Outside, the horns were blaring, and drums were pounding out a constant beat as fans of the Mexican national soccer team gathered recently at Empower Field for the international CONCACAF Nations League tournament.
But inside a mobile medical RV, all was calm and professional during halftime at Mexico’s game against the U.S. That was when soccer fan Oscar Filipe Sanchez rolled up his sleeve to receive the one-dose COVID-19 vaccine.
Sanchez is a house painter. He lives in Colorado Springs. After he got sick with COVID-19 a couple of months ago, he thought it was time.
“He was advised to wait a little bit afterwards before getting the shot,” a translator said.
Is he glad he got it?
“Yes!" the translator said. "He's more trusting to go out.”
Bringing the mobile vaccine program to an international soccer match was the latest effort by the state of Colorado and its partners to meet the unvaccinated where they are rather than asking them to find the vaccine.
Gone are the days when vaccine appointments were snatched up the instant they became available and when providers worried about making sure patients were eligible under state and federal criteria.
Colorado, as with most of the nation, has now moved into a hand-to-hand combat phase of bringing out vaccines, and using persuaders to convince the hesitant to get jabbed.
Hispanic and Latino Coloradans are still get vaccinated at lower rates
With just less than half the state’s population now fully immunized, the challenge cuts across all demographic groups. Men are more hesitant than women. Rural residents are more hesitant than urban dwellers. Younger Coloradans are more hesitant than their elders.
But perhaps no group has been harder to get vaccinated than the more than 20 percent of Coloradans who identify as Hispanic. Just about 10 percent of the state’s doses have gone to Hispanic residents, according to the state’s vaccination dashboard.
At first, it seemed a question of access to health care, and that might still play a role, though the vaccine is free with no insurance requirement. With vaccine availability now widespread, health leaders are searching for ways to get greater acceptance of the message that the vaccine will allow the vaccinated to return to their pre-pandemic lives.
Denver has hit the 70 percent threshold for resident vaccination, but some of its Latino neighborhoods are getting vaccinated at much lower rates, according to Dr. Lilia Cervantes, an associate professor in the department of medicine at Denver Health.
“There are some very high-risk neighborhoods where most of the community are first generation or foreign born individuals,” Cervantes said. “And that is where we're seeing the highest disparities.”
Denver’s health agencies updated their data last week. About 35 percent of Latinos older than 12 are vaccinated in Denver County — that’s less than half the rate for white Denverites. Latino residents makeup 29 percent of the Denver population but represent 47 percent of cases, 46 percent of hospitalizations, and 30 percent of deaths.
If you look at the map of Denver counties, the highest case rates are in some of the mostly Latino neighborhoods, like those in west Denver, like Barnum West, Westwood, and Ruby Hill, Cervantes noted.
“I think that it is critical that we improve vaccine uptake in our most marginalized groups, including those who are undocumented and those who are Spanish language dominant,” if the state hopes to reach broad levels of protection from the virus, she said.
Cervantes said she’s concerned the state will keep seeing a higher COVID-19 positivity rate in those marginalized groups, who make up much of the essential workforce.
“This past year, I think we have seen stark health inequities in the Latino community,” Cervantes said.
Black Coloradans also lag behind, according to the state dashboard, but not as much as Hispanic residents. They make up about 4 percent of the state’s population but are a little less than 3 percent of those who have been vaccinated.
Because of the different vaccination rates, the pandemic is not 'over' at the same time for everyone
All this portends a more uneven pandemic, said Dr. Fernando Holguin a pulmonologist and critical care doctor at the Latino Research and Policy Center at the Colorado School of Public Health.
He worries cases, hospitalizations and deaths will keep flaring up in unvaccinated communities, especially in predominantly Hispanic ones in parts of Colorado or other states where vaccination rates are poor.
“They're at risk, especially moving into the fall of seeing increasing waves of infections. I think it is really critical that people really become vaccinated,” he said.
Even as parts of the state and country are getting vaccinated at high rates, for the mostly unvaccinated “COVID infections in certain communities still will be devastating for them,” he said.
One group he spotlighted: rural migrant farmworkers. They often have poor access to the internet and may struggle to find good information about the vaccine and stay safe from the virus.
“So overcoming those access, cultural, language barriers is important,” he said.
When asked what the state has done to reach out to Latino Coloradans, a health department spokesperson pointed to over 1,500 vaccine equity clinics in 56 counties; a program, the Workplace Vaccination Program, where the state partners with businesses and organizations in our to provide vaccine clinics on worksites; and a Spanish-language Facebook page and COVID-19 website.
She said its Power the Comeback campaign is in English and Spanish and aims to reach disproportionately impacted populations with awareness ads, testimonials and animated videos.
The Champions for Vaccine Equity program provides information to those communities about the safety and efficacy of vaccines, as well as utilizing Promotoras, service providers, and crisis counselors to support vaccine literacy. The health department has also told vaccine providers no identification, proof of residency or insurance is required to obtain the vaccine.
Also, Colorado has a 24/7 vaccine hotline — 1-877-CO VAX CO (1-877-268-2926). Call agents provide assistance in multiple languages and can help schedule appointments.
About a third of all adults in the U.S. are unvaccinated, a “shrinking pool” that the latest KFF COVID-19 Vaccine Monitor report found, compared to vaccinated adults, are younger and more likely to say they are Republican or Republican-leaning.
The people in the unvaccinated pool also tend to have lower levels of education and income, and are more likely to be uninsured. The KFF report found 19 percent of unvaccinated adults are Hispanic, and that 20 percent of that group said they will “wait and see” about getting vaccinated, while 11 percent said they’d “definitely not” get it.
Vaccination efforts from trusted community members can make a difference
Both Cervantes and Holguin credit local, state and community groups with aggressively looking to boost vaccination rates with Latino Coloradans, while encouraging them to keep seeking trusted community voices to bring the message.
“You know, it's not going to be Dr. (Anthony) Fauci saying something that someone translates in Spanish that you need to get vaccinated. There's going to be people in the community convincing others to get vaccinated,” he said.
At Empower Field, soccer fan Diego Montemayor from Denver echoed that same sentiment, saying some fans who got shots themselves urged friends who came to the stadium to do the same.
“When they hear people that they trust sharing their experiences, that goes a long way,” he said.
Community health advocate Karimme Quintana, at the game too, agreed. She’s a Promotora de Salud Pública, with the group Lifespan Local, working in Denver’s largely Latino Westwood neighborhood.
Quintana says that population may trust someone close to them more than even a doctor.
“They need to be more educated about the COVID because they have a lot of questions,” Quintana said as she wore a button reading "Tiene preguntas sobre COVID? Pregunteme." ("You have questions about COVID? Ask me.")
“Latino people, they listen (to) the neighbor, they listen (to) my friend,” she said.
UCHealth nurse Danica Farrington said the push at the game was getting heavy messaging on billboards and big screens.
“They just plastered it everywhere and said, go get your shot,” she said. “That's pretty influential.”
Still, historic mistrust of the health care system is hard to overcome
The carnival atmosphere at the stadium helped make the pitch, said Jesus Romero Serrano, who wore a Mexico jersey and a red and green Luchador wrestling mask.
“Absolutely! It's a Mexico game versus Honduras! So lots of Latinos are here. This is the perfect place to be, to reach the Latin community. Absolutely.”
As a community ambassador with the Denver mayor’s office, Romera Serrano is what you could call a community influencer. He filtered through the crowd handing out cards about where to get the vaccine.
But he admitted sometimes it’s hard for many to break through what they see as years of historic mistreatment.
“They don't trust the health care system,” he said.
Romero Serrano waded into the crowd, shaking hands and shouting over the constant din of the drum bands, asking, “Hey guys, you get the vaccine?” The common answer was, “Everybody has it,” but he was skeptical and thought they were just being nice.
A few miles from the stadium, Dr. Pamela Valenza works to promote vaccines at the Tepeyac Community Health Center. It’s in the predominantly Hispanic Globeville neighborhood.
She tries to address patients’ fears and concerns, but many tell her they want to wait to see that “people who are vaccinated are not going to get complications, that people who are vaccinated are not going to get serious side effects,” she said.
Valenza hopes the state’s $1 million dollar drawings might help. And her clinic is planning more vaccine events soon — at a convenient time that doesn’t interfere with work, like Friday evenings. They’ll offer free grocery cards for the vaccinated. And Valenza says she liked the idea of pairing vaccines with fun.
“The Latino culture, food and culture and community is such a central part of the Latino community,” Valenza said. “Making the events maybe a little bit more than just a vaccine might, might encourage some community members to come out.”
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