It was Chamber of Commerce weather on a recent Saturday, and at the Latino Credit Union branch off Capital Boulevard in Raleigh, people lined the building in order to get their second doses of the COVID-19 vaccine. Off to the side, a DJ played music through a speaker hooked up to a car.
Dr. Viviana Martinez-Bianchi, the director for Health Equity in the Duke Department of Family Medicine and Community Health, couldn't stop smiling. Even though her mask covered her mouth, her eyes squinted in such a way that everyone knew she was happy.
"9 a.m. was the first appointment, and by 9:15 we already had 80 people vaccinated," she said. "So people were lining up wanting to get their second shot."
Inside the branch, it looked like a mashup of a bank and a health clinic. Vials lined cubicle desks where nurses called the next patient in line. Instead of the ropes that normally snake a line to see a bank teller, chairs sat spaced out so patients could wait to see if they experienced any side effects. Ana Esparza was there for her second shot to protect herself - and those she loves.
"For me, I want to (be vaccinated) because I don't want to be infected for my family, for my kids," she said.
Esparza cleans houses for a living, so she comes in contact with a lot of people, which increases her chances of coming in contact with the virus that causes COVID-19, even if she wears protective gear.
"I use my gloves. But still, you are scared. You are scared to get it and then bring it to your house," she said.
Her husband, a painter, was slightly hesitant to get the vaccine, but she encouraged him to come along.
"And today he was scared in the morning, but I said, 'No, no, no! Don't think anything is going to happen. Just let's go and let's do what we have to do,' and that's it."
Latino people faced the widest disparity in early vaccine distribution. In the first nine weeks that the COVID-19 vaccine was available in North Carolina, people who identified as Hispanic accounted for just 2.5% of those vaccinated, despite that group representing 10% of the total population. In recent weeks, those numbers saw improvement, though an imbalance remains. Although some within the Latino community remain hesitant to get the vaccine, survey data still show significant access barriers for those who really want a shot.
Latino Credit Union Chief Executive Luis Pastor said those barriers are rooted in how immigrants have been treated in this country.
"It's about lack of opportunity," he said. "It's about the way that some people can look at you when you speak with an accent. The way that some people look at you when you don't find the right word, because your vocabulary is not as fluent as it should be. It's the way that some people are going to require you to show certain documentation when it's completely unnecessary."
Undocumented immigrants in particular have an additional fear of coming in contact with American systems, said Pastor.
"So I don't believe we should blame the victim. And in this case the victim is the person who has been excluded from the system," said Pastor. "The system is not ready – has never been ready – to incorporate the new immigrant. It's not just the Latinos; it has been the history of the United States and any wave of immigration coming to the United States. The system is ready to expel them, not to incorporate them."
I think it's a mistake to say that access is no longer an issue. I think there still has been access issues in certain historically marginalized populations that need to be addressed.Brian Klausner
The partnership between Duke and the credit union makes good sense. Duke providers want to get the vaccine into underserved communities, and the credit union owns likely the biggest contact list of Latino residents in the state, something Dr. Martinez-Bianchi said was crucial in making the outreach campaign a success.
"Everybody's asking about getting their family members scheduled to get a vaccine. Or they're asking questions about their children, and they want their kids to come in and get vaccinated. They're asking questions about when will vaccines be available for the younger ones," she said. "So to me that means not only have we become a trusted entity – people trust us, trust this coalition to come in and get their shots today – but they're also wanting it for the rest of their family members."
Church As Trusted Provider
On the other side of Raleigh, a similar clinic offered vaccines as well as dental and eye screenings. WakeMed Health primary care physician Dr. Brian Klausner said providers must double efforts to reach underserved communities.
"I think it's a mistake to say that access is no longer an issue," he said. "I think there still has been access issues in certain historically marginalized populations that need to be addressed."
The clinic in the parking lot of Holy Name of Jesus Cathedral operated in partnership with St. Joseph Primary Care. Doctor Peter Le, himself an immigrant from Vietnam, has dedicated his life to providing health care in underserved communities, particularly immigrants.
"During this pandemic, the Hispanic (community), they're the ones who hurt the most. And so we just want to show love, right? Do little things with love," he said.
Even when there is hesitancy, he says to not dismiss concerns. Dismissing legitimate questions, or quoting language from the Centers for Disease Control and Prevention can turn some people off.
"Don't show me about all of this PubMed publication of doctor so-and-so," he said. "Just sit down and have a hamburger and talk to me. And the same thing with John Doe down the street. … Just give me a beer and then sit down. Talk to me, you know? And then we will go from there."
Across North Carolina, less than 40% of the total population is fully vaccinated. But other metrics have improved dramatically. Hospitalizations, for example, dropped from 4,000 in January to below 1,000 in May. State leaders say they will continue to provide education and information related to the vaccine, and work to bring doses to all corners of the state.
