San Diego Union-Tribune (Sunday)
SAN DIEGO VACCINATION RATES RISE AMONG LATINOS
Community groups have made concerted effort to inform residents and curb COVID-19 infections
About six months ago, San Diego’s health and community advocates were sounding alarms over soaring rates of coronavirus infections in largely Latino neighborhoods, especially in South County.
Hoping to stem the spread of COVID-19, officials and community groups dispatched neighborhood representatives door-to-door to educate residents about wearing masks, testing, and finally, vaccines.
Now there are signs that their efforts are working. Vaccination rates show Latinos in San Diego County are over-represented among people fully vaccinated against COVID-19 compared to most racial or ethnic groups.
About 68 percent of Latinos in the eligible age groups were fully vaccinated as of last week, county statistics show, compared with about 66 percent of Asians, 59 percent of White residents and 42 percent of Black San Diegans.
That’s a reversal from earlier this year when COVID-19 shots were first rolled out. Last March, Latinos made up nearly half of the county’s residents who were sickened by the novel coronavirus, but
consisted of barely 1 in 5 people vaccinated at the time.
Today, infection rates among Latinos remain twice high as among Black San Diegans and about three times higher than White and Asian residents, county numbers show.
Many Latinos are at higher risk, experts say, because they hold essential jobs that don’t allow for remote work. A lack of access to health care and housing that forces many family members to live together also increase the risk of exposure.
High countywide vaccination averages for Latinos obscure regional realities. Latino vaccination rates are above 87 percent in South County, but they lag in parts of North and East counties, the data shows.
The turnaround in South County resulted from months of concentrated efforts to educate families about vaccines, address their concerns and make the vaccination process easier, advocates said.
The Latino Health Coalition, a group of nonprofits, used culturally relevant messaging on radio and TV to talk about the virus, often in Spanish, and featured trusted community leaders in videos for social media.
It also distributed face masks, hand sanitizer and thermometers in South County, Barrio Logan and City Heights, where many residents held essential jobs that didn’t allow them to work from home.
The coalition also advocated for locating testing sites in those areas and worked with the county to reserve vaccination appointments for people who live in ZIP codes hardest hit by COVID-19.
Health officials also targeted their outreach to where COVID-19 infections were spiking, said Barbara Jimenez, community operations officer for the County Health and Human Services Agency.
“The data were driving where those (vaccination) efforts are,” Jimenez said. “When you look at the data, you’re able to prioritize communities with higher positivity rates.”
Promotoras
On a recent Wednesday, two volunteers from the Latino Health Coalition walked throughout Spring Valley for nearly two hours, knocking on doors and speaking to people on the street about available resources and the vaccine.
Sandra Mendoza, a special projects manager for the Chicano Federation, said that kind of outreach has been successful because it allows residents to connect with the messengers and it’s conversational and informative, not judgmental or authoritative.
No one is forcing them to do something they might not yet understand, she said.
Promotoras, who are usually trusted, non-medical individuals, use various inroads to discuss vaccinations and COVID-19 in neighborhoods.
Miriam Rodriguez, director of promotoras for the City Heights Community Development Corporation, said her team members set up tables at swap meets, community centers and food distribution sites. They hand out masks, gloves and hand sanitizer and talk about COVID-19 shots.
“We would have our popups and be there with resources, so it was easier for our families to come in and get their questions answered and get help with their appointments,” Rodriguez said.
Initially, the slow acceptance of COVID-19 shots stemmed from people’s safety concerns, as well as logistical obstacles, such as online appointment scheduling. Health workers had to tackle both.
“Myths had to do with the effectiveness of the vaccine, whether there were side effects, concern that it was too new, concern that it had been rushed and the myth that it was made with dangerous chemicals and toxins,” Jimenez said. “Those were things we were able to address through the promotoras, and in the media.”
Promotoras arranged
Zoom meetings, or virtual “cafecitos,” where residents could ask questions and hear from community members who had recently received COVID-19 shots, Rodriguez said.
Beyond vaccine hesitation, there were practical hurdles. Early in the rollout of COVID-19 shots, there were vaccine “superstations” with convoluted online sign-up systems and often hours of waiting in lines.
Eventually health authorities set up smaller clinics at community centers, high schools, parks and markets. They offered afterhours shots for people who couldn’t make it during the work day and opened walkin centers that removed scheduling barriers.
“At the beginning when you had to have an appointment, it was really challenging, or the system wouldn’t work,” Rodriguez said. “Once we got the walk-ins, that really helped.”
Promotoras offered rides to families they worked with or babysat young children while parents got vaccinated, she said.
San Diego County’s vaccination percentages are unclear for certain population segments — such as those labeled “other/multiple race” and people listed as “Native Hawaiian/pacific Islander” — because the county lists more people vaccinated in those categories than are listed in the population estimates of those categories. The population numbers are estimates based on census data.
Overall, however, San Diego County has outpaced state and national averages for vaccination; 71 percent of San Diegans who are 12 and older are fully vaccinated, compared with less than 70 percent for California and 65 percent nationwide.
Assemblymember Akilah Weber, D-LA Mesa, said progress came from partnering with community organizations and trusted messengers.
Still, some demographic groups and geographic areas are lagging. Countywide, fewer than 50 percent of Black San Diegans are fully vaccinated.
Part of that has to do with distrust, stemming from historic incidents when Black men with syphilis were deliberately left untreated, Black people were medically sterilized or some were otherwise discriminated against, neglected or abused by health professionals, experts have said.
“Particularly in the Black community, there’s a lot of resistance because of the things that have been done, the experiments that have been done to people in our community,” said Weber, who is a doctor. “We have to address that and to overcome that.”
Moreover, she said, there are few Black physicians in San Diego County, and there aren’t many community health advocates comparable to promotoras.
Black churches, which often are centers of community organizing, haven’t had their typical attendance during the pandemic, she said.
To address that hesitation, she and fellow doctors are speaking to Black audiences in online forums and other venues.
“It’s just going to take more time, more education, for some people to come around, and that’s what we’re going to do,” she said.
Among Latinos in inland and coastal North County and in East County, fewer than 60 percent of those eligible for vaccines have received them. Nancy Maldonado, CEO of the Chicano Federation, said groups are focusing on geographic areas where there continue to be low vaccination rates.
“We recognize that there is a lot of work to be done, and a lot of it is the same things that we are doing in south county,” Maldonado said.
The residents in North County and East County have asked volunteers for more information and outreach, she said.
“We go where the need is,” she said.
Vista Community Clinic recently started one-on-one outreach efforts to reach more residents of North County. A mobile bus goes to churches, parks and community resources.
The clinic also partners with local groups and school districts to target populations with low vaccination numbers, including Black residents, said Herminia Ramirez, program manager for Vista Community Clinic.
“Consistency and using a trusted messenger approach for our work has been crucial because we have been able to be out in the community very intentionally,” Ramirez said.
County health officials have planned 130 outreach events for vaccination and testing in North County since June, and run informational material in Spanish language media. They’re making similar efforts in East County and have launched programs focused on youth vaccinations.