When Jazmin Sanchez, a 30-year-old nurse in Reno, received the first dose of the Pfizer vaccine in December, she documented the moment in a video posted to her Instagram account.
“To receive something so new was scary, but I knew that I would make such a big impact to the community and to my own family,” Sanchez said in an interview with The Nevada Independent.
But after sharing her experience, Sanchez received messages from people who questioned the reality of the virus and the vaccines.
“There's still people out there who don't think this is real, because it has not touched them, which, good for them,” she said. “But I think that regardless, we all need to do our part in helping this.”
Early surveys on the heels of the initial vaccine rollout and distribution in late 2020 revealed that Latinos, among other groups of color, felt hesitant and skeptical about receiving a vaccine, despite being disproportionately hit by the pandemic. State and local groups identified a lack of access to accurate and up to date information as a reason for the hesitancy and skepticism as rumors and misinformation regarding the vaccines spread across social media.
Latinos have been consistently overrepresented in infection rates across the country and in Nevada since the pandemic began nearly a year ago. Latinos, who make up 29 percent of the state population, account for 35 percent of COVID-19 cases. Nationally, Latinos have died from COVID-19 at nearly three times the rate of white people.
The disproportionate infection and mortality rates are an outgrowth of health disparities that pre-exist the pandemic, limited access to health care and the population’s high representation in frontline essential work in Nevada.
Though vaccines provide a solution to curbing the spread of the virus among vulnerable populations, disparities are already prevalent, according to data released by the Southern Nevada Health District that shows wealthier ZIP codes in Clark County have received the bulk of vaccines so far. Washoe County health officials also announced last week that 11 percent of vaccines had been doled out to Latinos, who make up 24 percent of the county population and who have at times accounted for at least half of COVID-19 cases.
In response, Gov. Steve Sisolak launched an initiative meant to establish equity in the vaccine rollout process.
Carol Luna, project manager for Immunize Nevada, underscored the point that failure to reach Nevada Latinos, the largest racial group in the state besides white people, threatens to hinder the state’s efforts to reach widespread immunity and return to a semblance of life prior to the pandemic.
“It’s just so much of our world opening back up,” Luna said during an interview with The Nevada Independent. “It’s incredibly critical that people that want a vaccine can have access to it and can have the right information to it.”
Margarita Salas Crespo, senior advisor for the Governor’s Office for New Americans, said two groups of people hesitant to receive the vaccine were identified through meetings with stakeholders.
“The one group is the person who is receiving more misinformation, they might say, ‘I don't want to get sick from getting the vaccine,’ or just erroneous information that they're receiving, so that's where the hesitancy lies,” Salas Crespo said. “And then we have the second group, who does want to receive the vaccine, right, but doesn't know enough, doesn't know the process, doesn't know where to go, doesn't have a direct person to ask specific questions.”
Statewide and local outreach campaigns have been working to combat misinformation and level the access to accurate information, but building trust with vulnerable communities is a process that takes time and doesn’t come without challenges.
Access to information was a long-standing issue for non-English speakers and immigrants prior to the pandemic, but became a highlighted issue as the virus swept across Nevada, where 30 percent of the population speak a language other than English at home.
Individual community members, including local priests, have stepped up to help fill the gap, sifting through credible sources for research, then sharing that information with their community via social media.
Immunize Nevada, which launched a statewide COVID-19 information campaign at the onset of the pandemic, translated its website to offer information in Spanish and Chinese and works with liaisons in Clark, Washoe and Elko counties in an effort to spread information across the state. Clark and Washoe counties also organized smaller outreach campaigns for Latinos, called Está en Tus Manos Nevada and Pongamos de Nuestra Parte, respectively.
“We are working towards a targeted campaign that will address some of the concerns or some of the questions of the community that may not be what the general public wonders about,” Luna, with Immunize Nevada, said.
That includes clarifying concerns that Latinos and immigrants have brought forward regarding the cost of the vaccine (which is fully covered by the federal government), whether their private information will be shared and whether receiving the vaccine could affect their immigration status. The governor’s office announced in early January that it will not share any private information with federal agencies obtained through the process of administering the vaccine.
A Kaiser Family Foundation study published in January found that six in 10 Black and Latino adults reported not having sufficient information about where to get the vaccine, compared to about half of white adults. And though the majority of Latino respondents reported feeling optimistic about the vaccine, 42 percent said they felt “frustrated” and 38 percent said they felt “confused.”
The Governor’s Office for New Americans is collaborating with the existing campaigns to ensure the community leaders are connected to the resources they need to implement their outreach efforts.
“We work day in and day out to empower them with that information so that they can carry it on and be our trusted messengers,” Salas Crespo said.
One of the challenges the office confronts in its mission is the quick-paced nature of the vaccine rollout process, which can make providing real-time information difficult.
“The major need is identifying what that process is like, right? When it’s the turn for a specific group or person, where to go to sign up to get the information, when are these slots opening? I think that's been the most important bit of information that we've been getting requested,” Salas Crespo said.
Ivet Contreras, with the Pongamos de Nuestra Parte campaign launched by Washoe County, the City of Reno and the City of Sparks, said providing accurate messaging is only the first step of the battle. The second is providing the information in an authentic way that builds trust in and among the Latino community — not just translating messaging developed for the general population of English speakers.
“It cannot be a one-size-fits-all message, it cannot,” Contreras said. “Because if we do a one-size-fit-all message, these communities, Latinos, Black communities, Native Americans are going to suffer, because they are the target of these misinformation campaigns.”
To accomplish this, the campaign highlights information from established and trusted leaders within the community.
“What happens is that Latinos will listen to their circle, so we have to become their circle, part of their circle, and make sure that the information that they’re getting is coming through people that they trust,” Contreras said.
A Pongamos de Nuestra Parte billboard in a predominantly Latino Reno neighborhood, for example, features Alejandra Salas, a small gym owner whose clientele is mostly Latina women.
And while the Latino community thrives on face-to-face communication and contact, the campaign has pivoted to use social media during the pandemic, aligning with a recent Nielsen report that found that Latinos across the U.S. are 57 percent more likely to rely on social media for information related to COVID-19 and the pandemic as compared to non-Latinos.
The Northern Nevada campaign reinforces and promotes information related to the concerns most important to Latinos regarding the vaccines — “It’s safe, it’s effective, it’s free and it won’t affect your immigration status,” said Contreras.
Contreras also rebutted the idea that Latinos alone are refusing to receive the vaccine, and said it is a trend across all groups — albeit a smaller one as the vaccine rollout has ramped up and has become more normalized. She said she feels “very optimistic” from the engagement the campaign has received and believes many Latinos in Northern Nevada are well on their way to receiving the vaccine as soon as they are able to.
But the uncertainty and instability of immigration policy remains, making some immigrants’ hesitation unique.
“Obviously, the mistrust [of] the government has increased within the Latino community. So we're kind of feeling las secuelas (the aftermath) of the last administration, so there is an element of fear and mistrust, of course, about the vaccine,” Contreras said.
Another major hurdle is the fear present among immigrant community members that receiving the vaccine, or any kind of assistance, may result in damaging pending or future applications for legal residency as a result of the public charge rule, which no longer applies in Nevada after a Ninth Circuit Court of Appeals decision to block it. But the law is complex, hard to understand and chilling effects may continue.
Antonia Roman, a licensed social worker and Immunize Nevada COVID-19 outreach coordinator for Elko County, said she’s noticed the hesitancy and distrust among older Latino patients at the hospital as a result of racism.
“Our reality is that we go driving down the street, and there are Confederate flags up outside people's homes,” Roman said. “And so you understand that you get treated differently. And I think what I noticed with some elderly patients is that there is that distrust, even though there are people in the health care system that don't have those same values.”
Reaching Latinos and immigrants in rural Nevada
While access to information for Latinos and immigrants is scant across the state and country, it’s especially hard to come by in small, rural counties.
Roman noted that the small towns across the sprawling county, such as West Wendover and Jackpot, receive news and information from stations and campaigns across state borders, in Utah and Idaho. The information reaching those communities is not Nevada-specific, and mitigation strategies and vaccine rollout vary widely from state to state, which could lead to more confusion.
“In our area, we have a Spanish radio station that's in Elko once a week. And that's it. And in West Wendover, most of their information comes from Salt Lake (City), which, their outreach for the vaccine is different, their COVID outreach has been different,” she said.
Elko County is nearly 25 percent Latino and 18 percent of the population speak a language other than English at home.
Another hurdle to establish accurate information among community members is the general resistance to wear masks or comply with the governor’s mitigation measures in Elko County.
“You might have an opinion on it, but you've also never been in the hospital when people are dying by themselves because no one can come in,” said Roman, who has worked in a hospital during the pandemic.
Roman said her work as the COVID-19 outreach coordinator in Elko County is “different every day,” but lately, it’s involved more assistance with phone calls and scheduling appointments. This week, she traveled to towns on the outskirts of the county to speak with community members and visit churches, “because at the end of the day, that’s where a lot of Latinos are going to go for their information,” she said.
She’s already noticed how her efforts help foster a sense of comfort, familiarity and trust among community members.
Working at a clinic one weekend, a nurse asked Roman to help a woman who was trembling as she waited to receive the vaccine.
The woman told Roman, in Spanish, that she wanted to receive the shot, but wasn’t sure about it.
“I’m afraid to get this, but I’m more afraid of what it’ll do to my community if I don’t,” Roman recalled the woman saying to her.
After a quick explanation of the vaccine’s safety and efficacy from Roman, the woman calmed down.
“She asked me to hold her hand while she was getting her vaccine and it was very difficult not to cry because, like, as a member of a minority, you have that responsibility that you're the one that's helping your people,” Roman said. “To have somebody that I don't know ask me to hold their hand because she had reservations was really impactful to me because it showed that we're doing something better, we’re trying.”