Vaccine gap plagues Oregon’s effort to protect Latino communities

By Amelia Templeton (OPB)
April 15, 2021 2:01 p.m. Updated: April 16, 2021 4:30 p.m.

The choices that helped get older Oregonians and other groups vaccinated quickly slowed vaccinations in Latino populations.

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Latinos in Oregon are more likely to be essential workers. They’re more likely to have gotten COVID-19 in the last year. And when you adjust for their age, they’re more likely to have been hospitalized because of the virus.

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But they have the lowest vaccination rate of any racial or ethnic group in Oregon.

13% of Oregonians identify as Hispanic or Latino, according to the U.S. Census. Just 6% of the people who’ve been vaccinated in Oregon so far are Latino, according to the Oregon Health Authority.

A recent analysis by the Kaiser Family Foundation found Hispanic people in Oregon were only half as likely to have been vaccinated as whites — mirroring a national disparity in vaccination rate

State public health officials acknowledge the gap.

“What you’re raising is an unacceptable inequity,” said Rachel Banks, director of public health at the Oregon Health Authority.

Banks said the OHA is committed to closing the vaccination gap for Latino communities and is funding more than 100 groups in an effort to reach Latinos and other underserved populations.

Meanwhile, some of the same community groups that OHA has partnered with say the state is still moving too slowly allocating vaccines — and resources — to clinics, pharmacies and organizations that work with Latino communities.

They fear the gap will only worsen when vaccination opens up to all Oregonians 16 and older on April 19, and they are holding a press conference Thursday to ask the public — state leaders — for changes.

“It’s not secret sauce or rocket science, It’s about getting more vaccines to those places faster, and having more of the community partners in those places,” said Tony DeFalco, executive director of Latino Network.

Problem starts with prioritization

Vaccine hesitancy doesn’t appear to explain the gap: Nationally, 18% of Latinos say they will not get vaccinated or will only get the shots if required, similar to the 20% of whites who say the same, according to March polling by the Kaiser Family Foundation.

The vaccination gap in Oregon started with decisions Gov. Kate Brown made, based partially on CDC guidelines, about which groups to prioritize when doses were scarce in December, January, and February, according to both OHA and its critics.

A broadly defined group of health care workers went first, followed by educators and childcare workers.

“We saw some of these differences in who was getting vaccine pan out really early on, in those initial phases, based on who was in that workforce,” Banks said.

Latinos are dramatically underrepresented in both health care and education. They are just 5% of the total healthcare workforce in Oregon, for example, underrepresented in every field: dentistry, medicine, nursing, physical therapy and pharmacy.

Another reason who is eligible for the vaccine in Oregon may be contributing to the gap: age requirements. People 16 and under can’t get vaccinated, and Oregon, like every state prioritized those 65 and older — the population most likely to die from COVID-19.

Latinos are younger than the general population. Roughly half of the Latinos in Oregon are under 24.

“It almost was a perfect exclusion of our community,” DeFalco said of the state’s initial eligibility criteria.

Meanwhile, advocates for the Latino community say the state acted too slowly to make other essential workers, including migrant workers and agricultural workers, eligible.

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In February, public health departments and county commissioners in rural parts of the state, where thousands of Latino agricultural workers live, grew frustrated as the growing season drew closer and the state redirected their doses to urban areas that were still vaccinating health workers.

Statewide, essential workers became eligible April 5. Farmworkers became eligible in most counties a few weeks earlier.

Banks says the state has tried multiple strategies to get the vaccine to agricultural and food processing workers quickly.

In early March, it launched a pilot program that allowed seven federally qualified health centers, which work with migrant workers and people without insurance, among other groups,

to vaccinate all their patients, regardless of their eligibility group. That program later expanded to include all federally qualified health centers statewide.

In recent weeks OHA has worked with FEMA to bring vaccination clinics to Morrow and Malheur counties, two places with low vaccination rates and significant populations of Latino farm workers.

OHA has also surveyed agricultural employers to identify workplaces interested in hosting vaccination events.

Another challenge: Navigating a largely online system

Today, essential workers are all eligible for vaccination, and more appointments are opening up at mass vaccination sites and pharmacies.

But barriers to getting vaccinated remain in place for many Latinos.

Access to the state’s online registry and the multiple online appointment scheduling systems has been among the biggest obstacles.

“For our community, we can’t just send someone a link and tell them to register. Number one, they don’t just speak the language and read the language. They don’t have a computer,” said

Maria Caballero Rubio, director of the Centro Cultural, a community group in Washington County working with Latino families in need and undocumented immigrants.

Beyond difficulties signing up online, the unfamiliar location and bureaucratic feel of mass vaccination sites like the Oregon Convention Center may make some Latinos, particularly undocumented people, feel uncomfortable or unsafe, according to DeFalco.

“Add on to that you’ve got the potential for showing ID, or some armed security presence in those facilities, and that automatically starts to subtract the number of people there,” DeFalco said.

The convention center site is run by Legacy, OHSU, Providence and Kaiser Permanente. Providers say they have made an effort to provide greeters and signage in Spanish, but acknowledge the barriers cited by community groups.

“We are aware that the mass vaccination site is not right for everyone,” said Michael Foley, spokesman for Kaiser Permanente Northwest. “Each of the participating organizations are engaged in additional efforts to address equity.”

Kaiser, for example, is giving $1.1 million to help federally qualified health centers fund their vaccination work.

OHA and county public health departments are distributing vaccine doses to community health centers and supporting hundreds of smaller pop-up clinics with community partners.

Centro Cultural received support and vaccine allocations from Washington County and the Virginia Garcia Memorial Medical Center, an FQHC, to help get their clients vaccinated.

But the work is slow going. Caballero Rubio says the pandemic has made community outreach and education harder and more time-consuming because it can’t happen at in-person gatherings.

Five of her staff are essentially running a mini-call center, booking vaccinations for people over the phone.

“For the most part people are anxious to get it, in particular elders,” she said. “We have not had an issue with people hesitating to take the vaccine.”

DeFalco said there are plenty of examples of good work being done at the county level to get COVID-19 vaccines to the Latino community. Now, he says, with a fourth wave of cases underway, it’s time to scale that work up.

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