Abstract
Objectives. To evaluate a community health worker (CHW) intervention to decrease COVID-19 vaccine uptake disparities in historically disinvested communities of color. Methods. The New York City Health Department partnered with community-based organizations that served 75 zip code‒defined communities targeted for rapid response intervention. Analyses used community demographic and COVID-19 vaccine uptake data. Linear regression models evaluated high and low CHW outreach on community vaccine uptake between July 1, 2021, and June 30, 2022. Results. Of 75 communities, 65 (85%) experienced high CHW outreach, which prioritized trauma-informed engagement with 4.2 million Black and Latino community residents. On average, residents were 70% Black and Latino. Significant differences existed between high and low outreach communities for baseline community COVID-19 vaccine uptake (44% vs 59%; P < .001). CHWs provided vaccine information to community residents 18 million times and increased community vaccine uptake from 44% to 76% (P < .001) in 1 year. Conclusions. This research expands the body of evidence documenting the essential role played by CHWs to change population health behaviors. Public Health Implications. Response readiness during public health crises relies on pre-established trust. When this is lacking, CHW outreach can bridge the gap. (Am J Public Health. 2025;115(6):910-919. https://doi.org/10.2105/AJPH.2025.308039).