Liliana Borrero balanced her sleeping baby on one leg as she sat and waited out the 15 minutes a nurse asked her to stick around in case she had any reactions to her first dose of the Pfizer Covid-19 vaccine.
Borrero, 38, was accompanied by all nine of her children, three of whom also received the shot.
They were seated in a room off a hallway in the sprawling Prince of Peace church in Flowery Branch, a suburb about 45 miles north-east of Atlanta. It was a recent Sunday afternoon; a Spanish-language mass had just started in the large chapel nearby.
Borrero’s decision to get the vaccine made her part of a nationwide trend that has been holding steady for several months, and bodes well for Latinos, the country’s largest vulnerable population. As the US endures a wave of cases related to the highly infectious Delta variant, slightly more than one in four of all vaccinations nationwide are now going to Latinos, even though their share of the US population is only 17.2%, according to the CDC.
No other racial or ethnic group has been getting vaccinated at rates that exceed their share of the population by so much. The numbers are based on 59% of all people who had received at least one dose of the vaccine, because not all states report this data, according to the Kaiser Family Foundation. Still, the trend reverses narratives that began late last year suggesting Latinos were hesitant to seek the vaccine, even though they are twice as likely to die and nearly three times as likely to be hospitalized from the virus.
Borrero was one of more than three dozen people who also got vaccinated at the church, with the help of bilingual outreach workers from a Georgia-based non-profit organization called the Latino Community Fund (LCF) and nurse Leah Buchanan, who works with Core, an international crisis response organization. Both are working on the ground in Georgia to get Latinos vaccinated, with financial support from private and public sources, including local, state and federal agencies.
The partnership between the two organizations and the church is emblematic of the driving force behind the surge in Latino vaccinations nationwide: government and some private funding supporting grassroots and nonprofit organizations, who in turn rely on a wide web of community relationships ranging from houses of worship to soccer coaches and cashiers at local markets.
The idea, said Genesis Castro, network and program manager for LCF, is “to get to places where people congregate”, and identify and remove as many barriers as possible to help them get vaccinated – including speaking their language, when necessary.
It’s a public health approach that has been successful in reaching historically marginalized populations before, said Priti Radha Krishtel, co-founder of the Initiative for Medicines, Access & Knowledge, an international non-profit organization that works on health equity. “Time and time again – as seen with HIV or Hepatitis C – when you do community-based strategies and community-centered, culturally tailored content, you’re going to get better results,” she said.
In the case of Covid, “the initial uptick with vaccinations was with people who had access. The infrastructure favored a certain portion of the population,” said Angelina Esparza, associate vice-president for health equity at the CDC Foundation, which has given $30m in mostly federal funds to more than 170 community-based organizations working on vaccinating underserved communities across the US. “In order to increase vaccination rates in marginalized populations, you need to increase outreach and education, and look at accessibility challenges,” she added.
Working in Maryland, Dr Michelle LaRue has made such simple moves as scheduling vaccination events from 2 to 8pm, in order to reach people after work, and “moving from mass vaccination sites to the community”.
“We wanted to make sure the protocols we set up didn’t create barriers,” said LaRue, who directs the Health and Human Services department at Casa, an immigrant advocacy and services organization.
LaRue pointed to a cartoon public service announcement funded by local government that featured “la abuelina”, a grandmother who spoke Spanish and urged her community to get vaccinated. The effort came out of focus groups with Latinos. “We asked, ‘Who do you listen to?’” she said. “It turned out to be a local person – not Fauci, or Biden. It was the pastor, or la abuela.”
In the months since vaccines were rolled out earlier this year, her organization has created a team of five Latinos focused on promoting the shots. An information line went from receiving several hundred calls a month to receiving the same amount in a week.
In North Carolina, Edith M Nieves López, a pediatrician, has trained people hired by community organizations in “how to overcome misconceptions” about the vaccine. At the same time, “word of mouth is the best promoter you can find,” said Nieves López. “Once your neighbor gets vaccinated, and you notice they’re not a zombie, you say, ‘Maybe it’s not true.’
“I used to get more questions about things like microchips and fertility being affected by the vaccine,” she said. In recent months, “I’m not hearing so much misinformation.”
Nieves López has also helped community members in her area fill out vaccine registration forms. “They may not read or write,” she said. She posts her cell number online, and gets text and WhatsApp messages asking about vaccination sites.
Reaching Latinos at the high rates seen in recent months has come from “continuous feedback loops,” said Carolina Escobar, deputy site development manager for Core. “We pay attention to the smallest details … If we’re seeing that a registration system doesn’t work, we do more walk-up events.”
Or, seeing that Uber and Lyft offer free rides to vaccination sites, “we notice who’s on the other end of the line. Do they speak Spanish? Are the people who need rides tech-savvy?” Community volunteers or organizations help schedule the rides, she said.
In one Georgia county, her organization partnered with soccer coaches to get information to Latino families about vaccines. “The coach is a trusted figure. He can say, ‘We have information in Spanish,’” she said.
The Kaiser Family Foundation released a report last week looking deeper into CDC’s data, including a state-by-state analysis. The rise in Latino vaccination rates began sometime in the spring, said Samantha Artiga, director of the foundation’s racial equity and health policy program.
If the trend continues, “it means there’s growing levels of protection in the Hispanic community – which is so important because they’ve been so disproportionately affected by the virus,” Artiga said.
Still, she added, “It does not change the underlying socioeconomic indicators that created the risk. They’re in jobs that are more likely to be exposed to the virus – jobs that cannot be done at home, and don’t include other mitigating strategies like wearing masks.”
Leonardo Velásquez, who was at Prince of Peace church getting his first dose, works in commercial construction. He recently moved to northern Georgia from Washington DC, to live with his brother.
The 37-year-old said he “had doubts” about the vaccine. “I thought it didn’t work,” he said. Then his mother travelled from Mexico to visit the two brothers. “She said I should get the shot, for my children – so I don’t get them sick,” he said. In the few months he’s been in Georgia, his brother’s daughter, who is 12, fell ill with Covid. Her school closed its doors due to a rise in cases. She has since been vaccinated.
The church is Catholic; a recent survey found that between March and June, acceptance of the vaccine among Hispanic Catholics increased from 56% to 80% – more than any other religious group. Velásquez found out about the church’s vaccine site from a cousin, who got her shot there. “Having people who speak Spanish helps,” he said. “You feel more comfortable.”