The fear of undocumented immigrants may deter some from getting the coronavirus vaccine

“I am very concerned,” said Dr. Ranit Mishori, senior medical adviser for Doctors for Human Rights. “If we as a country are to achieve herd immunity, it means that non-citizens living among us must be immunized.”

But Mishori and other advocates and experts who recently spoke with CNN said a major obstacle is getting in the way of that goal: fear.

Here are some of the main problems they are already facing.

She hears concerns from her patients

Dr. Kathleen Page says she has seen this fear play out over and over during the pandemic. Sometimes, she says, undocumented patients are extremely ill with Covid-19, but still afraid of going to the hospital because they fear they could end up in the hands of immigration services.

And when it comes to the vaccine, Page says she’s starting to hear similar concerns from some of her patients.

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“I’ve heard people say, ‘You know what, I’m not sure about this vaccine. I’m not sure if I should trust it, I don’t trust this administration,’” said Page, an associate professor. from Johns Hopkins University School of Medicine.

Federal and state officials are still working out the details of how coronavirus vaccines will be distributed. It can take months for a vaccine to be available, even for some essential workers, let alone members of the general public. And a new government that has vowed to quickly change immigration policy is waiting in the wings.

But already in some corners of the immigrant communities disproportionately devastated by the pandemic, Page says, conspiracy theories about vaccines are emerging. She says it’s not hard to understand why there is skepticism and mistrust of the government in undocumented communities – and why some immigrants fear that data collected when vaccines are given could later be used by the immigration services.

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“ It doesn’t take much, ” she says, “ to convince someone who has seen things like families divorced on the border, children separated from their parents, to think, ‘Well, this government doesn’t take care of me, and why should I trust them? ”

Page says she tells her patients she will take the vaccine, and she hopes they will do the same.

But she says the concerns she’s already seeing bubbling up are a clear sign that community leaders need to get involved in the vaccine rollout.

“We need to get enough people to really trust and access the system and get vaccinated so we can make a difference,” she says. “Otherwise this group of people will continue to suffer disproportionately.”

Asked by CNN if – and how – vaccines would be made available to undocumented immigrants as part of the federal government’s distribution efforts, the Department of Health and Human Services issued a statement saying it “was not involved in this. policy decision “and to ensure that every American has access to the vaccine. State and local governments will ultimately decide how vaccines are distributed, HHS said.

“Operation Warp Speed ​​will deliver vaccines to application sites requested by the jurisdictions, enabling and executing their plans as they know their populations and territories best,” the statement said, referring to the federal vaccination effort.

Concerns about costs can also get in the way

The federal government has pledged that any coronavirus vaccine will be distributed to the American public free of charge.

“We paid for the vaccines, we paid for the shipping and handling costs … will be covered by health insurance companies, private insurance, Medicare, Medicaid and our program to cover Covid-19 expenses for the uninsured,” said Alex Azar, Minister of Health and Human Services earlier this month.

Some Black and Latino Americans are still hesitant to take the vaccine.  This is what feeds that mistrust
But other comments from leaders have given immigrant advocates a pause, as Pfizer CEO Albert Bourla told CNN last month. In an interview with Dr. Sanjay Gupta, CNN’s Chief Medical Correspondent, Bourla said the vaccine would be free “to all US citizens.”

That led to a letter from a New York legislator expressing concern.

As everyone waits in anticipation for a vaccine and a return to normalcy, your recent comment that the vaccine will be free for all US citizens raises an important question: will our refugee and immigrant neighbors (both documented and undocumented) be be included. distribution? ” New York State Senator Michael Gianaris wrote.

“Covid-19 does not discriminate, nor should we get any closer as access to a vaccine,” Gianaris, the deputy majority leader of the Senate, said in a statement released last month with the letter.

Boxes of COVID-19 vaccines are being prepared for shipment to the Pfizer Global Supply Kalamazoo facility in Portage, Michigan.

Asked this week by CNN to explain Bourla’s comments, Pfizer referred questions about the matter to the government, saying the CEO had referred to government statements on the subject.

Concerns about costs often keep undocumented immigrants from seeking medical care, Page says. And those same fears can also make the undocumented community more wary of a vaccine, she says, if clear messages aren’t being sent from community leaders.

And fear isn’t the only factor advocates worry about

While fighting fear around the vaccine is a top priority for lawyers and medical professionals who work with immigrant communities, it’s not all on their mind.

“There is fear, and then there are logistical barriers,” said Joel Diringer, an adviser to the California Rural Legal Assistance Foundation, who is urging California officials to give greater priority to agricultural workers in that state’s vaccination response.

“This is a crisis … This is one of these times in history when we need to protect our workers who feed us all over this country, and we need to meet them where they are to provide service and information and give them the help they need because it’s life and death, ”said Noe Paramo, a legislative advocate for the foundation.

That means, according to Diringer and Paramo, steps must now be taken to schedule things like mobile clinics and flexible hours and ensure that the largely immigrants living in remote, rural areas have access to vaccines.

Staff prepare to begin administering vaccinations in the vaccination pod at Mt.  Sinai Hospital in New York City this week.  Proponents say they are concerned that getting the vaccine to agricultural workers in rural communities will prove more difficult.

Mishori of Physicians for Human Rights says another important issue now deserves attention: getting ICE inmates vaccinated as soon as possible.

“They are even more vulnerable than the undocumented immigrants in the community … because they are in an environment where Covid is really spreading uncontrollably. They are almost like sitting ducks waiting to be infected,” she said.

ICE says the agency is working with its federal and contract facilities to ensure that inmates receive the vaccine.

“ICE will follow the recommendations of the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) and other relevant federal government guidelines regarding vaccine prioritization to ensure that inmates receive their vaccinations as soon as possible,” the agency said in a statement to CNN.

Detainees lay in their cages in their pod at the Stewart Detention Center, in Lumpkin, Georgia, in November 2019.  Hundreds of inmates there contracted the coronavirus during the pandemic and several have died.

But exactly when – and how – that will happen remains unclear.

It took time for officials to realize the extent of health inequalities during the pandemic and take steps to combat them, and Mishori says she is concerned that a similar situation will arise with the vaccine.

“We have frankly seen years of marginalization of health care in these communities. I don’t see it not going to be a repeat story,” she says. ‘But I hope it isn’t. I hope we can stop it. ‘

Mishori says she and other lawyers are speaking out now – before it’s too late.

CNN’s Samira Said, Nadia Kounang, Michael Nedelman and Maggie Fox contributed to this report.

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