Face-to-face outreach by community members persuades the unvaccinated
From left to right: Kim McCoy Wade, Director, California Department of Aging; Irma R. Muñoz, Founder and Executive Director, Mujeres de la Tierra; Esperanza Vielma, Executive Director, Environmental Coalition for Water; Jorge Pingarron, Canvasser, Todos Unidos
Through casual conversations, trusted messengers, and even the abuelos of the family, community members hired as outreach workers promote vaccines in marginalized neighborhoods to beat the Delta variant.
By: Jenny Manrique
As the Delta variant continues to cause COVID-19 infection rates to spike, the race to vaccinate those who haven’t yet been vaccinatd becomes more urgent. Community organizations in California have been implementing innovative approaches to reach neighborhoods in the heart of Los Angeles, in small cities like Stockton, and in rural San Joaquin communities where Latinos and minority populations live.
In California, according to official data, less than half of eligible Latinos and African Americans have been vaccinated and that is why canvassers want to close that racial gap despite facing racist situations, gangs, religious anti-vaxxers and even adverse weather conditions.
“Our big issue is a very strong religious community that is present in the park (McArthur),” said Irma Muñoz, Executive Director of Mujeres de la Tierra (MDLT), a nonprofit creating innovative approaches to community participation in Los Angeles, who spoke at a media briefing cohosted by The California Department of Aging and Ethnic Media Services.
“They are all against COVID-19 (vaccine). The parishioners say that the church leaders say ‘don’t get vaccinated, it will be a sin, the injection has poison’,” said Muñoz.
Undocumented Latino immigrants, mostly from Guatemala and Mexico, frequent McArthur Park. There are also three active gangs, who know the work of Muñoz and her vaccine promoters and have allowed them to move around the sector without major setbacks.
“A Latino young man, about 18 years old, was expelled by a gang member… We have had somebody pull a gun on one of our canvassers. They left immediately. No one is here to be a hero and so we give everybody extra training on being safe,” Muñoz said. “But gang members too need to be vaccinated, so I don’t believe in running away and pretending they don’t exist.”
To date, the MDLT has made nearly 2,300 vaccination appointments as a result of nearly 63,700 one-to-one conversations with neighbors. A team of 25 people, mostly promotoras who belong to the community and know the terrain, have dedicated more than 4700 hours to this persuasion work in which 95% of the interactions are in Spanish.
“Communities don’t want to provide personal information such as immigration status, because a lot of folks are not documented. To get the vaccine they have to provide an ID but nobody wants to do it because they think that the IRS or immigration will knock on the door to take them away,” said Muñoz.
In contrast, some unaccompanied minors who arrived from Guatemala do want to be vaccinated so they can work but cannot because they do not have a parent or guardian to authorize them. This population is in limbo “and we hope that the authorities can help us resolve this issue.”
Another barrier is that working-class people are not available for appointments Monday through Saturday. And also there is the eternal distrust in the government that has slowly dissipated as more people who were initially resistant end up receiving two doses of the COVID vaccine.
“Maybe 20% of the work is door-to-door, because during COVID people are not answering their doors … We do crowd canvassing at bus stops, metro stations, tienditas, panaderias, and also among a big vendor population, both permitted and not permitted.”
Recently they are focusing on convincing parents to get vaccinated “for the health of their children,” as the Delta variant is affecting those under 12, who still cannot receive a shot.
“People have fear of the unknown,” said Muñoz. “So we try to take fear out of people’s hearts and put facts in their heads, and many times it takes a while to do that.”
For Kim McCoy Wade, Director of the California Department of Aging, older Latinos, who represent “a disproportionate number of cases” of COVID, are the gateway to vaccinating an entire household. “The messenger is very important … If you start by asking older adults what is important to them, they are the ones who make the decisions in the family.”
In Hispanic households for example, sometimes two or three families live together and all can end up getting vaccinated if their leaders (grandparents and grandmothers), are more interested in doing so.
Another challenge in convincing those who refuse to be vaccinated is their strong political convictions. According to George Pingarrón, door-to-door promoter for Todos Unidos in Stockton, an organization that has already completed 7,500 hours of fieldwork, “a lot of people still do not believe in COVID and they are simply anti-government.”
“We come across the issue with people making a political statement instead of acknowledging that (vaccines are) a need for humanity … We are marking up 8,000 houses or doors, 30% of those are conversations we can have, and only 1% are actual vaccine signups.”
While canvassing in rural Modesto, Pingarrón and his team found themselves in neighborhoods where houses hoisted the American flag and locals let them know that their promotion of vaccines was not welcome. “We have encountered racism. We have encountered physical altercations. We have encountered harassment… But what does work is making that personal conversation. Part of education (about vaccines) is not to take a certain route right away, but to listen and learn how to answer properly to each personal situation.”
Sometimes the inclement summer heat and poor air quality resulting from the Northern California fires also restricts promoters from their outings.
“Although the weather here is sometimes 100 degrees, we adapt accordingly. We go out in the morning, instead of the afternoon, and we do some phone banking, but we rely on that personal touch,” said Esperanza Vielma, Executive Director of the Environmental Justice Coalition for Water (EJCW), an organization led by women of color working on vaccine outreach in the San Joaquin Valley.
“This is our ninth week and we have four zip codes assigned in the area … There have been 184,650 doors knocked, in 80,586 of them we had conversations, and in terms of actual vaccine signups, we have 700 for our area in Stockton.”
The population is predominantly Hispanic so the promotoras are bilingual speakers and some are also from Southeast Asia, which is the other demographic EJCW serves. At the Stribley Community Center they went from delivering 40 vaccines a day to 100, and were successful in spreading their message in places like the Mexican and Asian flea markets.
“We need to be able to amplify the message in multiple languages and work with the Air Pollution Control District, the county and the state, to decrease the potential hazard of the COVID Delta variant that is amplified by our unhealthy air in the valley.”
Vielma also mentioned the challenge of reaching rural areas where agricultural workers are highly impacted by these factors and residential areas are too scattered to reach in person.
“There you have to go back to that old fashioned flyer type but the message is the same: What is the positive in terms of taking the vaccine versus the negative? Amplify that message over and over again in terms of how important it is to get vaccinated, whether it’s for your own kids, your nieces, your nephews, or your grandkids,” she concluded.
To do vaccine promotion, these three organizations receive support from a grant from the Governor’s Operations Office, administered by the University of California in Los Angeles.