Latinos in Pitkin, Eagle and Garfield counties have been especially hard hit by the pandemic. While they’ve made up a disproportionate number of COVID-19 cases over the past year, efforts are underway to make sure they have equitable access to vaccines.
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Once the Colorado Department of Public Health and Environment started gathering demographic data earlier this year, it learned that the vaccine was being given disproportionately to more white Coloradans in wealthier neighborhoods.
People who identify as Latino or Hispanic make up over 20% of the state’s population, but as of March 17, they’ve only received about 8% of the COVID-19 vaccines administered. Compared to all other groups - including Black, Asian Americans, and Native Americans - Latinos currently have the largest disparity between population percentage and vaccination percentage of any demographic group in the state.
Voces Unidas overcomes hurdles with vaccine “equity clinics”
To address this inequity, the state developed the “Vaccine Equity Task Force” and locally selected the nonprofit Voces Unidas de las Montañas to run mobile clinics to help vaccinate Latinos in Pitkin, Eagle and Garfield counties.
The Executive Director of the Glenwood Springs-based organization Alex Sanchez believes the inequity in vaccine distribution can only be solved if barriers to access the vaccine are broken down locally.
“It’s not enough to just offer the vaccine,” he said. “We hope that we can reach some people who for a variety of factors don’t have a doctor, are not getting information, have been too afraid to go to a traditional place to get a vaccine.”
In addition to helping Latinos who have been impacted by COVID-19 get access to health care and financial assistance, Voces Unidas has been getting about 400 moderna vaccines from the state into people’s arms each month at their equity clinics.
As a small advocacy group, Sanchez says they never expected to be running monthly vaccine clinics for hundreds of people and they’ve had to overcome a lot of hurdles, including making sure everyone shows up for their second shot of the vaccine.
“We're already seeing a lot of folks not get their second dose and we’re going to continue seeing it,” Sanchez said. “It’s an extra step for some people who are working long hours, who have families to take care of, who are least likely to have health insurance and a good relationship with the healthcare system or the local government.”
Sanchez says these are just some of the many reasons he and his colleagues have observed that some in the Latino community might not show up for their second dose.
“It's because we don't have access, we don't have the same privilege. We probably have never been to some of these clinics,” he said.
This challenge has been especially frustrating for Voces Unidas because it currently has over 1,500 people from all three counties who are requesting a vaccine on its waitlist.
“The notion that Latinas and Latinos don't want to be vaccinated in our valley is just a myth,” Sanchez said. “I think it speaks to the larger challenges within our local government, our local ecosystems and the inequities that exist in our healthcare system as to why Latinas and Latinos are not always coming to the clinics.”
Given the long waiting list and the challenge of scheduling the second shot for some people, Sanchez says he was disappointed when he learned Voces Unidas wouldn’t be included in the state’s first shipment of the much anticipated one-dose Johnson and Johnson vaccine earlier this month.
“Convenience in single dose administration could be so advantageous and could really help us move the ball in communities that have so many barriers already that they're facing,” Sanchez said. “This could really be a great way to add more equity.”
Meanwhile, Pitkin and Eagle counties both received the Johnson and Johnson vaccine from the state’s first shipment that went out earlier this month.
“Instead of, you know, releasing that vaccine to counties and communities that already have a lot of privilege,” Sanchez said, “why not reserve a small amount of the one-dose vaccine so that the equity clinics can also start introducing it to a population where we’re going to see a lot of folks not get their second dose.”
Missing out on the Johnson and Johnson vaccine isn't the only hurdle Voces Unidas had to overcome in recent weeks, the latest being the winter storm that swept through the state this past weekend.
Sanchez said they nearly had to cancel their planned drive-thru clinic in Glenwood Springs because of the extreme weather on the Front Range, but they were able to pull it off at the 11th hour.
“It took more than 69 people, working day and sometimes night,” he said. “You know, our equity clinics are working.”
The City of Glenwood, volunteer doctors, nurses, EMTs, firefighters and public health officials all pitched in, and with their help, Voces Unidas was able to vaccinate 457 people, many of them essential workers, on Saturday, March 13. So far, the organization has administered 875 doses of the moderna vaccine to Valley locals.
Sanchez and his team know it’s this kind of effort that’s going to be required on a continuous basis to make sure all latinos in the Valley who want a vaccine are able to get one.
“When you create opportunities, access points that are equitable, that tear down the barriers to language, access, transportation, et cetera, and you see yourself reflected in the strategy, then Latinas and Latinos come out by the thousands,” he said, “as evidenced by our massive list of people who want the vaccine and have not been able to get it anywhere else.”
While Voces Unidas is making progress by offering their own equity clinics and culturally competent, bilingual COVID-19 support to Latinos in the valley, Sanchez says the bulk of the responsibility is still on local governments, hospitals and public health services.
“It's not just our little clinic, right? We're not the solution, we're not supposed to replicate a system.” he said. “We're supposed to add a little more equity in a few more access points, but we still want Pitkin, Eagle and Garfield counties to be equitable in their strategies, to reach the masses.”
In the coming months, Sanchez says Voces Unidas will continue working with volunteers and public health officials in all three counties and encourage them to increase Latino outreach and bring in more Spanish-speaking and multicultural staff.
Counties and hospitals work toward vaccine equity
In addition to the work of Voces Unidas, other major players in the valley’s vaccine distribution effort, such as Pitkin County Public Health and Valley View Hospital, are taking steps to bridge the gap.
In Pitkin County, where about 10% of all residents and a substantial portion of the workforce are Latino, the county recently ramped up their own vaccine equity efforts.
After inoculating thousands of people from the general population, many at drive-in mass vaccination clinics, last week the county’s health team designated 190 doses specifically for underserved populations.
Carly Senst, vaccine and testing coordinator for Pitkin County Public Health, said the underserved group also included people with limited access to internet or transportation. In an effort to reach Latinos, the county sent Spanish-language notices to people who had signed up for vaccine information and checked Spanish as their preferred language.
“Even though we've kind of focused on those issues and tried to meet those needs throughout the whole process,” Senst said, “Last week was certainly the first week that we really tried to do much more targeted and focused outreach.”
Ultimately, about 40% of people vaccinated at last week’s equity clinic self-identified as Latino.
The county plans to continue focusing on equity in their clinics going forward – designating 10% of all first doses in each weekly shipment for underserved populations. That percentage may change as the county fine tunes its approach over time.
Despite the success of early equity efforts, Senst said the road ahead is lined with challenges. People who work in Pitkin County but live downvalley, many of whom are Latino, may be particularly hard to reach.
Contacting those workers through their employers may prove unreliable.
“I'm very concerned that we're going to run into managers and owners of businesses that are less motivated than their employees,” Senst said.
But, she said, it may be just as hard to find and contact those employees individually if they live as far away as Rifle, for example.
In Garfield County, where nearly a third of the population identifies as Latino or Hispanic, Glenwood Springs’ Valley View Hospital said it is working to reach that community. The hospital accounts for the bulk of all vaccines administered in the county.
Stacey Gavrell, a spokeswoman for the hospital, said Spanish-speaking employees are sharing messaging about vaccine availability in places where Latinos are more likely to hear it.
“We’re reaching out to communities like the catholic churches and other networks to make sure that their friends and family members are aware of the opportunities to get vaccinated and create that bridge to come to the hospital.”
Gavrell said the hospital is also connecting with businesses that employ Latinos and other local health providers to reach more people.
Race and ethnicity data leaves some “unknown”
While state data shows a yawning gap between the portion of the state’s population that identifies as Latino and the portion of vaccines that have gone to Latinos, that data may be incomplete.
The state health department mandated that providers gather and report race and ethnicity information for vaccine recipients beginning Feb. 5, although the first vaccines in the state were administered in the middle of December. In that gap spanning about eight weeks, nearly 700,000 vaccine doses were administered statewide.
Race and ethnicity information is voluntarily given by vaccine recipients – meaning that even after vaccine providers started to collect it and send findings to the state, a large portion of vaccinated people did not self-identify and thus show up as “unknown” in the pool of race and ethnicity data.
For example, in the northwest region of Colorado – the area containing Pitkin, Eagle and Garfield counties – 24% of all vaccines went to people whose race or ethnicity are “unknown.” By comparison, 69% of vaccines went to white people and 5% went to Latino and Hispanic people.
Although it collects enough data to present that same breakdown for each specific county, the state does not publicly share it, claiming that “displaying demographic information in smaller counties could reveal personally identifiable information.”
Counties themselves are not responsible for tallying demographic information about vaccinated people. Although some county governments, like Pitkin County, play a major role in vaccine distribution, many vaccines are given out by hospitals, other healthcare providers, nonprofits and commercial pharmacies. The state collects vaccine data from each of those individually.
Going forward, Voces Unidas says it will continue to seek out the Johnson and Johnson vaccine and call on local counties, hospitals and public health officials to work towards a more equitable vaccine rollout. For now, those in underserved populations looking to secure a vaccine can register with Voces Unidas or visit the Pitkin, Eagle and Garfield County websites.