Preparing for SARS-CoV-2 Vaccines in US Immigrant Communities: Strategies for Allocation, Distribution, and Communication

Abstract

Widely administered efficacious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are the safest and most efficient way to achieve individual- and population-level immunity, making SARS-CoV-2 vaccination the most viable strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic in the United States. To this end, the US government has invested more than $10 billion in “Operation Warp Speed,” a public-private partnership including the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA), and the US Department of Defense. Operation Warp Speed funded the development of several SARS-CoV-2 vaccines and aimed to deliver 300 million doses of a vaccine by the ambitious date of January 2021. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e5. https://doi.org/10.2105/AJPH.2020.306047 )

Confidence and Hesitancy During the Early Roll-out of COVID-19 Vaccines Among Black, Hispanic, and Undocumented Immigrant Communities: a Review

“…For instance, many undocumented residents feared being asked for ID and insurance information that they may not have. Also, they believed the information would be used to contact immigration authorities such as the U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection who they fear may be waiting for them at the clinic [54][55][56][57][58][59][60][61]. In addition, the Trump Administration's redefinition of "public charge," which certified that use of public assistance services may be cause for rejection of residency, concerned many non-citizens as they are worried that the free publicly available vaccine would be included in this definition of a public charge [55,57,[61][62][63].…”

“…Also, they believed the information would be used to contact immigration authorities such as the U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection who they fear may be waiting for them at the clinic [54][55][56][57][58][59][60][61]. In addition, the Trump Administration's redefinition of "public charge," which certified that use of public assistance services may be cause for rejection of residency, concerned many non-citizens as they are worried that the free publicly available vaccine would be included in this definition of a public charge [55,57,[61][62][63]. Immigrants were also afraid of the cost of the vaccine despite the vaccine being free and the potential residual costs involved if the side effects affected their ability to work [55,58,63,64].…”

Words matter, humanity matters: alienating non-citizens from the COVID-19 vaccine

“…Simar Singh Bajaj , 1 Lucy Tu, 2 Fatima Cody Stanford 3 'Of or belonging to another, not one's own, foreign, strange. ' From the Latin alienus, the etymology of the word 'alien' signifies much of what the word connotes: a certain unnatural and inhuman nature.…”

“…As such, it should come to no surprise that immigrants of all documentation statuses have quietly retreated from the public sphere and the healthcare system altogether. 1 Countless reports have found that non-citizens increasingly avoid scheduling doctor's appointments and refuse to answer the door for home health visits, which may help to explain why immigrants are less likely to receive preventive care services and are more likely to suffer from chronic diseases. 1 4 5 While it may be secondary to challenges regarding access, exorbitant costs associated with care, or an unwillingness to put themselves and their families at risk, 4 the health consequences are disastrous.…”

COVID-19, the Pandemic, and Challenges Associated with Vaccines

“…A UK survey in December 2020 showed that vaccine hesitancy was higher among black, Bangladeshi, and Pakistani people compared with white people. Population groups with frequent address change have lower vaccination rates which is common among people from ethnic minorities and makes NHS records inaccurate [52]. Concerns about vaccine hesitancy have been laid primarily at the feet of African American and Latinx communities in the US.…”