Dr Fields is not surprised that vaccine rates are low in the Black community. Using New York City as an example, Dr Fields explained that mass vaccination sites were placed in the suburbs of the city that are not easily accessible to minority populations. The movement to increase vaccine supply at pharmacy retail chains also is not effective to reach minorities as pharmacies are more often located in white neighborhoods, he said.
“The issue of pharmacy deserts in a lot of brown and Black communities is very real,” Dr Fields said. Even a pharmacy that is 5 miles away may not be accessible to someone without transportation. Also, the race/ethnicity of vaccination teams often does not mirror the population in minority communities, which can be a barrier to vaccine uptake.
“We’ve got to take this to the people,” Dr Fields said. He also stressed the importance of leveraging kinship networks in the Black community. “So if not for yourself, then [get the vaccine] for others around you.” And if patients absolutely won’t get a vaccine, then he uses messaging about respecting the community with masks, hand washing, and social distancing.
He suggested setting up vaccination sites at Historically Black Colleges and Universities, predominantly Black churches, and other places of faith with open parking lots (for social distancing) and other trusted entities such as federally qualified health centers, which are often located in Black and other underserved communities. To overcome transportation-related barriers, use mobile vans and offer home visits, he suggested.
Vaccine Hesitancy Among Hispanic Patients and Undocumented Immigrants
In the Hispanic community, limited English speaking skills and poor health literacy are substantial barriers to vaccination, said Gina Miranda-Diaz, DNP, MS/MPH, APHN-BC, H-O, Certified Contact Tracer, Fellow New York Academy of Medicine (FNYAM), policy and legislation chair of the National Association of Hispanic Nurses-New Jersey Chapter. Additionally, undocumented immigrants have concerns about having their information gathered into a system where they might be sought out or deported.
Nurses can help address vaccine hesitancy among minority patients by listening to patients’ concerns and pointing them to credible sources of information rather than listening to word of mouth or inaccurate sources (Table), said Dr Miranda-Diaz, who also is a New Jersey state-licensed health officer, licensed home health aide instructor, and president/CEO of Hudson Consultants LLC.
Table. COVID-19 Vaccine Resources for Patients
|The Black Coalition Against COVID|
|The National Black Nurses Association|
|National Association of Hispanic Nurses|
|COVID-19 Prevention Network|
|CDC Covid-19 patient resources|
|State-specific federally qualified health centers Provide vaccines to patients with Medicaid, on a sliding scale, and often free of charge regardless of immigration status|
Many patients do not understand that the vaccine is free, Dr Miranda-Diaz said. While there may be administration costs involved in vaccine administration, patients who cannot afford these fees should be directed to facilities or clinics — such as federally qualified health centers — offering no-cost vaccines, she noted.
Also, President Biden “has said that he would not allow federal agents to be anywhere near the vaccinating centers,” Dr Miranda-Diaz noted. “People who want to get vaccinated do not have to reveal their immigration status and we have to go where they are.”
Dr Miranda-Diaz agreed with Dr Fields about the need to rethink the strategy of increasing vaccine supply at chain pharmacies to reach underserved communities. “Let nurses or practitioners who can get a mobile unit get out there put these vaccines in arms,” she said.
“Poverty, your inability to speak English, your immigration status should not be a cause of death,” she said.