‘We’re not given the option to get vaccinated’: Advocates work to narrow racial and ethnic disparities in Wisconsin | Milwaukee Neighborhood News Service
Bram Sable-Smith (Wisconsin Watch/WPR)
April 6, 2021
Barbarafelt ecstatic in January when a Wisconsin Department of Health Services letterconfirmed that she and her parents were eligible for COVID-19 vaccinations.
The28-year-old education student lives with her parents in Milwaukee. All threeshare caretaking duties for Barbara’s young child, who is on the autismspectrum. That unpaid work qualifies them as frontline health care personnel inWisconsin’s vaccine rollout.
WPRand Wisconsin Watch are withholding Barbara’s last name to avoid repercussionsfor her parents, who are living in the country without legal authorization. Thefamily arrived in Wisconsin from Mexico about two decades ago. Barbara iscurrently protected from deportation under the federal Deferred Action forChildhood Arrivals (DACA) policy, which grants some rights to eligibleimmigrants who came to the United States as children.
Barbarashouldered more caretaking duties during the pandemic because her parents workoutside of the home, and they feared exposing the child to the coronavirus.Vaccinations would make everyone’s life a little easier. Booking threeappointments at a Milwaukee Walgreens went smoothly.
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Butthe pharmacy staff turned away her parents because their IDs were expired, shesaid. Barbara said she presented two current, state-issued IDs but was askedfor additional proof of residency. The pharmacy gave her a 45-minute deadlineto return after fetching it from home, she said.
Thefamily left and didn’t come back. It is just one example of what some membersof racial and ethnic groups in Wisconsin say are barriers to getting vaccinatedamong people hardest hit by the pandemic.
Shots at last
Thefamily eventually received shots through the Milwaukee Health Department, wherea family member works. But not until a month later.
“Alot of us want to get vaccinated. But we’re not given the option to getvaccinated,” she said. It’s very challenging, especially for the undocumentedcommunity.”
Walgreenswould not comment on Barbara’s experience unless she signed a medical privacywaiver, a corporate spokesperson said in an emailed statement. The pharmacyasks for identification at the appointment and in the store to match the personreceiving the vaccine to the person who booked it online, according to thestatement.
“Unlessspecifically required by a jurisdiction, our policy is to not turn awayindividuals who do not produce an ID,” the statement said. “Neither astate-issued ID nor U.S. citizenship is a requirement for a vaccine. We arereiterating this policy with our 40,000+ pharmacy team members.”
Vaccinations hard to find for some
Publichealth leaders have called Wisconsin a national
leaderfor quickly and widely delivering shots to residents. But access remains farfrom even among Wisconsinites. The state’s racial, ethnic and other minoritygroups face major barriers to inoculation — just as those groups suffer a disproportionate share of COVID-19 infections,hospitalizations and deaths. A March study of 48 states ranked Wisconsin 32 indelivering shots to highly vulnerable communities.
Interviewswith Barbara and others illustrate how barriers are fueling disparities in thestate’s vaccination rollout.
ShengKhang of Wausau, who is Hmong, sees barriers in the form of“white-culture-based” security questions she answered in a health recordsportal while booking an appointment for her mother, who immigrated to Wisconsin26 years ago. The online portal asked for the patient’s astrological sign,which her mom would have little reason to know.
MelodyMcCurtis sees a range of barriers for residents in the Metcalfe Park neighborhoodon Milwaukee’s Black-majority North Side. Those include a lack of internetaccess, time and transportation — resources that more privileged vaccinehunters have used to find
appointmentsduring times of high vaccine demand.
Wisconsinofficials anticipated some challenges early in their vaccination campaign. DHSin April awarded $6.2 million in grants to promote vaccine accessin underserved communities. But DHS data reveal that stark disparitiespersist: Only 12% of Black residents have received at least one vaccine dose asof April 1, compared to 29% of white residents, 20% of American Indianresidents and 19% of Asian residents. Meanwhile, only 14% of residentsidentifying as Hispanic have received a dose, compared to 30% who arenon-Hispanic.
Aimingto understand what works, WPR and Wisconsin Watch interviewed nearly a dozenpeople working to bring vaccines into underserved communities. The barriers ineach community vary, but the solutions illustrate common themes, including thepower of partnerships, deep listening and meeting people where they are.
‘Our ZIP code has been left out’
Aimingto reach Black and brown-majority neighborhoods in deeply segregated Milwaukee,state and local officials in March broadened vaccine eligibility to allresidents 18 years and older who live in 10 city ZIP codes. Not on that list:53210, home to Metcalfe Park.
“OurZIP code has been left out,” said McCurtis, deputy director of the nonprofit Metcalfe Park Community Bridges, “even though we know that whenCOVID first broke out, 53210 had some of the the most cases, the most deathsand people were getting sick and dying from this virus.”
(Gov.Tony Evers last week expanded eligibility to all residents 16 andolder beginning Monday.)
McCurtis’group worked with the city health department and Milwaukee nonprofits to launchvaccination clinics open to residents 16 and older who live in the MetcalfePark and Amani neighborhoods.
Thecoalition, funded by The Northwestern Mutual Foundation, is planning eight vaccination events through earlyJune. COA Youth and Family Centers and the Wisconsin Black Historical Society,two familiar spaces, are hosting the clinics. Appointments are open to walk-upsonly —  to decrease the likelihood that digitally connected vaccinehunters living elsewhere will gobble up slots.
Thatrequires spreading the word. McCurtis and other volunteers are circulatinginformation about the events and vaccines themselves. They are also closelylistening to their neighbors.
Earlierlistening sessions revealed less trust in the Johnson & Johnson vaccine— hesitancy popping up
in various communities nationwide. Clinical trials have shownthe company’s single-dose vaccine to be safe and effective. But at one glance, the vaccine mightappear less effective at preventing COVID-19 illnesses, compared to the Modernaand Pfizer vaccines, whose trials produced a higher efficacy rate. Expertscaution that Johnson & Johnson performed its tests later in the pandemic ascoronavirus variants emerged, complicating
comparisons.
Evenso, McCurtis knows that perception matters, especially in communities that havereason to distrust an American health care system with a racist track record. So the coalition’s walk-in clinicswill deliver only the Pfizer vaccine — to reduce any hesitancy.
Asinterest grows in the community clinics, McCurtis said, “We’re seeing theeffects of what access, real outreach and commitment does to a community thathas been oppressed and almost left on the back burner for almost a year now.”
Offering comfort and familiarity
Madison,Wisconsin’s Hmong community is seeing similar success with vaccination events.The Hmong Institute, a nonprofit, hosted two such events in March and plansmore.
LifeCenter Madison is hosting the events, providing a familiar backdrop forresidents who previously attended Hmoob Kaj Siab, The Hmong Institute’s culturallyand linguistically accessible mental health program for elders, which pausedduring the pandemic.
Thefamiliarity is key to encouraging shots among Hmong elders, some of whom facedtrauma around vaccinations before arriving in Wisconsin as refugees from Laos,Vietnam and neighboring countries following the Vietnam War, said Peng Her, CEOof The Hmong Institute.
Insome cases, the military in Laos forced mass vaccinations upon villages. Otherresidents may have received poor treatment from disdainful Western doctors atrefugee camps decades ago, Her said.
“Therewas a lot of distrust built back then,” he said. “Fast forward to now when eventhe testing site at (Madison’s) Alliant Energy Center —  the National Guard was there to help. Thathelps trigger a lot of the things that they witnessed and saw back in Laos.”
Vaccinationsite staff speak in Hmong, and the Hmong Medical Association offers informationabout the vaccine and possible side effects through a video playing in awaiting room.
Sincesome residents lack internet access, The Hmong Institute uses word of mouth andother outreach channels. Most of the 49 people vaccinated at the first event,on March 9, previously participated in programs such as Hmoob Kaj Siab, Hersaid. A March 23 event vaccinated 80 residents, and the institute plans tovaccinate 200 more at the next event.
‘Why do you want to help me?’
InMarathon County, the COVID-19 Hmong and Hispanic
Communication Network (H2N) is spreading information and helping to book vaccineappointments through extensive on-the-ground outreach.
Khang,who booked her mother’s vaccine appointment in Wausau, serves as a Hmongcommunity coordinator for the network, a joint project of the WisconsinInstitute for Public Policy and Service and the Medical College of Wisconsin-CentralWisconsin. Khang said her team reaches residents in a variety of ways,including through a Hmong-language podcast and a booth at the Wausau World Market, whereher colleagues can schedule appointments.
TheWausau-based Hmong American Center is also a crucial partner, Khang said, sincestruggling residents have also relied on it during the pandemic for informationon everything from food to rental assistance.
Outreachto Marathon County’s Hispanic communities looks somewhat different, said TonyGonzalez, a Hispanic community coordinator for H2N. Their homes are spread outacross rural countryside and they lack a centralized community center, Gonzalezsaid.
SoGonzalez meets residents where they are. He runs a soccer league, where hecirculates  vaccine information. Gonzalezalso occasionally appears as a guest on El Premerito, a popular local Spanish-languagepodcast.
IsisVidal and Norma Castro, two network liaisons, perform additional outreach,delivering food door-to-door and sharing information about a variety of rent relief and other services, now includingvaccines.
Equippedwith training, the women answer questions such as how much vaccines cost(nothing) and what documents are needed. They also spend time building trust,Vidal said, which strengthens their work.
Theteam’s successes include working with an Abbotsford Pick ‘n Save pharmacy toreserve 100 doses for Latino residents. Spanish-speaking pharmacy employeescalled residents to schedule appointments over the phone, overcoming theobstacle of English-only scheduling websites. H2N community liaisons supplied acontact list.
INFO BOX: Five things to know about
vaccination
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