

LeadingAge’s Housing Advisory Group calls are held on Mondays at 12:30pm E.T. to give affordable housing providers a chance to hear updates and brainstorm challenges and solutions with one another. To join the calls, or to send follow-up questions for Dr. Piltch-Loeb, email jbilowich@leadingage.org or lcouch@leadingage.org.

Cultural- and Fear-Based Vaccine Hesitancy

Because the COVID-19 vaccine was developed quickly and using new technology, many affordable housing communities have seen high hesitancy rates among residents and staff. Dr. Piltch-Loeb explained that because most vaccines are now distributed to children, quickly and broadly convincing adults – including older adults – to adopt the vaccine as a new and critical medical intervention is newer territory and has been challenging.

Housing providers participating in the call identified a variety of reasons for hesitancy at their communities, including cultural-, and fear-based concerns. Above all, Dr. Piltch-Loeb stressed that most concerns around vaccines are valid and should be addressed.

One-on-One Conversations

The call stressed the importance of one-on-one conversations with hesitant residents and staff at housing communities, despite the time involved in reaching hundreds of residents individually. To overcome literacy issues among residents, Vida Wojewski with Catholic Charities shared that her teams are calling each resident as least two times each to discuss any concerns and provide information about the vaccine.

“This is what we do in the trenches,” said Jasmine Borrego, a senior housing provider and LeadingAge member out of southern California. As the President and CEO of Telacu Residential Management, Borrego and her staff have seen close to 100% resident participation rates at some of their community vaccine clinics.

Individual and Collective Messaging

If housing providers are able to reach residents one-on-one to address vaccine concerns, they need a plan for what to say, and some cultures have been found to respond better to different kinds of messaging.

To best reach the various cultural backgrounds that may be represented at a housing community, Dr. Piltch-Loeb recommended using a variety of strategies, including both individual and collective messaging:

  • Individual messaging – “Getting the vaccine will protect you and help you get the crisis sooner and safer”
  • Collective messaging – “Getting the vaccine is a critical step to help our community get through this pandemic”


Many providers on the call shared experiences of hesitant residents and staff looking to housing property leadership to take the first step of getting vaccinated. Dr. Piltch-Loeb cautioned that while it is helpful for community management to set a positive example, the success of this strategy can depend on the level of trust that exists between residents and leadership.

For example, this strategy can be less effective if the formal leadership at the community look differently than residents in terms of age, race, and ethnicity. In these cases, Dr. Piltch-Loeb recommended counteracting fear-based concerns by identifying an informal leader at the community, whether that’s a staff person that interacts regularly with residents, or even a resident “leader,” who can set a strong example for others.

Community Policies Post-Vaccinations

With affordable housing residents and staff eager to return to more relaxed community policies, Dr. Piltch-Loeb was careful to caution providers not to change policies too soon. As a tool in the toolbox, the COVID-19 vaccine is not enough to protect the community and must be continued to be paired with other infectious disease control measures, like mask-wearing and distancing, at least until greater levels of immunity are built up across the country.

However, Dr. Piltch-Loeb shared that while the practical impacts of getting vaccinated will be delayed, the mental health impacts will happen sooner: Communities will be able breathe easier because the chances of adverse outcomes due to COVID-19 reduces with each person vaccinated.