By Anne Blythe

As the sun set in leafy west Durham, leaving a palette of salmon- and gold-colored streaks across the sky, a steady stream of people walked up to the Asbury United Methodist Church on a windy Thursday evening.

Upbeat salsa music wafted from an amplifier in the church side yard.

Rapid response operators from La Semilla, a faith-based organization that reaches out to the Latino and larger immigrant communities, stood under a canopy, swaying to the festive beat.

For three hours, the La Semilla team signed in some 500 people who came to get a first dose of a two-shot COVID-19 vaccine at the community clinic operated in conjunction with Duke Health.

“We’ve been heavily invested in pandemic response,” said Edgar Vergara, pastor of Iglesia La Semilla, a new faith community that’s worshipped since 2019 at the nearly 100-year-old brick church on the edge of Duke’s East Campus.

As a couple checked in to get their vaccines together, Vergara pointed to another part of the church yard where others working with La Semilla were giving out boxes with food such as fruit, rice, canned goods, cooking oil and more.

For months, while La Semilla and its team of volunteers and rapid response operators distributed food at sites throughout the region, they also shared much more.

Nayeli Garcia, a full-time rapid response coordinator, has taken the time to talk with families about COVID-19 vaccines and respond to any questions.

As the sun sets at Asbury United Methodist Church in Durham, La Semilla and Duke Health get people vaccinated inside. Photo credit: Anne Blythe

“When I tell them, ‘My name is Nayeli and I took the vaccine,’ they say, You did?’,” Garcia recalled recently. “I tell them yes and it is safe, that I am OK. They want to know more.”

Though North Carolina’s governor and public health team have built the state’s COVID-19 vaccination distribution plan on the theme of being “fast and fair,” there are persistent disparities in the number of vaccinated individuals in communities of color.

Hispanics make up 9.8 percent of North Carolina’s population and have borne the burden of 21 percent of the state’s more than 930,000 cases of COVID-19. But, as of April 8, they only made up 5.5 percent of those vaccinated.

Black residents, who comprise 23.1 percent of the population, have had a lower rate of infection at 21 percent, but have made up 25 percent of the state’s deaths. Blacks only account for 17.2 percent of those vaccinated.

Initially, there was much talk among health care providers and others about vaccine hesitancy in such communities. More recently, though, the disparities have been framed more about issues of access.

“The average Hispanic family is eager to get the vaccine,” Vergara said.

As public health advocates work to knock down access barriers, they also want to ensure that accurate messages are being spread through communities and to vaccine providers.

“You don’t need to take a Social [Security card] or identification,” Garcia, who is fluent in Spanish and English, makes sure to tell the people she speaks with.

No ID necessary

Throughout the pandemic, there have been concerns among North Carolina’s Latin population about being asked by health care providers, COVID testing site workers and others to provide identification cards and papers that they fear might be turned over to immigration authorities and used against them.

Though it’s important for the state to collect ethnic and racial data to ensure fair distribution of vaccines, and to get a name entered into the state database correctly spelled that accurately reflects what’s on other documents, how that’s done has made some uneasy.

The Latinx Advocacy Team and Interdisciplinary Network for COVID-19, known more commonly as LATIN-19, has gone into depth during several weekly meetings about the confusion over whether an ID is required.

Though residents are told they are not required, some vaccine providers ask for them.

LATIN-19 dates back to March 2020, when several Latina physicians and health care workers at Duke formalized lunchtime conversations they had been having for months and invited others to join them once a week on Zoom.

Throughout the pandemic, the number of people attending the Zoom meetings has grown. For an hour in late March, more than 100 people tuned in at their lunch hour to listen to or take part in the discussion.

Community organizers, health care workers and others went on at great length about how North Carolina’s Hispanic population trailed the percentage of white and Black residents being inoculated.

Yazmin Garcia Rico, a social worker who is the director of Latinx/Hispanic Policy and Strategy at the state Department of Health and Human Services, said in late March that she had been hearing at least once a week about vaccine site workers asking for IDs.

Two rapid response operators from La Semilla hand out bags of personal protective equipment during a COVID-19 vaccine community event in Durham. Photo credit: Anne Blythe

During the March 31 meeting, there were anecdotes of people being asked for an ID at a Sampson County clinic, a Chapel Hill pharmacy and in Durham. Those are not isolated incidents, Garcia Rico said. It’s happening across the state.

“We continue to bring that up, we continue to address that with vaccine providers,” Garcia Rico told the Zoom attendees. “Case managers are reminding and having that conversation, and I ask for reports on how often that is being done so that we make sure when we’re doing vaccine allocations that they are being reminded.”

Additionally, Garcia Rico said, DHHS is in the process of developing a “My Rights” card, or something that could be distributed through Latino communities and organizations, to empower people with information they can use if providers insist on an ID.

“I know that doesn’t solve the issue on the health care providers and we’re also trying to push on that,” Garcia Rico said. “But I also want to make sure that when people show up to get their vaccine that they have something with them that says this is the way it should be.

“We need to work on the provider issue,” Garcia Rico added. “But we also need to make sure that we give our community the tools they need to make sure that they can also do the advocacy, having some sort of material that is bilingual that they understand but they also can show a list of their rights.”

Many names, one individual

At an Alamance County clinic where some people were deterred when asked for an ID, it became clear that volunteers entering information into the state’s vaccine database wanted to make sure they were entering a correct name.

For years, residents who have more than a first, middle and last name – something that’s common in Latin cultures –  can be entered into databases in a variety of ways, generating a trail of health care records under multiple names or a variety of sequencing of their names.

“I was with my mom for her naturalization papers and she has many names, she has seven names, the officer said pick two and made her just decide on two names, on the spot, in the moment, which was kind of devastating to her,” recalled Viviana Martinez-Bianchi, a LATIN-19 founder and family physician at Duke Health.

Which are the two most important ones, Martinez-Bianchi said her mother wondered at the time. Why should I have to make this choice? Her mom gave the officer the names to put down.

“Then they actually misspelled it,” Martinez-Bianchi recounted. “Now the letter DE is part of her last name, which normally shouldn’t have been.”

To get the names listed in the correct order and spelling, some community advocates suggest encouraging people who don’t want to show an ID to write their names on a slip of paper for people doing the data entry or asking those at the computers to turn laptop screens around so someone can confirm their name is spelled correctly.

“One of the issues that we have seen in the pop-up events is that people do not read or have their glasses,” Martinez-Bianchi. “They may not read from literacy levels or they may not read because they can’t really see the screen.”

Hope and optimism

At the Durham church, where La Semilla held the vaccine clinic, a bank of men and women sat behind laptops set up on folding tables as a steady stream of people seeking vaccines came into the room.

Leonor Corsino, an Duke Health endocrinologist and co-founder of LATIN-19, and other health care providers were in the church to administer vaccines after the data entry was completed.

After getting a shot, the newly vaccinated moved into the sanctuary where they were monitored by rapid response operators and others for 15 minutes.

As people rose from the wooden pews and headed toward the front entrance of the church to go out into the night with a new dose of hope and optimism, applause broke out in the sanctuary.

“We call this the blessing area,” Vergara said, pointing to the altar. “Because usually as people leave, we call the blessings.”

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Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.