Clinic turns to personal relationships to overcome vaccine delays and hesitation among Hispanic Utahns

At age 51, Leonardo Montes has been eligible for the coronavirus vaccine for almost two months. But he didn’t get signed up for his first dose until last week, when his doctor’s office advertised vaccine appointments on its Facebook page. Montes quickly snagged one of the 150 slots, which all were taken by the time he arrived in South Salt Lake for his shot Saturday.

“I know the people here,” Montes said, confirming what the medical director of Clinica de Salud EZ anticipated: Personal referrals appear to go a long way toward getting shots in the arms of people who otherwise might have delayed or opted out altogether.

“I think they feel more confident coming here because they know us,” Naomi Salazar said as cars lined up in the parking lot behind the clinic.

With vaccination rates lagging among Utah’s Latino population, health officials are increasingly trying to use community connections to promote and administer shots.

In Salt Lake County, 9.61% of Hispanic residents had been fully vaccinated as of Saturday, compared to 12.63% of non-Hispanic residents. And just 14.34% of Hispanic residents were partially vaccinated — barely half of the rate of non-Hispanic residents who were partially vaccinated.

Statewide, Hispanic or Latino Utahns accounted for just 8% of all vaccinated people, even though they represent 13.3% of Utah’s adult population. The national disparity is even bigger; data from the U.S. Centers for Disease Control and Prevention show Hispanic or Latino people account for 9.7% of all fully vaccinated people, while making up 17.2% of the population.

Health experts have pointed to barriers in language and access to technology, both of which may make it harder for some Latino patients to navigate online sign-up forms. In some cases, patients may not have learned the shots are free to those without insurance. Others have jobs that don’t allow for time off during the hours of vaccine clinics.

Naomi Salazar estimated that about 60% of patients at Clinica de Salud EZ had tried at some point to sign up for vaccine appointments at one of the daily county sites but got discouraged when they found all slots were full, or the available slots were too far in the future for the patient to realistically know whether they’d have that time free. By contrast, the appointments county health officials offered at Clinica de Salud EZ took place just days after the clinic sent invitations to its patients — another factor that prompted Montes to sign up.

When Clinica de Salud EZ staff reached directly out to patients, they in turn reached out to their family and friends. Betilia Alvarado Rubi signed up for a slot at the clinic because her work as a housekeeper requires exposure to other people’s spaces. Her husband, Oscar Hernandez Diaz, hadn’t planned on trying to get a vaccine right away — but he decided to tag along.

“I said, if she comes, I’ll get it, too,” Diaz said.

That type of personal interaction may become increasingly important to motivate patients following the early crush of vaccine registrations, Naomi Salazar said. Vaccines have already reached most of the patients who were willing — and had the the time and resources — to log into multiple county and pharmacy sign-up websites the moment appointments opened up.

Now health officials need to reach the people who may need an easier process or a bit of encouragement from a voice they already trust.

Lidia Leon and Carlos Salazar began texting friends from the parking lot after their shots Saturday, urging them to check for availability at Clinica de Salud EZ in case of any leftover doses from no-shows. Their neighborhood in West Valley City was ravaged by COVID-19, especially early in the pandemic. Nearly 17% of Utah’s Latino population has tested positive for the coronavirus, the highest rate of any racial or ethnic group except for Native Hawaiians and Pacific Islanders, at 18%. By contrast, only 10% of white Utahns have tested positive for the coronavirus.

Leon said she and her husband lost “easily 20″ personal friends and acquaintances to COVID-19.

“These were people we would see and say ‘Hi’ to, they were very well, and two weeks later, they were gone,” Carlos Salazar said.

As Leon and Salazar texted their friends, Leon was dismayed that so many people her age didn’t want to get vaccinated.

“They think the vaccine will give them COVID,” Leon said, speaking through a translator.

“Or they’ve heard people have died from the vaccine,” Carlos Salazar added.

Naomi Salazar said that concern has been raised more frequently among the clinic’s patients since the United States temporarily paused distribution of the Johnson & Johnson vaccine while researchers investigated a rare blood clotting disorder that occurred in about one in every million patients who received the shot. Clinic employees were able to reassure those patients that they were offering the Moderna vaccine — an intervention that is less available when patients sign up at a pharmacy, not knowing which company’s vaccine they’ll receive.

Still others were worried the government would install “microchip” monitors in their bodies via the shots, she said — a myth that has circulated since the vaccines first were introduced. When doctors offer the shots directly, they have an opportunity to dispel rumors that circulate on social media, Naomi Salazar said.

But after watching so many people die in the past year, Leon said she felt nothing but relief to get her first shot.

“I’m so happy,” she said.