When the needle entered just below the left eye of the wolf tattooed on his left arm earlier this month, Fernando Rodriguez became one of the last in his family to get vaccinated against COVID-19.
A few family members caught COVID-19, but recovered, the 32-year-old from Guatemala said in Spanish while visiting a health clinic for the Latino community at Garces Laboratories in Old City on July 17. Rodriguez, a butcher, never got sick, and didn’t feel much urgency to get vaccinated.
Yet when the opportunity to get his first Pfizer dose presented itself, he grabbed it. “He felt like it was the right thing to do for his family,” said his translator, Jose Torradas, a former emergency room doctor and current medical director of Unidos Contra COVID, a regional organization dedicated to boosting vaccination rates in Latino populations.
Helping the city’s Latino residents reach the decision to get vaccinated has required persistent effort, Torradas said. It appears to be paying off.
In recent weeks, Latino vaccination rates have grown faster than those of any other race demographic in the city, according to data from the Philadelphia Department of Public Health. A group that just a few months ago was seriously undervaccinated, now is poised to become the second most vaccinated in Philadelphia.
The growing rate of Latino vaccinations took “huge amounts of hard work,” said Matt Rankin, a spokesperson for the health department.
Latino community and health organizations have worked weekends and evenings reaching out to the city’s 241,000 Latino residents, Rankin said. Options such as door-to-door canvassing and small mobile clinics have chipped away at the number of unvaccinated Philadelphians, just as the highly contagious delta variant has been powering its way through unprotected communities.
“It’s not a matter of just having the vaccine in the community,” said Misha Rodriguez (no relation to Fernando), communications manager for Asociación Puertorriqueños en Marcha (APM), a North Philadelphia-based Puerto Rican community organization that has been participating in the outreach. “We have to be out there.”
As of Friday, 62% of the city’s Latino population has received at least one shot, health department data show, the same percentage as the city’s white population. Until this week, Latino vaccination rates had lagged behind white ones throughout this year. Just three months ago, Latino vaccination rates were 15 percentage points lower than white rates. As white and Black vaccination rates have stagnated, though, Latino rates continue to improve. The most vaccinated group of Philadelphians is Asians, at 88%.
As with other groups in the city, getting younger people vaccinated remains challenging, though vaccinations for 18- to 44-year-old Latinos are improving at a greater rate than white or Black populations.
City officials note that more shots are going to Black Philadelphians than Latinos, but because the city’s Black population is much larger — more than 43% of city residents are Black, compared with about 15% Latino — those rates are growing more slowly.
Higher vaccination rates are paying off in the form of lower COVID-19 rates. July 11 data, the most recent available, show Latino COVID-19 infections as the lowest rate in the city, 0.5 confirmed cases per 10,000 people.
From access to outreach
From November 2020 to February 2021, Manuel Jimenez of Rutgers Robert Wood Johnson Medical School studied Latino communities in four central New Jersey counties to investigate why people were reluctant to be vaccinated. The assistant professor of family medicine and community health found that people overwhelmingly took COVID-19 seriously, and many had suffered during the pandemic.
“The sense of loss, the experience of illness, the sense of constantly being under risk of contracting COVID, that really came through,” he said.
Still, people wanted more information before signing up for vaccines, Jimenez said, and they wanted answers from trusted sources.
The city’s vaccination effort got off to a rocky start in this respect. The FEMA vaccination site at the Pennsylvania Convention Center appealed more to the city’s majority white neighborhoods because of access issues. Plus, people needed computers and smart phones to register for vaccines at first, shutting out the less affluent.
“A lot of it, in some ways, is really kind of catch up,” Misha Rodriguez said.
Broadening outreach began with such measures as a second FEMA-run vaccination site at Esperanza, a North Philadelphia neighborhood with large Black and Latino populations. The majority of its shots went in Latino arms, city data showed, accounting for at least 7% of the more than 182,000 shots Latinos have received.
“Access,” said the Rev. Luis Cortés Jr., Esperanza’s founder and president. “It was access.”
Latino residents have been getting doses throughout the city, with pharmacies, hospitals, and public health providers all contributing. The FEMA site at the Pennsylvania Convention Center was the single largest source of doses for the Latino community — and the city overall — giving almost 20% of all shots received.
A few places have focused on Latino populations and helped boost their numbers significantly: Temple University Health System and Delaware Valley Community Health combined, for example, provided more than 10% of all doses given to Latino residents while making up 5.7% of all doses citywide. Similarly, Congreso and Esperanza’s solo site provided just under 5% of its doses to Hispanic recipients.
Torradas, whose group has been vaccinating since May in Philadelphia and Latino communities in the surrounding suburbs, said speaking to people in their language has been essential.
Cortés agreed, pointing to the fact that some of the city outreach workers in Latino neighborhoods spoke only English.
“You had a group of young people and not one of them spoke Spanish,” he said.
The health department has recognized the need for tailored outreach, assigning three grant-funded “ambassadors” to act as liaisons with Latino communities all summer.
“This work includes canvassing, phone banking, and working with the community to develop plans and actions that will support vaccination,” Rankin said.
One of the three ambassadors, who are focusing on Upper Kensington, Frankford, Hunting Park, Hartranft and Northeast, doesn’t speak Spanish, though, Rankin said.
The city’s Latino community organizations’ relationships and connections built over years has been invaluable. APM has turned to block captains for information, Misha Rodriguez said, an approach that can identify undervaccinated blocks that might not show up in city data.
“Nothing beats person-to-person conversation, either through door knocking and phone calls,” she said.
Knowing the cultures
Vaccine access is about more than clinic locations. Shots must be available on weekends, Torradas said, particularly Sundays, a day of rest and gathering, for a community whose members often work six days a week.
Latino neighborhoods often have close and influential networks of family and friends, and wisely placed clinics can make the most of those opportunities.
He recalled a vaccination clinic in Delaware County held at a soccer field that started slowly and blossomed.
“In that group, one or two bought in, then it was like a domino effect,” he said. “Word spreads.”
Unidos Contra COVID also was careful to tailor its approach to specific segments of the community. The priorities and concerns of Spanish-speakers who are undocumented immigrants, or who have family who are undocumented, are completely different from those who are naturalized citizens or have always been Americans, such as Philadelphia’s large Puerto Rican population.
People who fear deportation, Torradas said, don’t want to do anything to jeopardize their status.
“Going anywhere from work to home to a place of sanctuary or rest that they trust,” Torradas said, “they don’t really break that pattern because breaking that pattern represents introducing risk.”
Talking with Puerto Ricans, Torradas said, means overcoming some of the same history of mistreatment by the health system that has contributed to some Black Americans’ wariness of vaccination. Starting in the 1930s, Puerto Rico was subject to a government-sanctioned eugenics campaign that a 1965 study found had sterilized a third of the women on the island, the largest sterilization initiative in the world.
“There is a very traumatic, real history to their concerns,” Torradas said, “that whole idea that these are the colonizers.”
Overcoming that reticence means patiently and completely answering questions about the safety of the vaccine and its effects, and then answering them again.
“It’s been multiple conversations, layer on layer, that have got people trusting ... in the vaccination,” said Manuel Delgado, APM’s chief operating officer.
Partnered with Temple University Health Systems to provide doses, APM is arranging vaccination teams to meet people where they work so they can get shots during a break.
In the spring, canvassers saw their mission as simply information providers. Now, they are more willing to push back against misinformation, much of it spread on social media. Torradas won’t argue, he said, but he will ask pointed questions to puncture mistaken ideas.
“What is it going to take for you to get vaccinated?” he has said to people.
The boost in Latino vaccinations is encouraging, Cortés said, but the rate is still well below Esperanza’s goal of at least 80%.
“We’re not near the end of the goal,” he said.
Staff writer Jonathan Lai contributed to this article.