COVID Campaign 101: How Holy Cross Used the Spirit of Competition to Achieve a 90-plus Percent Campus Vaccination Rate

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By Stephanie Schorow for the Global Mass Vaccination Site Collaborative 

Aug 20, 2021

One of the looming challenges in mitigating the spread of COVID-19 and its variants is the return of thousands of college students to campuses around the country this fall. Many universities and colleges require students to be vaccinated and tested weekly; others are taking additional steps to prevent outbreaks on campus and in nearby communities. Yet concerns linger about COVID-19 outbreaks among students. 

An example of a successful campus COVID-19 vaccination effort was highlighted at the Aug. 20, 2021, meeting of the Global Vaccination Site Collaborative. Presenters illustrated how a carrot-and-stick campus vaccination campaign at the College of the Holy Cross in Worcester, Mass., resulted in more than 90 percent of the student body getting the vaccine. 

Liz Drexler-Hines, MPH, director of Student Wellness Education, and Kelsey DeVoe, FNP-C, director of Health Services and a nurse practitioner, presented on the efforts at Holy Cross, an undergraduate college of about 3,000 students, about 57 percent of them from outside Massachusetts. 

In fall 2020, Holy Cross students, like many college students, were taking classes remotely. In spring 2021, they returned to in-person classes and dorm life. Even before vaccines were available to college-age students, a community-wide education program on vaccinations was launched. On May 1, 2021, the first vaccine clinic was held, and about 400 were vaccinated. Some students took the initiative to go home and get vaccinated; others said that “they would get around to it,” said DeVoe. 

Drexler-Hines said she consulted directly with students themselves to come up with incentives for a major campus vaccination push. “The students and I spent a long time breaking down the headlines and trying to target misinformation and putting school policy in easy-to-grasp language,” she said. They opted to create a campaign that would emphasize how vaccinations would allow students to mingle and socialize – something disallowed the previous semester. Students were also worried about the timing of the vaccines – for example, if they got a shot and fell ill during finals. In response, on-campus clinics – allowing walk-ins without appointments – were held and proved to be popular. Students were particularly happy and comforted to see campus health officials were running the vaccine clinic. Students realized “they were making their home safer,” DeVoe said.

Another successful technique was the use of student health ambassadors, or volunteer peer educators. About 30 students were trained to regularly engage in encouraging health behavior, how to navigate difficult conversations, explain campus policy, and provide hand sanitizer and masks.

In weekly meetings, core ambassadors filed reports which allowed the school to keep track of what was going on under the surface, such as problematic off-campus parties, Drexler-Hines said. The ambassadors, who worked with students one-on-one, quickly developed their own sense of community. Even so, from August 2020 to May 2021, about 300 students tested positive for COVID-19, about 600 students were placed in quarantine, there were four dorm lockdowns, and two campus-wide lockdowns.

Later in May 2021, a vaccine mandate was announced, with a July 15deadline for at least one dose. But Holy Cross health officials wanted to incentivize students, not just punish them with expulsion. So they came up with campus-wide vaccination “challenge” to ensure a high vaccination level. “We asked students: ‘What are you most looking forward to if we can end COVID restrictions?’” said DeVoe. In addition to generally missing being together, students noted that they were sad that a concert planned for the spring semester had been cancelled.

So the HCOurShotChallenge was launched. If the campus could collectively reach 90 percent of the population having uploaded documentation of at least one dose by July 15, a fall concert would be held. The first class to hit 90 percent would also win a coveted VIP food truck experience. A large boost in posting vaccination documents followed. On June 25, a simple yet visually appealing dashboard was created, and 50 percent of the students reported at least one vaccination. With reminders, videos, and social posts, vaccinations for the campus community reached 82 percent by July 14, a day before the deadline.

Text alert reminders to get vaccinated were sent. By 9 a.m. on July 15, the total was 89 percent; the senior class hit 90 percent first. By 1:45 p.m. the campus reached 90 percent. Currently the campus is at 96 percent of students having one dose and 92 percent fully vaccinated. About 100 students applied for waivers.

“Our contest really had a large impact on our students,” DeVoe said. “The biggest boost we got was when we pulled in the students and asked, ‘What do you need to be vaccinated?’” 

“But then: Delta.”

By July 20, the campus had its first breakthrough COVID-19 case from a vaccinated person who had been traveling. On Aug. 16, an indoor mask mandate was re-instituted, which made students – who had been told “Get Vaccinated and You Won’t Have to Wear a Mask or Be in Quarantine” – feel a bit like they had been subject to a “bait and switch” trick.

“We really had to work on our communications,” DeVoe said. “We announced the mask mandate without any explanation so we had to follow up and explain that we need to have a safe start.”

She hopes that there will be an easing of restrictions as time goes on, although the situation with boosters adds another complication. The campus will host both flu and COVID-19 vaccination clinics monthly. “Holy Cross will be a pretty safe place to be this fall,” DeVoe said.

Key Takeaways for Campus Vaccination Campaigns

  • Keep it simple. Have easily recognizable incentives for vaccinations.
  • Work with partners and stakeholders, such as student government leaders, the college communications department, student ambassadors and senior administrators. 
  • Meet students where they are – which is usually by social media and text messaging. Parents read emails – students are more likely to read texts.
  • Positive peer pressure really works, even with young adults.

The Global Mass Vaccination Site Collaborative was launched as a way for stakeholders directing vaccination campaigns around the world to come together and learn from each other’s efforts. This blog series was created to record and share the learning and insights gained from this collaboration. Read blogs from our previous meetings here.