Growing Gaps in COVID-19 Vaccinations among Hispanic People
As noted in our latest analysis of state vaccination data by race/ethnicity, a big gap is emerging in COVID-19 vaccination rates for Hispanic people. As of mid-February, White people were over three times more likely than Hispanic people to have received at least the first dose of a vaccination (10% vs. 3%) based on data from just over half the states. These data are early, with vaccinations still only available to limited groups in some states, which may affect demographic trends. They also are subject to a range of gaps and limitations. However, the consistency in patterns across states point to potential challenges for vaccinating Hispanic people, whose health and finances have been extremely hard hit by the pandemic. Low rates of vaccination among Hispanic people would leave them at increased risk for the virus, could further widen existing health disparities, and would leave gaps that hinder our ability to achieve overall population immunity.
There has been substantial focus on heightened concerns among Hispanic and Black adults about the vaccines’ safety and side effects that leave many wanting to “wait and see” how others fare before they receive it. As of late January 2021, just over a third of Hispanic adults (37%) said they wanted to “wait and see” how the vaccine works for other people, compared to 43% of Black adults and just over a quarter (26%) of White adults, while 42% had already gotten the vaccine or wanted to get it as soon as possible and the remaining roughly one in five said they would only get it if required or definitely will not get it.
However, these differences in “willingness” to get the vaccine do not appear large enough to explain disparities that are emerging in vaccination rates, suggesting that other factors, such as access barriers, may be playing a significant role. Hispanic people face a combination of factors that may make accessing the vaccine particularly challenging. They have a high uninsured rate, which has likely further increased due to the pandemic. As such, they may be more likely to be concerned about potential costs associated with obtaining the vaccine and less likely to have an existing relationship with a health care provider. Hispanic adults also are more likely than White adults to say it is difficult to find a health care location that is easy for them to get to. Moreover, some Hispanic people may face linguistic barriers to care. Those with an immigrant family member face potential added complications, including confusion about eligibility to obtain the vaccine and concerns about whether accessing the vaccine could negatively affect their or a family member’s immigration status or put them at risk for enforcement action.
The federal government is making COVID-19 vaccines available in ways that address many of these potential barriers. They currently are available for free to all individuals regardless of insurance status. The federal government is launching new efforts to make vaccines available through more locations, including community health centers, which are a key source of care for the Hispanic population and a place where many Hispanic adults currently receive their flu vaccine. Moreover, the Department of Homeland Security has clarified that vaccines are available to all individuals regardless of immigration status and that enforcement activities will not be conducted at or near vaccine distribution sites or clinics. Further, U.S. Citizen and Immigration Services has specified that it will not consider testing, treatment, or preventive care, including vaccines, related to COVID-19 as part of a public charge inadmissibility determination.
However, for these broad policies to be effective, it will be important for the information to be clearly communicated to people in the community through trusted messengers and in-language, when needed. Proactively communicating that the vaccination is available for free even for people without insurance, providing details on when and how to access the vaccine, and clarifying that receiving the vaccine will not negatively impact immigration status will likely be particularly important. Notably, about six in ten Hispanic adults say they do not have enough information about where to get the vaccine, compared to about half of White adults who say the same. Moreover, survey data show Hispanic adults are much more likely than White adults to report an increased likelihood of getting vaccinated after hearing that there is no cost to get vaccinated (54% vs. 32%) or that a friend or family member (53% vs. 26%) or a health care provider they trust (51% vs. 34%) got the vaccine. Like other groups, the majority (81%) of Hispanic adults point to health care providers as a trusted resource for information to help them decide whether to get the vaccine. The Centers for Disease Control and Prevention, state or local health departments, and family or friends are also top trusted resources for Hispanic adults.
Beyond providing information through trusted resources, it will be important to ensure that, at the provider level, vaccine sign-up processes do not leave some people facing barriers. For example, although insurance is not required to obtain the vaccine, many providers are requesting insurance information to cover costs of administering the vaccine, and anecdotal reports suggest some providers have insurance information as a required field to book a vaccine appointment. Providers may also be requesting personal identification or proof of state residency to obtain the vaccine, particularly while vaccines are limited to certain priority groups. Ensuring that vaccine providers offer clear options for people to make a vaccine appointment if they do not have insurance and providing alternative options for people to provide documentation if they do not have a government-issued identification card will also be important for facilitating access.
Addressing these potential barriers to vaccination can be done. However, doing so will require intentional and deliberate action. Working closely with community leaders to better understand access barriers, develop strategies to address them, and provide outreach and education through trusted messengers is one place to start.