New 'Immunize Minnesota' coalition hopes to break down public health silos around vaccines

NINA MOINI: A new coalition is working to vaccinate more Minnesotans. It's called Immunize Minnesota, and it's working through advocacy, education, and partnerships statewide to achieve its mission. Joining me now is co-chair of the steering committee, Munira Maalimisaq who's a family nurse practitioner and CEO of the Inspire Change Clinic. Thanks for being with us, Munira.

MUNIRA MAALIMISAQ: Thank you for having me.

NINA MOINI: Would you tell us a little bit more about how this group of organizations came together, and why you wanted to be a part of it?

MUNIRA MAALIMISAQ: That's a great question. Minnesota needs a stronger, more coordinated approach to immunization. And a lot of different organizations were doing it, but just doing it alone and not one single organization can do it alone. We wanted to bring all of them together and Immunize Minnesota does just that. It brings health care, public health, community organization, advocates, health plans, and researchers to work together toward one shared goal, which is protecting all Minnesotans.

NINA MOINI: And one of the organizations, too, to your point about needing sort of everybody to come to the table, one of the members is the Minnesota Department of Health. Can you tell us a little bit more about why it was important to have a government or a policy side to all of this?

MUNIRA MAALIMISAQ: Having MDH be part of Immunize Minnesota was essential and we needed to have it. We wanted to create a coalition that was a cross-sector, and our goal was what brought us together and different perspectives together was what was needed. And support from MDH helps us build capacity. And our work is grounded in that shared principle, which is evidence, equity, access, transparency, and listening to community.

NINA MOINI: With listening to community, what is the biggest concern or some of the biggest concerns that people bring up about vaccines?

MUNIRA MAALIMISAQ: I think it's about giving families time to take the information, and there's so much misinformation out there. And when it gets hard, people tend to blame who's not taking it. And for us, especially with Immunize Minnesota, the focus is not about blaming, it's about understanding and creating resources, which is one of the main reasons why I really wanted to join. It's to help other organizations and where we fall short.

For us, especially for me, I have been doing this work for the last three years, having something called the motherhood circle at our clinic and listening to community, listening to parents, hearing from what they are seeing when they go in to get their well-child checks. And how they need accurate information, because when you get a lot of information coming at you and not all of them are accurate, it is really hard to decipher that, especially if health literacy is an issue.

And for us, being able to bring that information back to Immunize Minnesota and coming up with creative ways that we can be part of that work, and to change it and to shape it and to make sure that we're leading with community voices is very important and creating those tools for them. But mainly it is about understanding, access, trust, misinformation, language, culture, and having communities at the table.

NINA MOINI: As far as measles in particular, as far as immunity goes, we just had a conversation on the program just last week about how Minnesota's kindergarten measles vaccination rate is the third lowest in the country, at about 86% and that it's below the level of herd immunity.

So I'm wondering what you think it's going to take to get Minnesota back up to herd immunity, and why you think there is a particular issue happening with measles. I understand you also lost your sister to measles. I'm so sorry for your loss.

MUNIRA MAALIMISAQ: I did. This was before I immigrated to America. And thank you for saying sorry. But for me, that is why it is important to get the right information out there. The answer isn't shame. It is about trust, it is about access. It is about having conversations with your clinicians and understanding past experience with health care.

The questions and concerns families have are legit. And how do we answer those questions in a way that they feel like they're being heard. And tailoring the care that they need in it takes time. And making sure that we are able to understand that and to show up and to give them the information that they really need and to get ahead of it.

NINA MOINI: Yeah. Will you tell us a little bit more about just what it's like creating relationships with people and how sometimes the door might not even be open to begin with a conversation? I wonder how you approach situations like that when there is not only skepticism, but a true belief.

MUNIRA MAALIMISAQ: This is why it was really important for us to create the motherhood circle. It is not a one time thing. It happens over time. I can't just show up one day and say, oh, this is what's going on, and for everyone to go along with it.

We are hoping, as we build the trust over time, we meet once a month. We talk about anything. We talk about all health. We talk about preventative. What does cervical cancer look like? When should I get-- all of the preventative visits mean but also bringing in vaccines. Vaccines are very important. It is a way to keep all of us our community-- it's a way to protect our communities, unities.

But I can't talk at community. We cannot expect it to come into the room and say, do as I say. But more of walking and understanding their lived experience and giving them information and giving them time. And when I say time, it means if your child is due for MMR, which is a 12-month. Making sure that we start talking to them way before focusing on it, even at the ninth month visit, making sure that you give them the information. You ask them who the decision maker in your family is.

Giving them information about MMR that is culturally appropriate. And telling them that, hey, could call us, we'll answer the questions and keeping those doors open and just not stopping at no, I don't have a question. But leading with more of curiosity. And that is what we would need to do to build vaccine confidence.

NINA MOINI: And I hear you saying talking about vaccines, not necessarily as its own separate issue, but as a part of this holistic approach to all of the different ways that people take care of themselves and their bodies and that of their children. From your perspective, with that in mind, what would it mean or look like for you for Minnesota to have vaccine equity?

MUNIRA MAALIMISAQ: It would be dismantling barriers to immunization access, building vaccine confidence, advancing equity across Minnesota, which Immunize Minnesota, the reason why it was created was that. To ensuring that vaccine access across the lifespan, not just for children. Upholding science and evidence, sharing the resources and speaking with one voice.

And building a culture where every Minnesotan has an opportunity to protect their health and to protect their communities. As we know, Minnesotans take care of their neighbors and making sure that they are aware of what vaccines do.

NINA MOINI: Munira, what's next for this coalition, for this group of organizations working together?

MUNIRA MAALIMISAQ: We have over 10 organizations already. We have approximately 30 individuals that have already signed up so far. And we are bringing together community organizations and patient advocacy. And creating this hub of vaccine information.

I am hoping that we develop more education that is tailored. And we're going to the legislators. We're advocating in that we're making sure that everyone has access.

NINA MOINI: Munira, thanks so much for your time. We really appreciate it.

MUNIRA MAALIMISAQ: Thank you.

NINA MOINI: Munira Maalimisaq is the steering committee co-chair of Immunize Minnesota.