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Colorado still has a gulf between white, Hispanic vaccination rates, frustrating advocates | Coronavirus

By March 4, 2022COVID-19

More than 12 months since the COVID-19 vaccine first arrived in Colorado, the vaccination rate for Hispanic residents is almost half what it is for white Coloradans, a trend that is frustrating but unsurprising to advocates working to ensure equitable vaccine uptake and access across the state.

The gulf between white and Hispanic vaccination rates is the result of access issues, advocates and experts said, and a lack of culturally aware outreach and efforts. It also speaks to broader racial disparities within the health care system, inequities that were laid bare by the pandemic. Nationally, people of color have been more likely to be infected and die from COVID-19 than white people, multiple analyses over the past two years have found. In Colorado, the industries and occupations with the highest COVID-19 death rates employed workers of color at disproportionate rates.

As of Friday afternoon, fewer than 40% of the state’s Hispanic residents are at least partially vaccinated against COVID-19, according to state data. In comparison, 76.8% of white residents are partially inoculated.

The state Department of Public Health and Environment said that Hispanic residents are less likely to self-report their ethnicity when getting vaccinated than other groups, which, the agency said, may warp the numbers. The health department has projected that as much as 47.4% of Hispanic residents in Colorado are at least partially vaccinated. Even if that number is closer to reality, it’s still 25 points below the modeled white rate.

“While our data work is meant to help us gain a deeper understanding of the portion of vaccinated Coloradans who have unknown ethnicity in our data, it also shows what additional work we have to do to reach historically underserved communities,” said AnneMarie Harper, spokeswoman for the health department’s division of disease control and public health response. Communications Director, Division

In an early February brief, the Kaiser Family Foundation found that Colorado has the second-largest disparity between white and Hispanic vaccination rates of any state in the county. At a meeting of the Governor’s Expert Emergency Epidemic Response Committee last month, state officials showed data indicating that Coloradans of color have a vaccination rate that’s 15 points lower than the population as a whole.

Harper said the health department is aware of Kaiser’s analysis and is “learning more about how they’ve collected and analyzed their data. We realize there are disparities in our vaccine uptake, but we are not yet clear how Kaiser researchers determined that level of gap.”

“We really are behind in everything. It’s not surprising,” said Diana Pineda, the CEO of Vuela for Health, referring to broader disparities facing the Hispanic community. “I think this is history, every time. If you check diabetes, we’re the same. If you check overweight, we’re the same. Education, we’re the same. We’re behind all the time, no?”

Julissa Soto, a consultant and community leader who’s worked with the state to improve vaccine uptake among Hispanic Coloradans, was caustic in her assessment. She said “every single clinic” recently organized by the state to reach Hispanic residents “has gone wrong.” She said racially insensitive comments are common – she said she had personally been called a racial slur by someone working with a state mobile clinic – and the scheduling and logistics of events aren’t culturally aware. 

She, too, was unsurprised by the vaccine rate disparity.

“Let me tell you why: Because nobody cares about my community,” she said. “We organize clinics Monday through Friday, 8 to 5, 8 to 12, 8 to 1. Most of us have to two to three jobs. So what time do you want us to get vaccinated, when we need to have after-hour clinics and be available to the communities?” 

Soto said clinics are often not culturally relevant or sensitive to Hispanic residents, and mistreatment at – or distrust for – traditional health care settings and clinics further drive the community away. She said people would rather stand in line for vaccines in cold weather than go to established clinics, where they feel disrespected and insulted.

She said she hasn’t been successful bringing concerns to the state. She praised Tri-County Health Department, which oversees Adams and Arapahoe counties, for holding a culturally aware event at a church last week.

“The solution should be: Let’s go to the communities, let’s go to the hood, to the barrios, where the community is at, let’s show up so happy to see them,” she said.

“It’s a deadly embarrassment that Colorado is still doing so poorly at vaccinating our Latino/Hispanic residents,” said Matt Wynia, the director for the Center for Bioethics and Humanities at the University of Colorado School of Medicine. “While other states have narrowed the gap, or even eliminated it, we have not. We need to do more outreach and make it super easy for folks in this community to get vaccinated. With only about 40% of Colorado’s Latinx population vaccinated, we remain a set-up for future waves of infections in that community.”

Heather Roth, the immunization branch chief with the state health department, said that equity “has been at the forefront of both our planning and our implementation of vaccines.” When vaccine supply was thin last year, she said, the state set aside 15% of its allotments for equity clinics. It launched mobile buses and popup clinics to reach underserved communities, and it reimbursed providers who purchased equipment needed to store vaccines so they could better distribute them to communities who needed doses.

State officials are aware of the disparity, she said, “and we’re not happy with it.” But she said they’re continuing to work to address it. A state spokeswoman said  that, as part of the state’s vaccine equity efforts, “2,161 equity pop-up clinics have administered approximately 523,000 vaccine doses, and 2,830 mobile vaccine clinics have been held in key equity areas, administering 217,000 doses.”

“We know that we’re not going to undo 200 years of systemic racism and inequality in a two-year vaccine response. We’re just not,” Roth said. “But I think we’re being, again, really intentional about creating and maintaining these relationships.”

Soto, Pineda and other advocates and experts stressed the importance of trusted messengers: People familiar to particular communities who are better equipped to answer questions in a culturally relevant way. State leaders have talked of the importance of trusted messengers, too.

Pineda said her organization has helped vaccinate 11,000 people. Early on, requirements for online registration or reliance upon technology – like text messages about appointment availability or eligibility – hurt uptake in the Hispanic community. Vuela for Health began hosting events on the weekends, particularly in churches, to better reach people when they were free. Initially, police were present at events, and Pineda said that – along with concerns about money, insurance and showing ID – kept some people away. Materials weren’t initially available in Spanish or in paper form.

After some residents expressed concern about missing work from short-term side effects of the vaccine, she said, they began offering Friday evening clinics, so people could have the weekend to shake off any lingering effects before the workweek began again. Clinics weren’t left open to the broader public to ensure events set up for communities of color weren’t overtaken by white residents seeking available vaccines.

Pineda said she was “really proud” of her organization’s success. It’s validation, she said, that local organizations are best equipped to serve their communities and that the state should support them in doing so. It may cost the state $10,000 to run one event, she said, but if they give her organization that amount of money, she can do 10.

“In our community, this was a big push, and I think, finally, the state sees us,” she said. “Finally, they see the benefit to work with the community organizations, that we really know our community.” 

Pineda said she had reached out to state government officials so Gov. Jared Polis could visit some of Vuela’s events and thank the volunteer-reliant efforts. She never heard back, she said.

“In one way, I completely understand, it takes time,” she continued, referring to the effort needed to work with distinct communities. “In another way, we’re really frustrated. It’s like, we are here, so don’t wait until you find someone that you can put in your payroll when you can collaborate with organizations. We are the experts in our community.”

Lisa DeCamp, a pediatrician and professor with the Latino Policy Research Center at the Colorado School of Public Health, said grass-roots organizations had worked to their limits to improve uptake in their communities and needed more resources to keep protecting their communities going forward.

She said she thought the state had worked hard to vaccinate the Hispanic population, an effort, she said, that was complicated by lack of access to medical care. The state needs to work now to figure out where the gaps are.

“I really think that there has been that effort there, and now I think we need to drill down and understand, where are the communities that are not being vaccinated?” she said, referring to specific areas within the Hispanic community in Colorado. “These are local organizations I’m aware of. But they serve a particular catchment area. So are there not organizations in parts of the state?”

Efforts likely need to be improved in rural areas, DeCamp said, and in continuing to combat misinformation that’s common across every population in the United States. Regular clinics and events targeted to the Hispanic population and run by community organizations can continue to chip away at the disparity.

For Soto, it comes down to respecting the community, the people best equipped to reach it and the efforts that will most successfully serve it.

“It’s about the messenger, my friend,” she said. “Lots of love. Give me love, man, and treat me with respect. Give me respect, please.”


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