The rate at which vaccines are administered in communities of color continue to show the health inequities of COVID-19.
As of March 21, African Americans made up 8.3% of people in Monroe County who had received at least one dose of vaccine. African Americans are 15% of county population.
Hispanics or Latinos made up 5.2% of people who had received at least one dose; they are 8% of the population in the county.
Whites made up 87.5% of people who were vaccinated and they are 78.9% of the population.
The data is self-reported and may not reflect the true rate of vaccination by race and ethnicity. The state only in the previous couple of weeks began posting demographic data.
The differences may reflect challenges in access to vaccination centers, barriers to registration, limited language proficiency and centralized decision-making that does not allow for local needs, according to the African American Health Coalition and Latino Health Coalition.
The coalitions are groups of individuals and organizations, convened by Common Ground Health, to coordinate a community response that will eliminate health disparities.
The coalitions wrote a letter to Gov. Andrew Cuomo, asking for local decision making on vaccine registration and distribution, inclusion of farm workers in stages 1a-c, language access and timely local data to identify equity gaps.
The letter, dated March 18, was signed by Yvette Conyers and Sebrone Johnson of the African American Health Coalition and Lucia Colindres and Dr. I. Diana Fernandez of the Latino Health Coalition.
The letter has the subject line of equitable distribution of COVID vaccines.
It reads in full:
Dear Governor Cuomo:
The African American Health Coalition and the Latino Health Coalition have observed inequities in the distribution of vaccine to Black and Latino residents in the Finger Lakes region; we are offering the following priorities in the strategy to begin to change this disturbing trend.
Priority 1: Allow flexibility and local decision-making authority on vaccine registration and distribution.
Our coalition stakeholders know our community. We are both content and context experts and have trusted individuals, associations, and institutions in our networks that could assist in equitable distribution of the vaccine. Community-based organizations (CBOs) understand how to navigate people through systems and can serve as cultural brokers. In our communities, relationships matter, and communication strategies must be built upon trust. There is no replacement for direct outreach to clients and if adequately supported, local efforts to contact residents and visit homes in combination with neighborhood vaccination sites will increase vaccine participation and remove barriers such as limited transportation.
Current vaccine registration has all but deepened the digital divide. The state website is cumbersome even for tech savvy people. Turning over some control to local communities for vaccine registration and navigation will also increase access. “Equity PODs” are a prime example of public/private partnerships that work, as many community-based organizations (CBOs), faith-based organizations (FBOs) and government institutions worked together to register and provide vaccinations. Additionally, Federally Qualified Health Centers (FQHCs) must be adequately supported and viewed as a central asset to equitable distribution, as many are strategically located in underserved geographies, and they have the means to not only vaccinate, but provide much needed primary care to those without it. Limited funding to CBOs, FBOs, FQHCs and local government infrastructure supports can help realize this priority.
Priority 2: Prioritize Farm laborers in 1B
Farm laborers are not included in stages 1a, 1b, or 1c for vaccinations in New York State, despite the CDC recommending that they be prioritized; why not? (emphasis theirs) The 1b group includes others in the food industry like grocery, restaurants, and food delivery workers. Many farm laborers are near each other in the fields of the Finger Lakes, often operating machinery within 6 feet of each other. These workers are essential and produce much of our local harvest. Without them, our Finger Lakes region food systems would come to a halt. We must create pathways to reach further into our rural communities utilizing assets such as FQHCs and religious institutions to reach farm laborers; they are trusted entities and not feared. Protocols to keep workers safe are not prioritized by farmers. Farm laborer-serving agencies know how to reach this population. In the context of priority 1, we are asking for testing and vaccines in this population, including both H2A and undocumented individuals.
In addition to farm laborers who reside in this region, including migrant and seasonal workers of diverse racial and ethnic background who come to the region from southern states and abroad. In total, there are at least 15,000 farm workers in the Finger Lakes alone, but over 80,000 in the state. Since their infection and vaccination status are unknown, the potential for an increase in viral transmission is real. The WNY Coalition of Farmworker Serving Agencies and Finger Lakes Community Health, an FQHC, can be a central asset in the Finger Lakes region to strategize and engage farm workers and farm owners, and serve as a bridge to vaccine access.
Agriculture is a $3.6 billion industry in New York State. With more than 35,000 farms. If farm laborers are unable to work, it could cause a devastating economic impact to our region and the state of New York.
Priority 3: Mandate Language Access for all Limited English Proficient populations
For online registration on the state website, the very last question asked is “Do you need an interpreter?” Language needs must be acknowledged and managed at the beginning of the process. The Monroe County Language Access Coalition (MCLAC) engages many demographically diverse populations, and they are aware of several challenges for residents with Limited English Proficiency (LEP). This is not limited to those speaking “foreign” languages. The deaf community in Monroe County is the highest per capita in New York state, and English is a second language for those individuals. Many of our elders are classified as part of the hard of hearing population and struggle with existing systems.
While the deaf community is our primary example, the same issues are relevant across all LEP populations from the Latino to Refugee communities. Systems must be enhanced to prioritize robust and efficient language services as part of any equity strategy.
Priority 4: Provide timely and meaningful data for informed local decision-making
The AAHC and LHC recommends local access to data at the community level to understand equity gaps broken down by race, ethnicity, and zip codes. Conducting a geospatial analysis and creating overlays of “hot spots” for both COVID positive cases and under-vaccinated communities will be essential in identifying gaps in outreach. The data should be updated on a consistent basis and made public to the community at large. This strategy will influence priority 1.
We support the Finger Lakes Vaccine Task Force’s equity plan, and these recommendations are specific to our coalitions’ membership and goals. All priorities in this letter are presented to you in no particular order. These are all feasible and attainable if we work together and commit to enacting these recommendations.
The African American Health Coalition and the Latino Health Coalition jointly present these recommendations with the intent of advancing equity and offering ground level solutions. We hope you take these recommendations very seriously and provide the infrastructure to realize these solutions. If you have alternative solutions for any of these suggestions, we are open for conversation. Please direct all questions pertaining to this proposal to Miguel Meléndez at firstname.lastname@example.org.