The Vax Gap
The “vax” is here. I am not sure what that means, but a vaccine for Covid-19 is being rolled out across the country. As an 18 year old, I am not eligible yet, but my grandfather in California, currently 85 years old, has already gotten the first of two shots; and my mom, 55 years old, is getting her first shot today. She told me there was New York Times article a few months ago that indicated it would be November before she got a vaccine because of her age and health status, but evidently, the vaccines are rolling out at a much faster rate than originally expected.
I talked to Gregg, my boss from my summer construction job, yesterday to find out if he was also in the queue to get his vaccine. He told me he had not been able to navigate the online system to sign up. He said it was complicated and none of the sites he had tried online had presented a clear path for him to make an appointment. I knew that his construction company had had a few “breakouts” of Covid cases over the past 6 months. Not enough to shut a job site down, but certainly enough cases to delay work and complicate scheduling. I asked about getting vaccines for his staff and he laughed. If he was having trouble figuring out the system, how were his Hispanic employees going to figure it out? He said only a few of them had computers at home and navigating the vaccine process on a cell phone was impossible.
This afternoon, I got online and feigned being an adult male in my fifties. I wanted to see how difficult it was to make an appointment. I started by searching Covid vaccine and for at least 5 minutes could ONLY find testing sites. I didn’t want a test, I wanted a vaccine. I finally found two organizations that had vaccine sign-ups. One of them only gave 3 days of appointments and had hundreds of appointments about 90 miles away, and no appointments within 20 miles of my location. The other site took me nowhere but “around and around”. When I thought I had finally found an appointment, it was suddenly no longer available.
I just got off the phone with Gregg again and told him that it wasn’t him. I had the same issues and frustrations with the vaccine process. We laughed a bit and then he said something that hit me hard, the impetus for this post. If he can’t sign up as an educated white male, how are his employees going to navigate the system? He told me they needed the vaccine more than he did. He explained that they live communally and even if he is able to keep them separated at work by 6 feet and wearing a mask, the minute they went home, masks came off and the extended family was together.
I know all of this innately. I have been to my co-worker’s houses. I’ve been to BBQs and shared meals, but it didn’t dawn on me that this population was much more at risk for contracting Covid because of their living situations. And on top of that, much less eligible or able to get the vaccine.
I went online tonight and found a telling article from the New York Times wrote a few days ago (1). The article states that “Hispanic people across the United States continue to be especially underrepresented among those vaccinated for Covid-19”. The article went on to say that the Hispanic share of the vaccinated population is less than the Hispanic general population in all states with large Hispanic communities. New Mexico, Texas, California, Arizona, and Colorado had the largest gaps between the percentage of Hispanic vaccinated populations and general populations.
“The barriers to vaccine access faced in many Hispanic communities — alongside the structural limitations communities of color generally face — stand in the way of higher vaccination rates, even as the vaccine becomes more widely available, according to public health experts and community health organizers.”
As my boss had pointed out in our conversation yesterday, they also blamed limited access to the digital tools needed to secure an appointment as a huge barrier. “Our folks don’t have emails, they don’t have computers at home,” said James Rudyk, executive director of the Northwest Side Housing Center in Chicago, which runs vaccine clinics in Belmont Cragin, a largely Hispanic neighborhood. “They have smartphones, but they are not navigating registration systems that want you to fill out pages and pages of information.”
They also cited that the lack of information about vaccine eligibility and registration in Spanish as a major issue. I found this true in my own experience trying to make an appointment. There were NO options in Spanish on either of the sites I spent time on. According to the article “people didn’t even know that there was a vaccine” said Gilda Pedraza, the executive director of the Latino Community Fund in Atlanta, which called hundreds of older Hispanic people in late February to organize a vaccine clinic, before the state health department had posted eligibility information in Spanish.
The third hurdle to vaccine access for the Hispanic population is the cost of healthcare and healthcare insurance. A huge percentage of the Latino community is less likely to have healthcare (as I discussed a few weeks ago and need to investigate further). As a result, members of this community aren’t aware that the vaccine is free. One of the contributors of the article said that surveyed Latinos expressed concern about the cost of the vaccine. I am also sure many of them don’t have time off during the workday to get the vaccine or can afford to take time off if there are any side effects from the vaccine.
In a Los Angeles Times article written last week, they concur that there is a vaccination gap (2). The article stated that “just over 3% of Latinos in the county have received at least one dose of the vaccine, compared with 10% of white residents, according to county statistics”. The LA Times article brought up a few other barriers I had not thought of. They attributed low vaccination rates to difficulties of traveling to the appointment (if they were able to make the appointment online). They also cited that the Hispanic population was more suspicious of the efficacy of the vaccine because they did not have access to research or information about the vaccine.
According to California State data more Latinos become infected with the coronavirus, more are hospitalized and they died at higher rates than any other ethnic group. I was really impacted by a quote in the article from Bernadette Boden-Albala, a professor of public health and the founding dean of the Program in Public Health at UC Irvine. She said that her findings “provide evidence of deeply rooted health inequities that exist even in affluent counties.” She went on to say “COVID-19 is the disease of disparity. If anything, what we’ve learned from this horrible epidemic is there’s got to be a paradigm shift in public health — what it stands for and how to approach it so we don’t have health equity issues again.”
I do understand that our current pandemic is very changing. New research is emerging by the minute, but that does not change the fact that we need to lower the barriers for our Latinos communities to gain access to information and to vaccination itself.
I have a few off-the-cuff ideas however, I still contend that the largest hurdle remains access to healthcare. I don’t think that would solve the issue with vaccine availability. There are still language barriers, transportation barriers, and technology barriers but healthcare reform for our underserved populations would go a long way.
As stated in a previous blog, employer-mandated insurance for all employees and subsidized healthcare for spouses and dependents
Increased federal and state funding for Community Healthcare Clinics to provide less intimidating, easier access to acute care
Governmental investment in multi-lingual educational collateral: printed, video, digital and auditory.
In my next blog, I am committed to doing additional research specific to healthcare reform as it relates to education, access, and coverage.
New York Times: What’s Behind the Hispanic Vaccination Gap? By Amy Shoenfeld Walker, Lauren Leatherby, and Yuriria Avila. March 29, 2021
2. LA times: Despite months of alarm, many O.C. Latinos are still unvaccinated. By Hannah Fry. March 23, 2021