Juanita Ruiz, 99, wasn’t nervous about getting jabbed with a needle to protect her from COVID-19 as long as her son, Jose Garcia, was close by.
“My mother will turn 100 in June,” Garcia said. “When my wife told me there was going to be this first-come, first-served vaccine clinic, I got mom over here right away… We want to make sure that she is protected and as soon as we’re eligible we’re all going to get the vaccine to make sure that we are protected and we’re also protecting her.”
Garcia and Ruiz were at a pop-up clinic staffed by Reno Fire Department medics at the Neil Road Recreation Center in March, when immunizations were limited to people older than 65. Now that vaccines are available to anyone 18 and older, more neighborhood clinics are planned to get shots in arms as quickly as possible.
Speaking the language
Latino communities have been among the hardest hit by the COVID-19 pandemic. Local volunteers use a wide range of methods to educate people about the virus, the safety of the vaccines, and to make it convenient for Latinos to get vaccinated, said Ivet Contreras of Reno, who has been doing community outreach work throughout the pandemic.
The effort to reach minority communities “has to be culturally competent and not just a translation,” Contreras said. “It has to be sent in a lot of different ways, by people with insight into the community, and who have relationships with trusted messengers in the community.”
Since the start of the pandemic in March of last year, minority communities have been disproportionally affected by the contagion. Latinos, for example, currently comprise 29.5% of COVID-19 cases in the United States, second only to non-Hispanic whites (49.7%), according to Centers for Disease Control data on April 14. The U.S. COVID-19-associated hospitalization rates for Latinos were 3.2 times high than the rate among whites, according to the CDC.
In Nevada, Latinos comprise 29% of the population, but account for more than one-fourth (25.7%) of COVID-19 deaths. Hispanics and Latinos are 1.7 times more likely to contract COVID-19 than their non-Hispanic white counterparts, as well as 4.1 times more likely to be hospitalized from COVID-19 and 2.8 times more likely to die from COVID-19, according to the CDC.
Contreras and others have been working to educate residents about COVID-19; the need for safety precautions and virus testing; and focusing on getting the messages to Spanish-speaking residents.
A Kaiser Family Foundation poll found that a general willingness to get vaccinated against COVID-19 has gone up since December. But there’s still hesitancy, most notably among Blacks and Latinos, with more than half of Latino adults surveyed saying they were in no rush to get vaccinated. Minorities in Washoe County are being vaccinated at a lower rate than their share of the population. Rates for Latinos show an especially large disparity in the numbers.
“The main worry about vaccines that I’ve heard is the safety of it; people worry that it was rushed through the approval process,” said Christabell Sotelo, epidemiologist with the Washoe County Health District.
Sotelo said she counters those concerns by explaining that the technology behind the vaccines is decades old and was developed to counter other new virus outbreaks. Often, she said, people tell her they want to wait and see how others fare with the inoculations.
More recent surveys indicate that as more and more people get vaccinated, the “wait-and-see” response dwindles, but the percentage of those who say they will “definitely not” get the vaccine, at 13%, has remained steady since December.
Conspiracy theories and a general mistrust of the government also play a role in vaccine hesitancy.
“People hear lot of misinformation. There are all these conspiracy theories about microchips and nanotechnology. It’s difficult to push against those campaigns; they feed into the mistrust of the government that people already have.”– Christabell Sotelo, Washoe County Health District epidemiologist.
Undocumented people also often are reluctant to get the vaccine because they fear having anything to do with a government program that could draw attention to their status, or think taking advantage of the inoculations will bar them from achieving legal residency in the U.S.
Sotelo notes that both the federal government and the state have decreed that information gathered in COVID-19 testing or vaccinations will neither be shared with immigration authorities nor affect anyone’s eligibility for legal residency. Still, Sotelo said, fears often persist.
Educating by example
Efforts to overcome vaccine reluctance in minority communities must come from within those communities, she said. “Testimonials are important,” she said “People see someone they know and they trust getting the vaccine and explaining why it’s important and that can overcome fears. It’s a community effort.”
Sotelo said there’s a fine line between educating people and trying to force your own views on them. “When people ask me if they should be vaccinated or say they are worried about it, I describe my own experience,” she said. “I tell them how I got my shot, waited 15 minutes to make sure there were no reactions and then went about my day. I had a bit of a sore arm; that’s it.
“I tell them I think it’s really important to get it right now, considering how fast we’re opening up,” Solelo said. “I offer my experience and they make their own decisions.”
Across all platforms
Such testimonials have been part of the outreach efforts in minority communities. Sotelo, Contreras and others have been focused on getting accurate COVID-19 information out to the area’s Hispanic residents during the last year.
“We still have work to do,” Contreras said. “We want to reach everyone in every way we can. The county’s 311 (information) line has Spanish speakers available. Websites have been translated into Spanish not by Google Translate but by native speakers. Spanish language radio and TV stations carry the messages, and billboards in Spanish have been up in several neighborhoods.”
Spanish language Facebook pages were created or pressed into service to promote campaigns about COVID-19 awareness, including Mi Motivo, run by Maria Davis, a Reno Spanish translator; Pongamos De Nuestra Parte (“Let’s Do Our Part,” an offshoot of the existing “Mask on. Move 0n” campaign), an effort by Washoe County; the Latinos de Nevada page; a page by Luis O Latino, a photographer at KRNV Channel 2; and others.
“People in our community love face-to-face communication, but the pandemic has made that difficult,” Contreras said. “We knew that Facebook is the primary platform used by Latinos, so that’s one way we’re getting the word out.” Many people aren’t digitally connected, she noted, so TV, radio, billboards, businesses, churches and direct mail also help get the messages into living rooms and workplaces.
“Five hundred packets were mailed in Spanish and English to introduce the Pongamos De Nuestra campaign last year and fliers were delivered to businesses around Wells Avenue,” she said. “Then 200,000 bilingual mailers were sent out.”
Part of the outreach strategy is using “trusted messengers,” including Latino clergy, medical and other professionals as well as community leaders and business owners, to get the word out. Their testimonials explaining why they got immunized and why it’s important for everyone to get the shots are featured on Facebook pages and videos.
“The average age of Latinos in northern Nevada is between 30 and 32 years old and a high percentage are connected to the digital space,” Contreras said. “The younger generations also are a source of information for their older family members and it is very common to have multigenerational homes, so information on platforms on Facebook are a very popular way of reaching this demographic directly and indirectly.”
The campaign also is promoting resources such as the Immunize Nevada’s vaccine locator.
Faith community involved
Father Jorge Herrera, pastor at Saint Francis of Assisi Parish in Incline Village, was part of two town hall presentations about COVID-19. The Catholic Diocese of Reno is sharing vaccine information among its churches and flyers posted at Little Flower Church helped bring people to the vaccine clinic at the Neil Road Recreation Center. Protestant churches with large Latino congregations also have joined the effort.
“Coming up, we have a partnership with the Mexican Consulate to provide vaccines,” Contreras said.
The racial disparities seen in COVID-19 cases and deaths also carry over into vaccine distribution rates. Overall, across the 43 states where such demographic data us available, the vaccination rate among white people is 1.7 times higher than the rate for Hispanic people (32% vs. 19%), and 1.6 times as high as the rate for Black people (32% vs. 20%), according to the Kaiser Family Foundation.
Contreras cautioned that comparing local vaccine rates to total population may be misleading, because for more than a month only older people were eligible for the shots. The ethnic gap in distribution will narrow now that people aged 16 and older are eligible for the inoculations, she said, and “once those numbers come in I think the data will present a better picture.”
“We tested a variety of potential incentives, messages, and pieces of information that might be used to increase vaccination uptake. We find there is a role for convenient access to vaccines in medical settings; about half of those in the “wait and see” group say they would be more likely to get vaccinated if the vaccine were offered to them during a routine medical appointment.”– Kaiser Family Foundation COVID-19 Vaccine Monitor Report, March, 2021.
The outreach effort will continue to stress precautions and testing, educate people about the vaccines and make it as easy as possible for people to get the shots, she said.
“The information will come from everywhere and it needs to come from people who are trusted,” Contreras said. “I’ve seen that working. A local survey showed that a high percentage of Latinos said that when the opportunity comes they will get vaccinated.”
A reachable goal
The Neil Road clinic is an example of the campaign’s success, she said. Previously, about 10% of people who came to clinics were Latino, but the rate was 35% at the March clinic.
The campaign’s most recent town hall event, carried on Facebook Live, had 2,200 viewers, she noted.
“We’re meeting people where they are and making it as convenient as possible for them to get the shots,” Contreras said. “Our goal is get 100% of the people who want vaccines to get vaccinated… What’s happened so far is just the beginning of our vaccine outreach get to herd immunity so we can end this pandemic.”