Immigrants face barriers to vaccine
Providers have turned away people after requesting ID
BOSTON — The line started outside, on a street usually teeming with people waiting to enter college bars, and snaked up the stairs of an old firehouse to the Brazilian Worker Center, where shots of the coronavirus vaccine were being administered on this cold New England spring morning.
Finally, it was Maria Sousa’s turn. She had been waiting for more than an hour with her husband and daughter when a center volunteer greeted them in Portuguese and guided them to the registration desk, where they presented their identification — Brazilian passports.
Getting vaccinated here was the only option they considered.
Immigrants have been turned away from pharmacies and other places after being asked for driver’s licenses, Social Security numbers or health insurance cards — specific documentation not mandated by states or the federal government but often requested at vaccination sites across the country, including right down the road from here. Often the request comes in English, a language many of the vaccine-seekers don’t fully understand.
Some state agencies and businesses that provide vaccinations have acknowledged the problem and vowed that it will stop.
Sousa’s family wasn’t willing to take the risk.
The life-or-death race to get as many people vaccinated as possible before the coronavirus spawns more viral mutations, like the one that emerged in Brazil, started slowly but has accelerated as many of those crossing the finish line possess the wherewithal and inclination to navigate a maze-like system. As the nation nears the point where supply soon outpaces demand, the unvaccinated
will increasingly be people who are reluctant or who are rebuffed by barriers blocking their way.
“We’ve done a good job of equality in rolling out the vaccine. A lot of states have opened to everyone 16 and over now,” said Jeffrey Hines, medical director for diversity, inclusion and health equity at Wellstar Health System in Atlanta. “But equality is not equity.”
The federal government says everyone has a right to the coronavirus vaccine regardless of immigration status, with the Department of Homeland Security calling it “a moral and public health imperative to ensure that all individuals residing in the United States have access to the vaccine.”
But each state’s registration process is different, and vaccination sites often make up their own rules — policies inflaming racial and ethnic divides in coronavirus vaccinations.
Twenty-six states restrict access to people who live and work there, status that can be proved with a utility bill or a work ID. But only about one-quarter of state websites make it clear that undocumented immigrants are eligible for the shot and that getting vaccinated will not negatively affect immigration status, according to recent analyses by the health policy group Kaiser Family Foundation.
Only 10 states and the District of Columbia, which have residency requirements, also allow undocumented immigrants to obtain driver’s licenses or state identification cards.
Massachusetts is not one of them, and the state’s website telling people how to prepare for their vaccine appointment says that although vaccination sites might request an ID or insurance card, “that only applies to people that have them.”
“The idea of having to be ID’d is a major source of stress for immigrants,” said Natalícia Tracy, executive director of Boston’s Brazilian Worker Center, a nonprofit dedicated to defending and advancing labor and immigrant rights. “When people ask for ID, they say Massachusetts ID. They don’t say any ID.”
It is often left up to the very people made vulnerable by these ad hoc rules to push back against them.
Experts and immigration advocates say that while talk about closing the gap in vaccination rates has focused largely on bolstering acceptance of vaccines, access to them must be part of the conversation, too. That’s especially true, they say, in communities still reeling from immigration policies implemented during the Trump administration that were openly hostile to immigrants of color.
“It’s very easy to say vaccine hesitation,” said Frankie Miranda, president of the Hispanic Federation, a New York-based nonprofit and advocacy group.
Instead, he said, a constellation of factors come into play, including the time and technology required to book appointments online, the need for transportation to vaccination sites and translation services — even the language used on promotional flyers.
Take, for instance, a colorful, bilingual bulletin advertising a recent drive-thru vaccination event in one North Carolina county. It included images of a diverse cluster of masked essential workers, a group made up disproportionately of people of color and immigrants. Yet in English and Spanish, the flyer proclaimed “citizens 65 and older” are eligible for vaccination. “Already, you’re sending the message: Don’t come here,” Miranda said. “This is an example where language can hamper your efforts to reach out to the community you actually want to help.”
Many immigrants won’t risk the consequences of coming forward to be vaccinated at unfamiliar places, advocates and public health experts say — even though their jobs, housing and underlying health conditions place them at higher risk of infection.
“Vulnerable populations are going to go to those places where they have trust,” Hines said. “They may not necessarily go to the mass vax site.”
Administering thousands of shots at big facilities might be a quicker way to get as many people vaccinated as possible, but “you’re going to chip away” at the number of unvaccinated people in marginalized communities by using trusted spaces, Hines said.
The Brazilian Worker Center administered more than 200 shots on Good Friday. But that was only a small fraction of those seeking protection. The center’s vaccination waiting list: 2,500, and growing.