The Congressional Hispanic Caucus is calling on governors to follow guidance from the Centers for Disease Control and Prevention to prioritize food and agriculture workers in the vaccine rollout.
In a letter sent to the National Governor's Association on Wednesday, the caucus made an urgent case: Latinos make up more than a third of the workforce in those industries, yet they account for nearly three-fourths of confirmed coronavirus cases in the same sectors.
"The COVID-19 pandemic has highlighted long-standing health, economic, and social inequities that continue to disproportionately impact Latinos and other communities of color," the letter reads. "... Given the nature of the work and the urgency to understand how best to reach workers in culturally and linguistically appropriate ways, collaboration with farm workers, food production workers, and community-based organizations will be crucial to any State Vaccination Plan."
Rep. Raul Ruiz (D-Calif.), chair of the Hispanic Caucus, told All Things Considered that prioritizing these groups is only the start of many hurdles to getting Latino populations vaccinated.
"They are disproportionately not receiving allocations of vaccines, or the method of opening up vaccines to them do not work," Ruiz says.
While Latinos are getting sick from COVID-19 at disproportionate rates, early data show a relatively small number of Latinos are getting vaccinated.
Ruiz, who's also a physician, has recently spent time educating farm workers in his district about vaccines. Ruiz represents the state's 36th district, based largely in the desert communities of Riverside County where Latinos account for almost half of the population.
He says language barriers, misinformation and a general distrust of the health system are among the challenges that contribute to vaccine hesitancy among Latino communities. A survey from the Kaiser Family Foundation released last month found that 26% of Hispanics were unlikely to get vaccinated. Those hesitant cited misinformation about the cost of a vaccine, perceived vaccine side effects, a lack of transportation and — particularly among young Hispanics — a distrust of government officials.
"A lot of the information is in English and not in a language that will help them understand and empower them to navigate the system," the congressman says.
To build trust, he says, "partnering with local communities is key."
The congressman is also urging states to prioritize vaccine distribution to retail pharmacies near hard-hit communities.
Latino populations in many parts of the country lack access to available vaccines. In major cities across the Southern U.S., as NPR found, most vaccination sites are located in whiter neighborhoods.
It's also up to governors, Ruiz says, to make an "active, concerted effort to reach the communities in order to make their vaccine plan actually work for the hardest-hit communities within their states."
That effort should involve buy-in from employers within the food and agricultural industry, he says.
"These programs won't work if growers don't allow the time for their workers to go to the vaccine clinic and also provide transportation," says Ruiz.
At the same time, he says, counties and vaccine providers should be required to document their distribution efforts "so that we can understand where we have inequity issues and the mismatch between the high burden of disease and illness from COVID and the amount of vaccines that they're receiving."
NPR's Lauren Hodges and Andrea Hsu produced and edited this story for broadcast.
AUDIE CORNISH, HOST:
On that front, we're also seeing some improvement. Over the past week, the U.S. averaged 1.3 million shots a day. There is still a long way to go. More than 90% of the country has not yet gotten a single dose.
MARY LOUISE KELLY, HOST:
Which brings us to the alarm the Congressional Hispanic Caucus sounded this week over how few Latinos are getting vaccinated. In a letter to the National Governors Association, the caucus pleaded with state leaders to prioritize food and agriculture workers in the rollout. And they made an urgent case. Latinos make up more than a third of the workforce in those industries, but nearly three-quarters of confirmed coronavirus cases. Congressman Raul Ruiz of California is chair of the caucus. I asked him what prompted the letter to governors now.
RAUL RUIZ: There are some states that have not started vaccinating, for example, farmworkers. And then, even within states, some counties have prioritized farmworkers, but other counties haven't. Now, the other barrier in this is that if they have, for example, farmworkers, agricultural workers, food supply industry workers on paper, they are disproportionately not receiving allocations of vaccines or the method of opening up vaccines to them do not work.
For example, here in my own district, many don't have Internet at all. So how are they going to make their appointments online? Furthermore, they don't have a car to be driving to these vaccination sites. And then, a lot of the information is in English and not in a language that will help them understand and empower them to navigate the system.
KELLY: That's interesting because I was going to ask what else you believe needs to be done to try to fix this. I'm speaking to you from Washington, D.C., which is one of, I'm sure, a number of places that are prioritizing certain ZIP codes where COVID rates are higher and saying those people are going to go to the front of the line. It sounds like you would say, great, but that only get you so far if, again, people can't go online and see that their ZIP code is prioritized and get an appointment.
RUIZ: Yeah, that's absolutely true. So one is we need to measure equity. We need to mandate that all counties and all providers document who they're giving the vaccine to so that we can understand where we have inequity issues and the mismatch between the high burden of disease and illness from COVID and the amount of vaccines that they're receiving. Second, we have to ensure, for example, that when the administration starts to deliver the vaccine directly to retail pharmacies, that the retail pharmacies in those hardest hit communities are the ones prioritize offering the vaccine. Finally, we need to ensure that vaccine goes towards - directly from the federal government to the FQHCs and community health centers.
Now, how do you put the vaccine in an individual's arm is the whole other issue. Look, I'm an emergency medicine physician. And I have been, during COVID, going to farmworker communities, to the homeless, administering tests and just recently went to a worksite for farmworkers to help administer vaccines and then go out into the fields to educate the farmworkers, to correct the misinformation about the vaccine and to encourage them to get it.
KELLY: Give us a sense of what type things you are hearing when you're out and about and trying to talk to people. Are people - do they want the vaccine or is there some hesitancy?
RUIZ: Well, there is some hesitancy because of the misinformation that they get from sometimes social media or the rumors that they hear that the vaccine is going to make them sick with COVID. Two, they're concerned it doesn't work. Three, there're concerns about the costs. Four, some of the undocumenteds are concerned about whether or not they need to register and put their, you know, name somewhere. And so there's a lot of this misinformation or concerns from farmworkers.
And so the important part is that the messenger has to be someone who's trusted. I am the son of farmworkers. I grew up in the community. And I have spent a lot of time out in the fields working as a physician, public health promoter. I'm a messenger that they trust.
KELLY: Yeah, but you can't be everywhere, so what's the answer.
RUIZ: We also need the local physicians, and we need the priests and pastors and faith-based leaders to go out and to communicate this. Now, another source of trusted messengers are the schools, right? The parents trust their children's teachers. And so the youth in the Hispanic community plays a very vital role, too. Oftentimes, the youth are the ones that are up to date with the information. And they go home, and they educate their grandparents, their parents and their uncles. And so partnering with local communities is key.
KELLY: To circle back to that question of - that if you're trying to get shots into people's arms, you need to get the shots to where the people are, would you like to see vaccination sites set up, say, at meatpacking plants where there are large numbers of Latino workers or on some of these farms that you're talking about?
RUIZ: Yes, absolutely. I think that that has to be a very key component. If the workplace is the site of risk, then we need to go to the workplace to minimize and mitigate that risk. That is smart public health. There needs to be partnerships with the industries that has the high-risk essential workforce to inoculate their workers at the workplace, which means that they need protected time to go get the vaccine. These programs won't work if growers don't allow the time for their workers to go to the vaccine clinic and also provide transportation.
KELLY: That is Representative Raul Ruiz, chairman of the Congressional Hispanic Caucus. Congressman, thanks for joining us.
RUIZ: Thank you. It's my pleasure.
KELLY: And elsewhere in the show, we look at vaccine disparities around the world. Transcript provided by NPR, Copyright NPR.