The Vaccination Gap Among Hispanic Communities Reflects Barriers to Access

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Hispanic people across the United States continue to be especiallyunderrepresented among those vaccinated for Covid-19, according to a New York Times analysis of state-reported race and ethnicity information. The Hispanic share of the vaccinated population is less than the Hispanic general population in all states with large Hispanic communities.

Known Hispanic share of the vaccinated population and of the general population

New Mexico

Texas

California

Arizona

Florida

Colorado

New York

Illinois

Connecticut

Rhode Island

Utah

Oregon

Washington

Massachusetts

Nebraska

Oklahoma

MarylandHispanic sharevaccinatedShare ofpopulation0%

0%
25%

25%
50%

50%

Note: The states that were included had Hispanic populations of 10 percent or more. Nevada and New Jersey were excluded because they do not report the race and ethnicity of vaccinated people, but rather of all doses given. States define race and ethnicity differently and with varying levels of completeness — in some states as much as a third of vaccinations are missing race and ethnicity data. Comparisons between states should be made with caution.

Barriers to vaccine access faced in many Hispanic communities — alongside the structural limitations communities of color generally face — stand in the way of higher vaccination rates, even as the vaccine becomes more widely available, according to public health experts and community health organizers.

There is limited access to the digital tools needed to secure an appointment, for instance, especially among those who are older and live in immigrant communities.

“Our folks don’t have emails, they don’t have computers at home,” said James Rudyk, executive director of the Northwest Side Housing Center in Chicago, which runs vaccine clinics in Belmont Cragin, a largely Hispanic neighborhood. “They have smartphones, but they are not navigating registration systems that want you to fill out pages and pages of information.”

And often information about vaccine eligibility and registration is only readily available in English.

“People didn’t even know that there was a vaccine when we talked to them,” said Gilda Pedraza, the executive director of the Latino Community Fund in Atlanta, which called hundreds of older Hispanic people in late February to organize a vaccine clinic, before the state health department had posted eligibility information in Spanish.

Counties across the United States with significant Hispanic populations are more likely to face technology and language barriers, as well as cost barriers to pursuing health care, and are less likely to have insurance.

U.S. counties grouped by residents’ access to information

Counties with the:
Less Hispanic than national avg.

Best access
Top 20%

Worst access
Bottom 20%

More Hispanic than national avg.

Majority Hispanic

U.S. counties grouped by residents’ health care cost barriers

Counties with the:
Less Hispanic than national avg.

Fewest barriers
Top 20%

Most barriers
Bottom 20%

More Hispanic than national avg.

Majority Hispanic

Vaccine clinic organizers also report that Hispanic members of their communities, many of them uninsured, are unaware that the vaccine is free for all and have expressed concern about its cost. Some, especially essential workers with limited or no time off, say that they can’t miss work to get a shot or can’t afford to miss a day if they have side effects from the vaccine.

And while the Biden administration has stated that getting a vaccine will not affect a person’s immigration status, community health workers say this is still a major concern for immigrant families.

“Yesterday I received two calls from people who are in the process of trying to regularize their situation, and they were saying, ‘We would rather not have our vaccine, because what if they find out that we got it and it affects our immigration process?’” Ms. Pedraza said. “And I said, ‘You might not live to see your immigration process if you don’t get your vaccine.’”

A trusted health care provider who shares information about the vaccine can alleviate some of these barriers, according to public health experts. But Hispanic people are less likely to have an existing relationship with a health care provider. And counties with significant Hispanic populations are less likely to have dependable or regular access to health care.

U.S. counties grouped by access to routine medical care

Counties with the:
Less Hispanic than national avg.

Most care
Top 20%

Least care
Bottom 20%

More Hispanic than national avg.

Majority Hispanic

U.S. counties grouped by residents who have a regular doctor

Counties with the:
Less Hispanic than national avg.

Most residents
Top 20%

Least residents
Bottom 20%

More Hispanic than national avg.

Majority Hispanic

Community health advocates who live and work in the neighborhoods they are helping to vaccinate are taking on some of this responsibility and sharing critical information about the vaccine.

“We had a nearly 20 percent no-show rate initially for our first day of second doses and we got that down to less than 2 percent with phone calls,” Mr. Rudyk said. “Lots of people thought one dose was enough.”

And while concerns about vaccine safety often come up, advocates say that talking through these fears, even if it takes time, helps people decide to get immunized.

“Seeing people like you, speaking like you, it is critical,” Ms. Pedraza said. “It is what changes behavior.”

States that partner with community-based organizations are administering the vaccine more equitably than others, said Rita Carreón, vice president of health at UnidosUS, a civil rights organization for Hispanic communities.

In the states included in The Times’s analysis, the gap between the Hispanic share of the general population and the vaccinated population has declined slightly since the start of the month. Widening eligibility for the vaccine in some states may be contributing to the narrowing gap, but public health experts say that barriers to access still play an outsized role in the disparity.

The vaccination gap has narrowed since early March

Gap between the Hispanic share of the general population and the Hispanic share of those vaccinated in each state

Change from

Mar. 3 …

… to

Mar. 20.

pts.

–2.4

California

New Mexico

Connecticut

Washington

Rhode Island

Massachusetts

Note: The data represents the most recent available figures collected by The Times by March 3 and March 20. In a few cases, the data that states provided publicly by those dates came from as much as a week earlier. Arizona was excluded as it changed the way it reports race and ethnicity between the two surveys, so figures were not comparable.

Federal efforts to close the vaccination gap for Hispanic Americans through community health centers, while limited in size, are having some success. While the Hispanic share of the U.S. population is about 18 percent, Hispanic people made up more than a quarter of those nationwide who received their first dose at a community health center, according to an analysis of federal data by the Kaiser Family Foundation.