On a recent Sunday, Paola Laverde reported from her Berkeley apartment on her computer and joined a dozen fellow Latino op Zoom residents during an hour-long conversation about coronavirus vaccines with a UCSF doctor.
Dr. Maria Garcia explained in Spanish how the vaccines work, what the benefits are and why it is important to receive one.
Laverde, 57, was happy to see faces like hers. She is eager to get a vaccine when it’s her turn, and was curious about which workers would be put first. Others asked if they should still wear masks and exercise social distance as soon as they got a chance, and how to respond to dubious family members who believe false rumors about problems with vaccinations.
“We know that knowledge is power,” said Laverde, a member of the Latinos Unidos de Berkeley group that co-hosted the session. Vaccine information is particularly important in the Latino community, which makes up 39% of the California population. However, Latinos are disproportionately responsible for 55% of COVID infections in the state and 46% of deaths.
As the distribution of vaccines rises locally and in California, health officials and advocates hope to reach more residents like Laverde.
They strive to ensure that color communities and other groups – such as those with limited internet access – do not lag behind. It is especially important that they are reached, as many are essential workers who face risks at work on a daily basis, and others may live in multigenerational households or in more crowded conditions.
However, there is a big problem: it is difficult to know whether people of color are vaccinated on an equal footing with the prevalence of COVID-19 in those communities, because the state and most provinces do not have information on racial and ethnic demographics. of vaccine recipients. .
This lack of transparency is widespread. On Jan. 22, only 20 states reported information on the race or ethnicity of people receiving vaccines, though this was often incomplete, according to an analysis by the Washington Post. California was not on the list. White House officials last week called on states to disclose more consistent demographic data.
California officials say it is important that vaccines are distributed fairly, and they also want metrics to measure their work. On Wednesday, state officials announced that Blue Shield of California, the health insurance company Oakland, will take over the distribution of vaccines on behalf of the state. It is expected to contain a better way to compare the vaccine, although details have not yet been released. Similar problems arose early in the coronavirus testing pandemic, but the state and provinces rectified the problem and provided demographic data – reflecting that testing in some areas reached more white residents than color communities affected by the virus. use of mobile testing areas based in the environment.
Racial and ethnic data on vaccinations may also be more difficult to interpret, at least initially, because vaccines are currently mostly available to certain groups such as the elderly and health workers, who may have different demographic characteristics than the general population.
Within the nine-county Bay Area, only the provinces of Contra Costa and San Mateo provided a breakdown of vaccine recipients by race and ethnicity. However, it is difficult to draw conclusions from the local data, which largely reflects who is eligible for the vaccine, because not all providers receive the breed or ethnicity of the vaccine.
In Contra Costa County, the largest number of vaccine doses are among white people (37%), people of multiple races (16%), people who identify themselves as ‘other’ (16%) and Asians (14%), according to country data. According to the census data, the province is 43% white (excluding Spanish or Latino), 5.4% multiple and 18% Asian.
Some of them reflect the demographic composition of health workers and the elderly. These groups “are” excessively white, excessively Asian and excessively rich, “said Dr. Ori Tzvieli, deputy health officer of Contra Costa.
Tzvieli said the blacks are currently the biggest difference. There is also some inequality among Latinos, but he is not that strong.
“We look at equity in everything we do, and obviously inequalities were a big sign of the COVID-19 pandemic,” Tzvieli said. ‘We saw inequalities in case numbers, inequalities in the test. And now, although the data is incomplete, we are also seeing inequalities in vaccines, and the causes are many. ‘
In the province of San Mateo, most people vaccinated are white (32%) and Asian (24%), according to provincial data; 12% went to people with more races. According to the census figures, the province is 39% white (not including Spanish and Latino) and 31% Asian, with 4.5% identifying themselves as multi-racial.
The lack of state data is worrying, experts say.
“I’m very upset,” said Garcia, an assistant professor of medicine at UCSF and co-director of the Multiethnic Health Equity Research Center. ‘We already know that there are inequalities in COVID infection per se. To address the inequalities, we need to make sure we target the same communities specifically for some of the therapeutic agents, the vaccine, and prevention efforts. I find it really hard to believe that the information is really not available. ”
Dr Sergio Aguilar-Gaxiola, director of the UC Davis Center for Reducing Health Disparities, said that although more information is needed, the state has an enormous task at hand.
“I think the state is trying to do its best, given the restrictions on the supply of vaccines,” Aguilar-Gaxiola said.
Aguilar-Gaxiola is a member of the COVID-19 Guidelines Committee for the Establishment of Vaccines of the State, and ‘it was a very intense process to try to be as fair and considerate as possible and to make our decision by science to lead. and through data, ”he said, emphasizing that he was speaking from his own experience and not on behalf of the committee.
Doctors said they are also concerned about people with language barriers and those who do not have access to computers, or who have little computer literacy – such as the elderly and some low-income people – and may miss out on signing up for a vaccine.
Vivian Lem, a 69-year-old Japanese American from San Franciscan, said she reached out to a representative on the Sutter Health phone line by sheer perseverance.
She has not yet had any luck planning a vaccination, as Sutter currently prefers patients over 75 to appointments.
Lem said that success can be a matter of ‘haves or have-nots’ because it is a luxury to be able to go on the internet and sometimes stop for hours.
“It’s awful. It’s so sad. Everyone’s so desperate,” she said. “It’s a life or death thing.”
The non-profit organization On Lok has an all-inclusive care program for the elderly and is the primary medical provider for 1,600 elderly people in the provinces of San Francisco, Alameda and Santa Clara.
More than 90% of the On Lok participants in federal housing for low-income seniors have given permission to take a vaccine – the result of relationships, trust over time and culturally competent care, said Dr. Ben Lui, chief medical officer of the organization, said. .
The average age of participants is 81 and half have dementia, Liu said. Many people are colored and some are not English speakers. The consent process involved translating documents into several languages and communicating with families – including in some cases the consent of the family members – before vaccines became available.
“In the elderly, depending on their support of their families, depending on their own abilities, which means that some elderly people are not very technically proficient or have cognitive impairment, they often need help to obtain the information,” Lui said. “It benefits those who have the resources and family members who can spend the time and get the information for it.”
Outreach will also be critical to the Black community. Black people in California are responsible for 4% of coronavirus cases and 7% of COVID-19 deaths, while representing 6% of the population.
Many doctors have told The Chronicle that mobile vaccination sites are an important way to tackle language barriers, digital divisions and other challenges.
In Contra Costa, for example, officials plan to grow the number of vaccination sites in underserved areas. They also plan several mobile vaccination clinics at businesses that employ a large number of food distribution and service workers.
UCSF doctors who helped set up community tests in Fruitvale last year are now campaigning for culturally sensitive and bilingual outreach to people of color.
The UCSF doctors, including Dr Alicia Fernandez, work with groups that have local and national residents with black elderly and Spanish-speaking residents to answer their questions about vaccinations. The “COVID-19 Vaccine Speaker’s Bureau” started spontaneously and many questions about answers and answers are done on Zoom of doctors’ homes.
Many experts expect more coloreds to be vaccinated as soon as essential workers can gain access to shots.
Earlier this month, government officials said they were considering allocating 20% of the vaccine distribution to the provinces, based on a stock state that affects the zip codes hardest hit by the virus.
A major obstacle remains the reluctance of vaccines – partly due to deep mistrust among some coloreds in the country’s healthcare system.
“People are sensitive to history,” Aguilar-Gaxiola said. ‘They know of abuse that has taken place, and there is a deep-rooted mistrust in some communities over government agencies or other groups. Not only about recommendations such as vaccines, but also to provide any (personal) information that is identifiable. ”
Dr. Adrian James, chief medical officer of West Oakland Health, knows this well. Lately, he starts every conversation with a patient by asking them, “Do you have questions about the COVID-19 vaccine?”
About 70% of his patients say they prefer to wait until others get a COVID-19 vaccine first. For those patients who agree to be vaccinated, James moves quickly, hoping they will spread the message to friends and family.
“I had a 65-year-old lady today who said she would take the vaccine,” he said. “My question to her was, ‘OK, we have one with your name on it, when do you want to come in?’ ”
Tatiana Sanchez, Catherine Ho and Mallory Moench are San Francisco Chronicle staff writers. Email: [email protected], [email protected], [email protected] Twitter: @TatianaYSanchez, @ kat_ho, @mallorymoench