Anna Almendrala, Author at ��ýҕ�l Health News

Want Fries With That Vaccine? Even at a Fast-Food Restaurant, Pop-Up Clinics See Slow Traffic

Anna Almendrala — Tue, 27 Jul 2021 09:00:00 +0000

SAN BERNARDINO, Calif. — A few months ago, the boxy, teal truck parked outside a McDonald’s in this Inland Empire city might have drawn hundreds of people willing to stand in line for hours under the scorching sun.

The truck is San Bernardino County’s mobile vaccine unit, which brings covid-19 vaccines directly to people. But on July 15, only 22 people got a covid shot during the four hours it sat there.

Roughly 12 feet away, more people were often seen waiting by a red canopy for free, government-subsidized smartphones, intended for low-income people, than were stepping up for the potentially lifesaving shots.

Barry Luque, a 37-year-old car wash worker who visited the red canopy that day for a free phone, was lured by the truck. He had been but never got around to making an appointment. Had he not seen the truck in the parking lot on his day off, “this wouldn’t have gotten done,” he said.

It’s Luque’s job to guide drivers into the car wash, but his boss won’t let him take his mask off unless he can show proof he’s vaccinated.

“People come in from different lives, different styles, different moods at different times,” he said after getting his first dose of the Pfizer-BioNTech vaccine. “I’ve got to guide them carefully and gently, and it’s kinda hard for them to see the smile on my face.”

Car wash worker Barry Luque got a covid vaccine because his boss requires employees to wear masks unless they can show proof of vaccination. After months of guiding people into the car wash with a mask on, Luque wanted people to see his smile. (Anna Almendrala/KHN)

Luque and the other 21 people who got vaccinated that day — in addition to the scores of others who drove by or waited in the McDonald’s drive-thru line without seeking a shot — offer a snapshot of California’s stalling vaccination effort.

Some who finally got the shot, like Luque, were motivated by mandates from employers or are tired of wearing masks. Others want to visit other countries, and vaccinations travel or quarantine requirements. Some were persuaded, at long last, by family and friends.

Those who continued to hold out primarily cited potential side effects and distrust of the medical system.

Recent polling shows that no matter which tactics are used, a are unlikely to budge on getting a shot, creating an increasingly dangerous scenario as the highly contagious delta variant . In California, about 2,800 people were hospitalized for covid or suspected covid — more than twice the number six weeks earlier — as of Wednesday.

About were fully vaccinated by then, according to the U.S. Centers for Disease Control and Prevention, ranking the state 18th among other states and the District of Columbia.

But the overall rate masks deep disparities among, and even within, regions. In geographically and ethnically diverse San Bernardino County, of eligible residents were fully vaccinated as of Wednesday, with the lowest rates among young people, men, Latinos, Blacks and those who live in the poorest and unhealthiest communities. Statewide, the profile of unvaccinated people is largely the same.

San Bernardino County’s pop-up covid vaccine clinic in the parking lot of a McDonald’s in San Bernardino, California, on July 15 was open to walk-ups and those who made appointments. During the four-hour event, 22 people received shots. (Anna Almendrala/KHN)

One way local and state leaders are trying to get shots into residents’ arms is by hosting pop-up clinics that make covid vaccines more convenient and accessible for those who can’t or won’t sign up for an appointment.

San Bernardino County is at supermarkets, schools, churches and community centers. The state is also funding vaccine clinics, including 155 events at more than 80 restaurants in 11 counties as of Wednesday.

The pop-ups require significant resources and are showing diminishing returns. About 2,500 doses have been administered at the McDonald’s clinics so far — an average of 16 shots per event. The California Department of Public Health declined to say how much these events cost, saying it varies.

At the McDonald’s in San Bernardino, a city of more than 200,000 that serves as the county seat, eight staffers were on hand to check people in, administer shots and watch for side effects from 9 a.m. to 1 p.m. They also scheduled the necessary second dose for another local pop-up event.

Nancy Garcia, a San Bernardino County employee who managed the July 15 pop-up vaccine clinic in San Bernardino, California, says she works a “crazy schedule” to get people vaccinated. Garcia, who lost her mother and a cousin to covid, says she’s deep in the throes of grief. (Anna Almendrala/KHN)

Jeisel Estabillo, 36, hadn’t been vaccinated, even though she is a registered nurse who sometimes cares for covid patients at a hospital. She was one of the first people in the county to become eligible for vaccines, in December, but avoided getting a shot because she wanted to wait and see how it would affect others. She also tested positive for covid during the winter surge.

But Estabillo changed her mind and visited the vaccine clinic with her father and teenage son because they plan to vacation in the Philippines next year and hope vaccination will reduce travel restrictions or quarantines.

Estabillo also likes that vaccinated people can forgo masks in most public places, although that perk may slip away as more California counties respond to the delta surge by to mask up again indoors.

But Jasmine Woodson continued to hold out against the vaccine even though she was hired to provide security and direct traffic for the clinic. Woodson, 24, is studying to become a pharmacy technician and has been tracking vaccine news. She said she was alarmed by the of the one-shot Johnson & Johnson vaccine over concern about blood clots, and reports of rare heart inflammation . She also knows that no covid vaccine has been fully approved by the Food and Drug Administration, which puts her on high alert.

Woodson, who is Black, is also wary because these mobile vaccine events seem to take place only in low-income Black and Latino neighborhoods — a tactic public health officials say is meant to increase uptake in these communities.

“Every day there’s always something new. You’re not meant to live that long, so if you get it, you get it, and if you don’t, you don’t,” Woodson said of covid.

Jasmine Woodson provided security for the San Bernardino County pop-up covid vaccine clinic on July 15 in San Bernardino, California, but hasn’t gotten vaccinated herself. Woodson says she is cautious about the new vaccines because of the blood clots linked to the Johnson & Johnson shot, as well as the rare heart inflammation side effects linked to the mRNA vaccines. (Anna Almendrala/KHN)

Maxine Luna, 69, who came to the nearby red canopy to get a phone, also was not swayed. A longtime smoker whose doctor has been pleading with her to get a covid shot, she fears side effects, mentioning a friend who battled two weeks of headaches, diarrhea and vomiting after getting vaccinated.

To mitigate her risk, Luna sticks close to her home, which she shares with her brother, who is vaccinated, and her sister and brother-in-law, who are not.

“We’re not out and about, we don’t go to shows, and we don’t go to crowded places,” she said.

Concern about side effects is holdouts cite for not getting a covid vaccine, said Ashley Kirzinger, associate director of public opinion and survey research for KFF. (The KHN newsroom is an editorially independent program of KFF.) This is followed by fear that the vaccine is too new or hasn’t been tested enough.

Kirzinger said it’s important to acknowledge that some people simply can’t be persuaded.

“They don’t see themselves at risk for covid, they think that the vaccine is a greater risk to their health than the virus itself, and there’s really no incentive, no stick, no message, no messenger that’s going to convince these populations,” she said. “It’s going to be really hard to reach the goals set by public health officials, with the decreasing enthusiasm around the vaccine that we have seen in the past several weeks.”

Maxine Luna says she hasn’t gotten a covid vaccine because a friend experienced two weeks of unpleasant side effects afterward. Still, she’s scared of the delta variant and mostly stays at home to reduce her risk. (Anna Almendrala/KHN)

This story was produced by KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

This story was produced by , which publishes , an editorially independent service of the .

��ýҕ�l Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

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California Takes a Nibble at Offering Food Stamps to Undocumented Immigrants

Anna Almendrala — Tue, 13 Jul 2021 09:00:00 +0000

SANTA ANA, Calif. — One week the food pantry had frozen crabmeat; other weeks, deli meat or plant-based “meat.” The week before the Fourth of July, there was no meat at all, and a reminder that the pantry would be closed the next two weeks.

Even though she never knows exactly what she’ll get, Lesli Pastrana is grateful for the Mercado El Sol food pantry. She has frequented it ever since she lost her job in January. On a recent Friday, she walked away with produce, eggs and staples like ramen noodles, pasta and oats.

She and her husband are both in the United States without legal authorization. Before the pandemic, they got by with their wages and the food stamps they received for their two young children — both U.S. citizens.

But now that Pastrana has lost her job at a bowling supplies factory where she worked 10 years, and her husband has been downgraded to part-time work at a warehouse, the couple must save every dollar for their $1,500-a-month, two-bedroom apartment in Tustin. Pastrana is looking for a single room to rent for her family of four. She’s worried about her kids.

“I don’t want them to focus on the fact that I don’t have a job right now,” she said. “They don’t know the magnitude of the situation, but they can sense the worry.”

Additional food stamps could help lighten Pastrana’s load and cut down on trips to the food pantry, but like all undocumented immigrants in the U.S., she and her husband are not eligible for these benefits, despite having worked and paid taxes here.

Democrats in the state legislature this year proposed opening California’s state-funded food stamp program — which serves about 35,000 authorized immigrants who don’t qualify for federal food stamps — to all income-eligible Californians, regardless of immigration status. The cost of the proposed expansion, starting in 2023, was put at about $550 million a year.

Julie Bautista, who runs the food pantry at Mercado El Sol, rushes to arrange goods on June 25, 2021. She was expecting about 125 people to show up for boxes of produce, eggs and dried goods like pasta, oatmeal and beans. Before the pandemic, she said, a usual pantry giveaway would attract 45 to 50 people. (Anna Almendrala/KHN)

But after negotiations with Gov. Gavin Newsom’s administration, the proposal was pared down to a two-year, $30 million project to update the state food aid program so it can accept applications from some of the in California, should the program be extended to them in the future.

A in the legislature would expand the food stamp benefit to the undocumented once the system is updated and the legislature has appropriated funds for the expansion.

For now, the state has not committed to expanding the program. But the legislature’s efforts this year put California at the forefront of extending food aid to unauthorized residents. Advocates say the state has a responsibility to help feed them, especially since toil in California’s fields, feeding the state and the rest of the country.

“They’re working and risking their lives, not just through the pandemic, but right now through a heat wave,” said (D-Sanger), co-author of the bill, whose district is in the Central Valley. “They’re risking their lives to provide food for us. Why wouldn’t we invest in them as well?”

The program would be expensive, and the state would have to foot the whole bill. Right now, California is flush with a $76 billion surplus, but state revenue can swing wildly. For instance, the pandemic’s economic restrictions had the Newsom administration just the year before.

California has already expanded eligibility to undocumented immigrants for its Medicaid health coverage program. Since last year it has allowed people under age 26 to participate , at a cost of roughly $450 million annually. Starting in 2022, unauthorized immigrants age 50 and over will be eligible, and the state’s annual costs are expected to grow to $1.3 billion by fiscal year 2024.

Up to 1 million unauthorized immigrants would meet the income requirements for food stamps, according to advocate Jared Call of Nourish California, which co-sponsored Hurtado’s bill. But the program would likely begin by offering the benefit to subgroups such as children and seniors.

To qualify for food stamps in California, most families would have to earn 200% or less of the federal poverty level for their household size. For a family of four, this would mean grossing no more than .

The governor’s office declined to comment on the “Food for All” proposal and its funding, citing ongoing discussions with the legislature to finalize the budget.

Conservatives have expressed caution. Republican state senators voted as a bloc against Hurtado’s bill. In an email explaining his “no” vote, Sen. Brian Jones (R-Santee) said it asks California taxpayers to “bear the burden of a chaotic border situation that is a federal responsibility.”

In the Assembly, where committees are debating the bill, member Steven Choi (R-Irvine) suggested the program’s generosity would compound problems at the U.S.-Mexico border by encouraging people to try to immigrate to California.

Even Democrats, who hold supermajorities in both houses of the state legislature, are wary of making commitments they can’t keep. Food for All would need to be in case revenues lag or other spending increases, according to an Assembly budget report.

, which Newsom was expected to sign Monday, includes other measures to make food available to poor people, regardless of immigration status, including more investment in food banks and a to all California public school students, regardless of income.

The crushing demand for emergency food assistance during the pandemic put a spotlight on food insecurity. In California, said they went without sufficient food during the first three months of the pandemic lockdown, up 22% from before it began in March 2020, according to a study by researchers at UCLA’s Fielding School of Public Health and Luskin School of Public Affairs.

Food banks in response doubled or tripled their food distribution. Schools, closed for classes, kept cafeterias running so families could drop by every week for free breakfasts and lunches. Nonprofits scrambled to organize emergency grocery deliveries for those sick with covid-19.

But people behind these efforts say charity food giveaways are stopgap solutions that often distribute unhealthy food, result in massive waste and rob people of choice.

“Food banks get — I don’t want to say ‘hand-me-down food’ — but they often get food near its expiration date,” said Claudia Keller, chief mission officer of Second Harvest Food Bank in Orange County. “Food that might be high in sugar, salt and fat. And that, to us, is a disservice to the most vulnerable in our community.”

Advocates say there is a better solution to hunger: Simply give families cash or stamps to buy their own food.

Vanessa Terán of , on California’s Central Coast, said this is why her organization, which primarily serves undocumented immigrant farmworkers, switched from organizing food drives to raising money for prepaid grocery cards.

“People are able to buy what they need, and also there’s a shopper’s dignity,” she said. “They can make choices for their own families that best meet their needs.”

The same approach was taken by the federal benefits program — known nationally as SNAP and in California as CalFresh and often called food stamps — which mails beneficiaries grocery-usable cash cards that automatically reload each month.

Undocumented immigrants make up an estimated 8.1% of California’s workforce, according to a 2019 summary of data from the think tank. A 2019 analysis by the nonpartisan California Budget & Policy Center estimated the state’s undocumented immigrants .

Hurtado praised her colleagues’ decision to expand Medi-Cal to more groups of undocumented immigrants, saying “hunger and health go hand in hand.”

“The foundation for good health is having access to adequate food, and healthy food,” she said. “But I think that something is better than nothing, and I’m happy with the progress that we’re making.”

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Newsom Wants to Spend Millions on the Health of Low-Income Mothers and Their Babies

Anna Almendrala — Thu, 03 Jun 2021 09:00:00 +0000

Amid a pandemic that has pushed millions of , caused and , California Gov. Gavin Newsom and Democratic lawmakers are seeking a slate of health proposals for low-income families and children.

Newsom, a self-described feminist and the father of four young children, has long advocated family-friendly health and economic policies. Flush with a projected budget surplus of $75.7 billion, state politicians have come up with myriad legislative and budget proposals to make poorer families healthier and wealthier.

They include ending sales taxes on ; adding benefits such as doulas and early childhood trauma screenings to Medi-Cal, the state’s Medicaid program; allowing pregnant women to retain Medi-Cal coverage for a year after giving birth; and a pilot program to provide a universal basic income to low-income new parents.

“COVID-19 laid inequity bare for all to see,” Assembly member Wendy Carrillo (D-Los Angeles) said in a written statement. She is the co-author of Senate Bill 65, led by Sen. Nancy Skinner (D-Berkeley), which would pour hundreds of millions of dollars into family and health care programs annually, focusing on minority groups that Carrillo said were “pushed out of the social safety net by the prior White House.”

Newsom and the Democratic-controlled legislature are unified on major health care and social safety-net expansions, which would direct billions in health benefits and cash assistance to the state’s most vulnerable residents and low-income parents. Legislative Democrats for years have pushed a progressive agenda to help struggling parents and families, featuring proposals like those to permanently end taxes on menstrual products and diapers — .

“We don’t need to balance the budget on half of the population that has a uterus,” said Assembly member Cristina Garcia (D-Bell Gardens), who has to the “pink tax” on diapers and menstrual products.

Skinner, chair of the Senate budget committee, is among the powerful lawmakers who’ve put forward legislation to make childbirth safer and parenthood more affordable. Her bill, which cleared the Senate and was up for consideration this week in the state Assembly, has several features that would dramatically expand maternal health care (transgender men also get pregnant and give birth).

Before the pandemic, Medi-Cal covered mothers only up to 60 days after their pregnancies ended unless their income fell below a certain line or they had a mental health diagnosis. Skinner’s bill, part of a to improve birth outcomes, would expand full Medi-Cal coverage to 12 months after the end of a pregnancy. Other would intensify state reporting and reviews of fetal and pregnancy-related deaths and severe maternal morbidity, expand housing benefits for families that have a pregnant member, and increase training programs for midwives.

Newsom’s $268 billion budget blueprint includes about $200 million a year to fully implement the expansion of Medi-Cal coverage for new mothers, with matching dollars from the federal government until those funds expire in 2027. If the expansion were not renewed, the state would revert to previous Medi-Cal qualifications.

in California in 2017, the last year for which data could be found.

“Not all postpartum issues end at 60 days, and when patients lose insurance, we can’t address them in the usual way,” said Dr. Yen Truong, an OB-GYN who works with the American College of Obstetricians and Gynecologists on legislative issues in California.

About half of pregnancy-related deaths occur during the pregnancy or on the day of delivery, but about 12% take place after giving birth, according to the Centers for Disease Control and Prevention.

The U.S. had 17.4 early maternal deaths per 100,000 live births in 2018, according to the most recent CDC data with state figures. California’s rate, , was among the lowest in the nation, but the state collects data on maternal deaths in a way that could result in underestimates.

California’s overall numbers also obscure stark racial disparities. Statewide, Black infants averaged , compared with an average of three deaths among white babies. Data from 2013 from showed Black women had pregnancy-related deaths at rates more than four times as high as the overall rate in the state’s largest county.

“Given our state’s wealth and medical advancements, this is unacceptable,” Skinner, vice chair of the Legislative Women’s Caucus, said in a news release.

Democrats also appear unified on another aspect of Skinner’s bill: a pilot program to test a universal basic income program for struggling families. The bill would give $1,000 a month to low-income expectant and new parents with kids under 2 years old in counties that decide to participate. Newsom has also proposed for pilot programs for universal basic income.

These issues could play well, especially among women, and improve Newsom’s standing going into a recall election later this year, said Rose Kapolczynski, a longtime campaign consultant to former U.S. Sen. Barbara Boxer who has worked on reproductive health care issues in Sacramento.

Indefinitely rescinding sales taxes on diapers and menstrual products — the taxes have been — is a particular no-brainer because of its bipartisan appeal, she said.

“It’s hard for Republicans to attack something that is a tax cut, and sales taxes are regressive, so progressives would like it,” Kapolczynski said.

As for Medi-Cal expansions, Kapolczynski said that even though it wouldn’t affect most Californians, the pandemic has made health care even more important to voters. “The budget surplus is allowing many things that were called impossible to be possible, and that includes health care bills,” she said.

Investing in California’s young families could help close the racial gap in maternal and infant mortality, said Nourbese Flint, executive director of the Black Women for Wellness Action Project, which endorsed Skinner’s bill.

Flint is especially excited about the possibility of covering doulas through Medi-Cal. Doulas, trained as emotional and physical supports for women in pregnancy and postpartum, have been linked to and . If doulas saved Medi-Cal money by reducing cesarean births, that could enable the state to renegotiate payments for labor and delivery, according to an . Under Newsom’s proposed budget, Medi-Cal coverage of doulas would cost about .

California’s would become the first Medicaid program to include “full spectrum” doula coverage, meaning it would include care for women who have abortions, miscarriages and stillbirths, said Amy Chen, a senior attorney at the National Health Law Program.

“California has always led the country and been a little bit in front of where our federal government is when it comes to covering folks,” Flint said.

California Healthline correspondent Angela Hart contributed to this report.

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Corporations Encourage Employee Vaccination but Stop Short of Mandates

Anna Almendrala — Tue, 25 May 2021 09:00:00 +0000

Many of the companies with the largest number of employees say they’ll do almost anything to encourage their employees to get vaccinated. But a survey of some of them found that none would be inclined to mandate shots as a condition for holding a job.

Almost all 15 companies surveyed — among the largest and most influential — have strong pro-vaccine messages from their corporate leadership, emphasizing that the shots can both help protect individuals and bring the pandemic to a close.

CVS Health, which administers covid vaccines as part of the federal pharmacy distribution program, says it strongly encourages the shots for its employees “” but won’t mandate them. Starbucks is also encouraging the shots “,” but also doesn’t mandate them.

Some companies are giving employees paid time off to either get shots or stay home if they have side effects, a trend that could increase now that the Biden administration has for smaller companies to offer up to 80 hours of paid sick leave until Sept. 30.

Target is giving hourly employees up to four additional hours of pay if they get the vaccine (two hours per shot). Amazon is offering $40 a shot for hourly workers, and Kroger is giving employees $100 if they receive both doses.

“Vaccination, in our view, is absolutely the only way out of the pandemic, both for us to get to normalcy and also for the country,” said Dr. Vin Gupta, a pulmonologist and chief medical officer for Amazon’s covid response.

Amazon, like other large retailers, has experienced covid outbreaks at its workplaces throughout the pandemic. In October it revealed that had tested positive or were presumed to have been infected with the covid virus.

The company, which includes Whole Foods Market, distribution warehouses and data centers, has organized vaccination events for employees such as delivery workers in at least 29 states, and is among the giant companies doing the most to bring shots to its workers. But for now, Amazon isn’t making vaccines mandatory.

Target, the only company among those surveyed that is offering financial incentives, extra paid time off and vaccinations at the worksite, has no plans to mandate the vaccinations.

However, the pandemic has brought a stream of fast-changing policies and recommendations from federal health authorities, and some companies, while declining mandates for now, indicated that could change.

“I don’t have a crystal ball, and I can’t predict the future, but that’s what our message is now,” said Carrie Altieri, vice president of communications for covid strategy at IBM.

Legal and public health experts caution against any mandates before the Food and Drug Administration fully licenses the shots, which could happen this summer. The vaccines were authorized by the FDA for “emergency use” and as such employers can’t require them, some legal experts have argued. Even post-licensure, though, companies could spark a backlash if they require employees to get them, said Joanne Rosen, senior lecturer and associate director at the Center for Law and the Public’s Health at Johns Hopkins University.

A mandate could anger certain employees while only marginally increasing the number of vaccinations, Rosen and others say. It would be more prudent to focus on “carrots instead of sticks,” she said.

“If the purpose of a mandate is to ensure that the largest number of people get vaccinated, a backlash to a mandate, in which you have more reluctance or opposition to vaccination, is the opposite of the outcome you want to get,” she said.

Post-licensure, employers would face fewer legal challenges to vaccine mandates, especially if staff members work with medically vulnerable or at-risk patients, as in nursing homes or prisons. Aside from these special sectors, employee mandates aren’t necessarily a good idea from a public health perspective, said Michelle Mello, a professor of law and medicine at Stanford University.

Hard-line vaccine opponents likely wouldn’t be swayed by an employment-based vaccine requirement, and it could risk alienating some in the “wait and see” contingent, she said.

About not yet vaccinated against covid said they would accept a shot if it was required, according to an April survey from KFF. An additional 15% who hadn’t gotten a shot expressed a “wait and see” attitude toward vaccination. And 13% flatly refused to be vaccinated.

Gains in the small group who say they’d get a shot if it’s required might not be worth the uproar a mandate could foment, Mello said.

Mandates risk further politicizing covid vaccines in U.S. society, said Brian Castrucci, CEO of the de Beaumont Foundation, a charity focused on public health.

Polling conducted by de Beaumont and GOP pollster Frank Luntz on that 36% of those who voted for Donald Trump in the 2020 presidential election agreed it was important for American businesses to encourage and incentivize the vaccines, versus 54% of Joe Biden voters. The survey also found that 41% of Trump voters believed that businesses should not be involved in covid vaccinations at all, compared with 18% of Biden voters.

“Mandating vaccination will hit every button there is on the political right,” Castrucci said.

Once public health tools and strategies become politicized, local governments can choose to simply take them off the table as an option. A new bans businesses and government entities from requiring proof of a covid vaccination. The law builds on Gov. Ron DeSantis’ , which he signed April 2.

“Vaccine verification can be a useful tool,” Castrucci said. “Now it’s no longer available in Florida.”

Despite the potential backlash, the financial case for covid vaccinations is clear, said Aaron Yelowitz, an economics professor at the University of Kentucky, given .

Taking into account the costs of a shortened life span, mental health conditions and lost income due to illness and shutdowns, the covid pandemic has cost the average American family of four almost $200,000, according to an analysis by .

Some of these costs may be borne by businesses in the form of lost productivity and higher health insurance prices, said Yelowitz. Financial incentives for the shots are thus an extremely tempting trade-off, he said.

Incentives for vaccination — like a $25 gift card or free Uber ride — are “surely worth it in terms of savings,” Yelowitz said. In the same vein, he also called Ohio Gov. Mike DeWine’s “innovative and imaginative.”

But for now, employers are sensitive about what they can and can’t demand of workers, said Lindsey Leininger, a clinical professor of business administration at Dartmouth College. The tight labor market and the fraught, ongoing negotiations over when and how to bring employees back to the office makes some companies wary of asking too much of their workers, said Leininger, who advises smaller businesses on covid vaccines and other issues.

“All of the businesses I work with have a general preference for carrot versus stick types of approaches,” she said. “How many things do you want to mandate of your employees right now?”

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Latinos Are the Most Eager to Get Vaccinated, Survey Shows — But Face Obstacles

Anna Almendrala — Thu, 13 May 2021 17:05:00 +0000

Hispanics who have yet to receive a covid shot are about twice as likely as non-Hispanic whites or Blacks to say they’d like to get vaccinated as soon as possible, according to a survey released Thursday. The findings hint at fixable, though difficult, vaccine access problems for the population.

One-third of unvaccinated Hispanics say they want the shots, compared with 17% of Blacks and 16% of whites, according to the survey released Thursday by KFF. (KHN is an editorially independent program of KFF.)

One-third of Hispanic adults who haven’t received the covid-19 vaccination say that they’d like to get it “as soon as possible.” The figure is about twice that of non-Hispanic Black and white groups, and suggests that targeting Hispanics for vaccine education and outreach represents a major opportunity to raise overall vaccination rates. (KFF)

The results reflect an opportunity for public health departments and local governments to reach out to Hispanics with information and vaccinating teams, said Liz Hamel, vice president and director of public opinion and survey research at KFF and director of the organization’s monthly covid vaccine surveys.

“There definitely is a large chunk of the Hispanic population that’s eager to get it, but they just have either not been able to fit it into their schedule, or they have some concerns or questions or they haven’t been able to access it,” Hamel said.

According to the Centers for Disease Control and Prevention, in the U.S. who have received at least one vaccine dose are Hispanics, though they make up about 17% of the overall population. (Only about half of the CDC’s data includes the race or ethnicity of vaccinated individuals.)

Among unvaccinated Hispanics, 64% were worried about missing work because of vaccine side effects, and 52% were concerned about having to pay for the shots — although the shots are offered at no cost. These numbers are even higher for Hispanics who lacked lawful permanent resident status.

Among Hispanics who are unvaccinated, the two most commonly cited worries about getting the covid-19 vaccine are the possibility of having to miss work to recover from side effects and the worry they could be charged for the shots. (KFF)

“It’s hard for somebody who lives day-to-day to take off half a day to come to a clinic and try to get a vaccination,” said Dr. José Pérez, chief medical officer of the South Central Family Health Center, a nonprofit health organization with clinic locations throughout South Los Angeles. “If they don’t work that day, they don’t earn a living and they don’t eat.”

Those facing immigration issues were more likely to be worried about being asked to show government-issued ID or a Social Security number, according to the KFF survey.

The Trump administration’s anti-immigrant policies scared people away from seeking any public health services, for fear it could jeopardize their immigration status, Pérez said.

“For Americans who are used to having order in their life, and don’t have to be fearful of this or that, this may seem a little bit foreign,” he said. “But for the immigrant community in South L.A., these are factors that they deal with on an everyday basis.”

Despite the survey’s hopeful message, Pérez’s organization has administered only a fraction of the doses it has on hand, although it has expanded vaccination sites and now offers a shot to anyone who walks into one of its clinics, Pérez said.

“All we can do is continue to push, educate and continue to put our name out there,” he said. “Hopefully, we’ll catch up.”

The Biden administration small businesses that give their workers paid time off to get the shot and recover in case of side effects. Providers are not allowed to charge people for the covid vaccine, and must give out shots regardless of immigration status or health insurance coverage.

In California, where Hispanics make up nearly 40% of the population, 48% of covid deaths and 63% of covid infections, about . Cases and deaths are especially concentrated in dense, low-income neighborhoods that are majority Latino.

Community health clinics and organizations throughout the state are taking the case for vaccinations to sidewalks, supermarkets and anywhere else people gather, seeking to ensure people know how to sign up for a shot.

In the ZIP code around South Central Family Health Center’s main site, only 16% of eligible residents had at least one shot as of May 7, according to the . Five months into the nation’s vaccination campaign, as the CDC relaxes mask recommendations, the clinic is still pushing the importance of masks because of how few people have been vaccinated, Pérez said.

“Vaccine hesitancy” has become a catch-all excuse to explain low rates of vaccinations among minority populations, but the problem is complex, said Nancy Mejía, chief program officer of Latino Health Access in Santa Ana, California, a nonprofit that contracts with Orange County to bring covid vaccine to Latinos.

Her group’s community health workers, or promotoras, encounter people who face a wide variety of obstacles to get the shot, she said.

Carmelo Morales was skeptical of the covid-19 vaccine. But seeing his colleagues and families get sick from the disease, as well as encountering a vaccine event on his walk home from work, helped push him to get his first Pfizer shot in late April. (Anna Almendrala/KHN)

“We hear all of these questions about, ‘Well, I don’t have health insurance,’ or ‘Do I have to pay?’ or ‘I don’t have email, how do I register?’” Mejía said. “When folks talk about hesitancy, we really have to ask what it is that we’re talking about, and not continue to place blame on individuals who actually have really good questions.”

Now that demand for vaccine appointments has plunged, Mejía and her group are focusing more on mobile vaccine events at condominium buildings, swap meets and parking lots where pedestrians and residents can simply walk up. The events are happening in the evenings after work or on the weekends to make the decision to get vaccinated as easy as possible.

“We’re seeing other places that have been open the entire day and gotten only five people in,” she said. “So, for us being open just a few hours in the evening, and getting over 100 people — that’s a success story.”

Carmelo Morales, a 35-year-old Los Angeles resident, used to count himself among the vaccine skeptical. After talking to friends and seeing posts on Instagram, he feared the shots might be a plot to make people sick. He didn’t see the urgency of getting a shot.

But Morales, who works in a meatpacking plant, has been deeply affected by the cases and deaths he has seen among colleagues and their families over the past year. One day in late April, as he was walking home from work, he noticed health care workers at a church near his house packing up after a covid vaccine event.

He asked if there were any leftover doses, and because his house was nearby, nurses waited for him to run home to get his ID so he could get his first shot.

“I just thought about it and was like, hey, it’d be better just to be maybe on the safer side.”

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As Vaccine Demand Slows, Political Differences Go on Display in California Counties

Anna Almendrala — Mon, 03 May 2021 09:00:00 +0000

Demand for covid vaccines is slowing across most of California, but as traffic at vaccination sites eases, the vaccination rates across the state are showing wide disparities.

In Santa Clara County, home to Silicon Valley, 16 and older have had at least one dose as of Wednesday, compared with in San Bernardino County, east of Los Angeles. Statewide, about have received at least one dose.

The differences reflect regional trends in vaccine hesitancy and resistance that researchers have been tracking for months, said , associate survey director at the Public Policy Institute of California, a nonpartisan think tank.

In a , only 5% of respondents in the San Francisco Bay Area and 6% of those in Los Angeles said they wouldn’t be getting vaccinated. But that share is 19% in the Inland Empire and 20% in the Central Valley.

“More urban areas might be hitting a wall, but their number of shots given is higher,” said Bonner. “The rural areas might be hitting a wall maybe even before, but their shots given isn’t quite as high.”

Infectious disease experts estimate that anywhere from 50% to 85% of the population would need to get vaccinated to put a damper on the spread of the virus. But overall state numbers may mask pockets of unvaccinated Californians, concentrated inland, that will prevent these regions from achieving “herd immunity,” the point at which the unvaccinated are protected by the vaccinated. Epidemiologists worry that the virus may continue to circulate in these communities, threatening everyone.

The regional differences could be attributed, at least in part, to political opposition to the vaccine, said Bonner, as about 22% of Republicans and 17% of independents in the survey said they wouldn’t be getting the vaccine, compared with 3% of Democrats.

But officials and epidemiologists see some encouraging signs that the state has yet to hit a wall of vaccine refusal. “As a strongly blue state, one would expect that California is less likely than red states to hit a relatively low ceiling of vaccination, assuming that the access is good and the messaging is strong,” said , chair of the department of medicine at the University of California-San Francisco School of Medicine.

As of Wednesday, 77% of , and 68% of those ages 50 to 64, had received at least one dose of covid vaccine, according to a KHN analysis. These large percentages reflect the early vaccine eligibility of these age groups and are a hopeful sign considering how difficult it was to get a shot in the beginning of the year, said , an assistant professor at the University of California-San Diego specializing in infectious diseases and public health.

“I’m very hopeful that addressing access would pick up at least another 10-15% before we need to really start addressing myths and hesitancy issues,” she said.

The state could see a new jump in vaccinations as workplaces, schools and event organizers begin to require the shots, Wachter said. For example, the University of California and California State University systems that their 1 million-plus students and staff members will be required to get vaccinated against covid once the shots are formally licensed by the Food and Drug Administration, likely to occur this summer.

Still, the red-blue political distinction on vaccination is meaningful within California as well as nationally. Despite depressed vaccine demand across the board, counties that lean conservative have lower rates of vaccinations.

In true-blue Los Angeles, 4.5 million first covid vaccine doses have been administered, meaning that about 55% of eligible Angelenos have gotten at least one shot.

But first-dose appointments at county-run sites were down at least 50% last week, said public health director Barbara Ferrer on Thursday. The county has opened several sites where people can walk in and , but these walk-ins don’t make up for all of the unfilled spots.

Last week probably marked the first time the county did not administer 95% of the doses distributed to it, she said.

In San Diego and Orange counties, meanwhile, vaccination appointments are going unfilled or taking days to get booked up.

About 20% of appointments in Orange County started going unclaimed on April 25 and the slack has persisted, said Dr. Regina Chinsio-Kwong, deputy health officer.

However, based on survey data from last winter indicating that about to get vaccinated against the coronavirus, the county is still expecting more residents to seek out appointments. As of Sunday, about had received at least one dose.

In San Diego, officials expect all appointments to be filled despite the slowdown, said county spokesperson Michael Workman. had received at least one dose as of Wednesday.

In San Bernardino, the slowdown started in late March, said county spokesperson David Wert. Only had gotten at least one dose as of Monday.

Across the state, officials are unclear on the extent to which hesitancy or lack of access to a vaccine are responsible for the slowdown.

Campaigns to educate, convince and reach out to people have started to pick up throughout the country, including targeted messaging for conservatives. Ten GOP doctors in Congress urging their constituents to get vaccinated.

Santa Clara is shifting most county-run sites to enable walk-ins and expanding evening and weekend hours to make it easier for working people to get a shot. San Diego and San Bernardino are also allowing walk-ins.

Other counties are returning unused doses to the state to be redistributed, a bounty from which Los Angeles County has benefited, according to Barbara Ferrer, director of the county public health department. Representatives from Blue Shield and the California Department of Public Health would not say which counties are sending doses back.

California’s good pandemic news, which has enabled counties to reopen many businesses, is one of the challenges to getting less-than-enthusiastic people in for their shots right now, said Wachter of UCSF.

As of Thursday, California has at and a covid-test positivity rate of 1.3%.

“My hope is that a strong communication campaign, perhaps coupled with some degree of vaccine requirements, will get some people to jump off the fence,” Wachter said.

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California and Texas Took Different Routes to Vaccination. Who’s Ahead?

Anna Almendrala — Thu, 22 Apr 2021 09:00:00 +0000

California and Texas, the country’s two most populous states, have taken radically different approaches to the pandemic and the vaccination campaign to end it.

California has trumpeted its reliance on science and policies it says are aimed at improving social equity.

Texas state officials have emphasized individual rights and protecting the economy, often ignoring public health warnings but encouraging vaccination — while calling it a personal choice.

Yet California’s commitment to equity the state ahead of Texas in vaccinating Latinos, who make up roughly 40% of the population in both states. Latinos have suffered disproportionately from covid because the poorest tend to live in crowded housing, get less quality health care and have been more likely to work outside the home.

In California, as of April 12; in Texas, 21%.

at reaching highly vulnerable groups during the first months of vaccine distribution, according to a recent analysis by the Centers for Disease Control and Prevention. Texas was seventh on the list; California was fifth from last.

Overall, however, California’s pandemic metrics have been better. As it opened vaccine eligibility to all ages on April 15, were either partially or fully vaccinated, compared with .

The two states were neck and neck until a harsh winter storm in February knocked out power for a week in much of Texas. “We never really recovered after that, and exactly why, beyond our size, is not entirely clear,” said , dean for the National School of Tropical Medicine at Baylor College of Medicine.

California is also doing much better when it comes to driving down infections. is 52.7 cases and 1.8 deaths per 100,000 as of April 15, with a seven-day average . Texas, meanwhile, is at 73.3 cases and 1.5 deaths per 100,000, with a seven-day average .

The states’ leaders have reacted differently to those metrics. California Gov. Gavin Newsom has set June 15 as the , barring major setbacks, but he plans to continue to require mask-wearing in public and in high-risk workplaces. Meanwhile, Texas Gov. Greg Abbott on March 10 allowed all businesses to fully reopen and lifted a statewide mask mandate.

The concept of individual freedom plays well in Texas politics and has been front and center throughout the pandemic and the vaccine rollout. While encouraging Texans to protect themselves against the spread of the coronavirus, state officials at the same time have fought local authorities’ efforts to enforce such measures.

While Newsom instituted one of the earliest and strictest state lockdowns in the country on March 19, Texas Attorney General Ken Paxton initially called local mask mandates and business restrictions “.” Abbott finally instituted a in July after a surge of the disease. Those measures met opposition within his own party, with Texas Republican Chair Allen West outside the governor’s mansion in October.

Against this tense political backdrop, Texas state leaders have been softer in their vaccination messaging compared with California. Both governors received their vaccinations on live TV, but each has offered different messaging about how their constituents should view the shots.

In an April 8 tweet, Abbott celebrated the state’s adding, “These vaccine shots are always voluntary.” That soft-pedaled message also comes through in Abbott’s stance on masks. Despite lifting the order in early March, the governor .

Public health experts in Texas have been frustrated by what they see as a half-hearted endorsement of public health measures. “It’s psychotic to have to listen to two very different messages,” said , CEO of the HOPE Clinic in Houston, which serves minorities and immigrants. “Vaccines were not made just for your individual protection. They were made for community benefit. It is a message that has been lost in our society.”

Newsom, on the other hand, talks about vaccines in terms of responsibility to others. “Getting vaccinated is a vital step we can take to protect ourselves, our loved ones and our community, and brings us that much closer to ending this pandemic,” Newsom said on April 1, when .

Newsom’s oft-repeated “north star” value is equity — the notion that the well-being of those hurt most by the pandemic should be essential to the battle against it. Starting March 4, his administration allocated 40% of its vaccines to neighborhoods that have seen 40% of covid cases and deaths. California has also invested $52.7 million to fund more than 300 “trusted messenger” community organizations to do outreach on vaccines. He didn’t make the general public eligible for vaccination until April 15 in order to prioritize more vulnerable and at-risk groups. Texas, meanwhile, fully opened the vaccine spigot on March 29.

California’s struggles to vaccinate racial and ethnic minorities and the most vulnerable, despite intense public health investment and attention to these communities, raises questions about the state’s vaccine eligibility decisions, said , assistant professor of sociology at the University of Minnesota.

Both Texas and California, like many states, first vaccinated health care workers and long-term care residents, populations that are majority white. But in Texas, people with underlying medical conditions — like Type 2 diabetes, sickle cell disease or obesity — also .

In California, people with underlying medical conditions weren’t added to the eligibility list until mid-March, and the was much more stringent than Texas’ guidelines.

“That gap between January and mid-March, that’s kind of the story to me,” Wrigley-Field said.

California officials decided Jan. 13 to prioritize people over 65. Many over-65 whites were at substantially lower risk than younger people of color, said Wrigley-Field, who that age-based eligibility benefited older, white populations at the expense of younger people of color who were more at risk of covid hospitalization and death.

Prioritizing those over 65 immediately put Hispanics at a 2-to-1 disadvantage to whites, concluded , based on at the Agency for Healthcare Research and Quality (their conclusions don’t necessarily represent AHRQ or HHS). Priority tiers for those with certain diseases and essential workers would have benefited the poor and Hispanics, respectively, and pushing them down the list “could be one of the factors why we’re seeing lower rates for these groups,” he said.

Hispanics ages 20-54 in California were than whites of the same age from March to July, according to a University of Southern California study.

, first responders and workers in education, food and agriculture became eligible for vaccination in California. County health departments were permitted to set their own schedules, however, and in Los Angeles these due to limited vaccine supply.

In effect, from December until March there was no eligibility tier that prioritized groups that were predominantly Latino or Black in the state’s largest county and the epicenter of the state’s covid cases and deaths.

The state’s approach harmed efforts to reach out to Latinos, some county health departments say. In Kern County, Latinos make up 53% of the population and 57% of covid cases, but got only 36% of the vaccines administered as of April 15. Confusion over the essential-worker eligibility tiers caused many to think it wasn’t their “turn,” said Brynn Carrigan, the county public health director.

Dr. Tomás Aragón, state public health officer and director of the California Department of Public Health, defended the state’s initial age-based approach and said it was a strategy to make sure Latinos were prioritized. He noted that, while Latinos accounted for 48% of the state’s covid deaths, the majority of those deaths occurred in .

“We are in a significantly better place today than many states, not just because our vaccine strategy saved lives and kept people out of hospitals, but also because we focused on proven public health interventions, such as masking, distancing, hand washing and tracing,” Aragón said in an emailed statement.

Vaccine hesitancy among racial and ethnic minorities has faded as educational outreach has ramped up, access has improved, and more people see friends and neighbors safely get the shot. Vaccine hesitancy instead , particularly white evangelicals, according to several polls.

But confidence in vaccines is growing even among Republicans, according to a poll recently conducted by Frank Luntz and released by the . It showed that 38% of Trump voters and 48% of Biden voters were more likely to get vaccinated than they were in March.

While some experts said consistent messaging from politicians would be helpful, time and experience watching friends and family safely receive vaccinations as well as communication with trusted individuals — particularly personal doctors — is the most effective way to overcome lingering concerns about the shots.

“What’s going to change that is getting vaccine more readily available to primary care providers … who they trust and get their questions answered, because I think they are vaccine-hesitant versus anti-vaccination,” said , chief medical officer at the University of Texas System.

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Beating the Pavement to Vaccinate the Underrepresented — And Protect Everyone

Anna Almendrala — Fri, 02 Apr 2021 09:00:00 +0000

Leonor Garcia held her clipboard close to her chest and rapped on the car window with her knuckles. The driver was in one of dozens of cars lined up on a quiet stretch of road in Adelanto, California, a small city near the southwestern edge of the Mojave Desert. He was waiting for the food bank line to start moving and lowered the passenger window just enough to hear what Garcia wanted. Then she launched into her pitch.

“Good morning! We’re here to talk about covid-19 today! Do you have a minute?” she said in Spanish.

After a brief conversation, Garcia learned the man had no internet connection or phone of his own but was 66 years old and wanted to get the covid vaccine. He had tried to visit a pharmacy in person, but the shots were all out for the day. Garcia took down his name and the phone number of a friend, so she could reach the driver later about a mobile vaccine clinic that her organization, El Sol Neighborhood Educational Center, was putting together for the remote desert city sometime in April.

Then it was on to the next car. And the next. As the line started moving, she and fellow health worker Erika Marroquin jogged up and down the sidewalk, taking down names, phone numbers and preexisting conditions. It was the first mild, sunny day the High Desert region had seen in weeks, and the exercise made them sweat.

El Sol community health worker Leonor Garcia speaks to a driver waiting in line for a church food bank in Adelanto, California, on March 17. In addition to letting people know about the covid vaccines, she and her colleagues also ask whether people need help with mental health care, food or rent. (Anna Almendrala/KHN)

After 90 minutes, the food bank was done for the day, and Garcia and Marroquin had spoken to people in 54 cars. They had found six people eager for the covid vaccine and eligible for it immediately. Ten more wanted to be put on a waiting list for leftover doses.

The rollout of vaccinations in California, as in many states, has been slow and chaotic. More than in the nation’s most populous state have been at least partially vaccinated, while an additional 5.6 million are fully vaccinated. Come April 15, all adults in California will be eligible to sign up for a vaccine, and by early summer the goal is to have plenty of vaccine for any adult who wants it.

But the country needs to get the to keep the virus from easily spreading — a level called herd immunity by experts on infectious diseases. But even that figure assumes the population is homogenous in terms of vaccination. That’s why the state’s ability to stave off another covid surge may rely on people like Garcia and Marroquin — community health workers and organizers doing time-intensive, laborious work — to prevent pockets of the population with low vaccination rates in remote or isolated communities from becoming a tinderbox for a new covid surge.

“When you have geographical or social pockets of unvaccinated people, it really messes up herd immunity,” said Daniel Salmon, director at the Institute for Vaccine Safety at Johns Hopkins University’s Bloomberg School of Public Health.

in recent years provide a sobering example. State and national vaccine coverage is quite high, “but then you’d have these communities where a lot of people would refuse vaccines, and then measles would be imported and create an outbreak,” Salmon said. Outbreaks have hit certain Orthodox Jewish communities in New York, Somali immigrants in Minnesota and affluent pockets of Southern California where anti-vaccine parents lived.

Residents of California’s High Desert region line up at the Centro Cristiano Luz y Esperanza church in Adelanto to receive their second doses of covid vaccine at El Sol’s March 19 vaccination event. In line on the left are those who got their first shot at an event the previous month. The line on the right is full of people hoping for leftover doses. (Anna Almendrala/KHN)

The coronavirus is still circulating widely in California, though at much lower levels than two months ago. The virus, especially an increasingly common, more contagious variant, could easily rip through vulnerable communities with low levels of immunity. In Adelanto, where 29% of residents live in poverty, had been fully vaccinated by March 20.

As of March 26, most of the more than 15.9 million vaccine doses distributed since December had gone to in the state. Community-based organizations like nonprofits and churches are clamoring for more funding — and trust — to carry the vaccine the final mile to the people they’ve been serving for years.

El Sol’s success in getting Black, Latino and other underrepresented populations vaccinated debunks the idea that these groups won’t get the shot, said Juan Carlos Belliard, assistant vice president for community partnerships at Loma Linda University Health in San Bernardino County. Loma Linda is collaborating with El Sol to staff and provide doses for clinics. The people who show up are ready for their vaccine, though some are a bit hesitant, he said.

“They’re not like our middle-class folks who are literally crying for the vaccine,” Belliard said. “These folks are still nervous about it, but you’ve removed almost all of these other barriers for them.”

Staff members and students from Loma Linda University Health in San Bernardino County guide people into the church hall for vaccinations at El Sol’s pop-up event. Special paper forms were created so people wouldn’t have to enter their information into a computer to make an appointment. After the event is over, the hospital’s clinical team manually uploads all the data. (Anna Almendrala/KHN)

El Sol’s community workers were supported by a $52.7 million combined effort from state and philanthropic funding that provided grants to 337 organizations considered “trusted messengers” in their communities. The money was pushed out to groups like El Sol that had proven track records of shoe-leather canvassing for voter registration or census surveys.

El Sol received $120,000 from the public-private initiative to support its general outreach and educational efforts for covid vaccination. But the group was in the dark about whether it would get any reimbursement for the mobile vaccination events it has organized in San Bernardino County, said executive director Alex Fajardo.

El Sol held a pop-up vaccination event Feb. 17 at Centro Cristiano Luz y Esperanza, a church located off a two-lane expressway in Adelanto, surrounded by desert scrub. Medical staffers, students and vaccines arrived from Loma Linda University Health, about an hour away, to vaccinate 250 people, and returned a month later to give people their second doses.

Patricia Perez, 47, and Rosa Hernandez, 69, a mother-daughter pair, were among those who got their vaccines at Centro Cristiano.

Rosa Hernandez (left) and daughter Patricia Perez received their second doses of a covid vaccine at El Sol’s March 19 clinic, and were waiting the requisite 15 minutes before heading home to Hesperia, California. Hernandez is a cancer survivor, and her husband struggled with a severe case of covid in June. No one else in their seven-member household got sick. (Anna Almendrala/KHN)

Perez’s father, who works in a supermarket dairy department, fell ill with covid in June and was unable to return to work for six months. No one else in the seven-member household ended up testing positive, but Rosa Hernandez is a cancer survivor and her daughter was worried about her.

Despite multiple calls to a county phone line, Perez had been unable to line up a vaccine for her mom. The family’s internet connection, in the nearby town of Hesperia, was spotty, and Perez couldn’t really navigate the websites or find any information in Spanish, the language she’s most comfortable with.

She jumped at the chance when she heard about El Sol’s pop-up event through someone at her church. Perez also managed to snag an additional dose for herself after someone didn’t show up for their appointment. Now she and her mom are fully vaccinated, Perez said, and it wouldn’t have happened without El Sol.

The group plans to do three more vaccination pop-ups in the High Desert area. But future support for its clinics, vaccine outreach and education are murky, said Fajardo.

“What is going to happen after?” he said. “When we need you, we pay you. When we don’t need you, ‘Bye-bye.’”

“That’s a very fair assessment,” said Susan Watson, program director for the Together Toward Health initiative of the Public Health Institute, the philanthropic funder behind some of El Sol’s work. “There’s an opportunity here for people to be thinking about the future, and how we do things that doesn’t necessarily leave community groups permanently on the outside, only tapped into when there’s an emergency.”

Community Coalition, a South Los Angeles nonprofit founded in 1990, also received grants from the public-private partnership to raise awareness about covid vaccines, but no additional funding to deliver vaccines to the people. Still, it mobilized staff to knock on doors, text and email eligible people to turn out for a two-week pop-up vaccination event at a neighborhood park in early March — providing 4,487 people with their first vaccine dose, said the group’s chief operating officer, Corey Matthews.

Dr. Marx Genovez injects Guadalupe Neri with a covid-19 vaccine. (Anna Almendrala/KHN)

Dr. Mark Ghaly, the state’s secretary for health and human services, promised to provide more money for groups that are getting their communities vaccinated. “This is not a volunteer job,” he told KHN at a news briefing. “This is real work, and I want to be part of the team that makes that a reality for all of them.”

Los Angeles County department of public health Director Barbara Ferrer echoed that sentiment. “They were there before the pandemic started, they’ve been there the entire time during the pandemic, and they’ll be here long after the pandemic,” she said.

Whether or not those promises hold up, community groups say, they want to be part of the vaccination effort.

“Even if they don’t give us money, we’ll keep doing the work,” said Fajardo.

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In a Year of Zoom Memorials, Art Exhibit Makes Space for Grief

Anna Almendrala — Thu, 11 Mar 2021 10:00:00 +0000

Tami Roncskevitz has attended two Zoom memorials for her daughter, Sarah, a who died of covid on May 30. But she longs to gather Sarah’s friends and family together in one place so they can embrace and mourn together.

“It just isn’t the same,” said Roncskevitz. “You feel like your grieving is not complete.”

With more than to the coronavirus, the United States has millions of people like Roncskevitz whose grief is compounded because families — which, in her case, includes Sarah’s fiancé and two young children — have been unable to publicly celebrate the lost lives with in-person memorials.

Honolulu artist Taiji Terasaki is stepping into that breach with a project to commemorate fallen health care workers.

Terasaki first projects an image of the deceased onto a screen of mist droplets. He then photographs several dynamic, ephemeral portraits of the mist projections, and then prints these photos onto a long scroll. The effect is a mashup of traditional kakejiku, or Japanese hanging scrolls, and a gigantic filmstrip.

Each scroll is then placed in an inscribed wooden box and can be unfurled for display.

The effect is bittersweet, said 59-year-old Roncskevitz, who lives in Benicia, California, and saw the images online.

“I can see her smiling face, but I can also see it evaporating in that picture,” she said. “For me, I feel like it’s representative of Sarah’s body dissipating, and her spirit moving forward.”

So far, Terasaki has created 15 mist portraits for health care workers, who include radiologists, janitors and nurses. The scrolls can be unfurled up to 20 feet and are currently installed in the in downtown Los Angeles, which is closed due to covid restrictions. But the exhibit, called “Transcendients: Memorial to Healthcare Workers,” will make its , along with other artwork Terasaki has made to commemorate pandemic heroes. “Transcendient” is Terasaki’s neologism from “transcendent” and “transient”; it’s a concept he has used in past exhibits on immigration, the U.S. migrant border crisis and the internment of Japanese Americans during World War II.

At the beginning of the pandemic, Terasaki passed his lockdown time cutting photographs and weaving them back together to create pixelated, screen-like images of people who had helped others during the pandemic. He posted these works on .

As deaths mounted, he decided to create memorials and came across “Lost on the Frontline,” a collaborative reporting project between KHN and The Guardian. The series features short profiles of health care workers who have died of covid, as well as investigative stories about the lack of personal protective equipment many workers endured as they showed up for work during the pandemic.

“Who’s sacrificing the most? It’s these health care workers who are out there risking their lives,” said Terasaki.

Terasaki reached out to KHN to see if he could add to the collaboration with the memorial scrolls, and then set out to contact the families featured in Lost on the Frontline.

Artist Taiji Terasaki is commemorating health care workers lost to covid in an exhibit called “Transcendients: Memorial to Healthcare Workers” at the Japanese American National Museum. Terasaki used photos of the deceased to create mist portraits, which he then printed on long scrolls. (Paloma Dooley)

Expanding the project to incorporate art is going to widen the project’s reach, said Christina Jewett, KHN’s lead investigative reporter for Lost on the Frontline. To date, the team has identified more than 3,500 health care worker deaths caused by covid and is the most comprehensive database to date, as states have different requirements about recording and reporting these deaths.

Helena Cawley contributed a portrait of her father to Terasaki’s project to keep his memory alive. She recalled receiving the news that her father had unexpectedly died of covid. Cawley let out a primal scream and dropped to the floor, sobbing.

This was March 30, back when covid tests were scarce, hospitals were scrambling to obtain ventilators and masks, and the U.S. had just passed .

Cawley’s father, 74-year-old , was the first person Cawley knew who tested positive for the virus. A month later, Wolin’s wife, Susan, Cawley’s stepmother, also succumbed to the disease.

Vaccine Altruists Find Appointments for Those Who Can’t

Anna Almendrala — Thu, 11 Mar 2021 10:00:00 +0000

Ana Guevara was determined to get a covid vaccine for her mother, 85-year-old Adelina Coto, but she needed help. Guevara, a full-time nanny in Los Angeles, didn’t have the time or knowledge to search for appointments online. Guevara’s son, a school district employee, lacked the time to park himself in front of a computer waiting for new appointments to drop.

Then Guevara’s boss connected her with a group that volunteers to help people like her mother get vaccinated.

Three days and one phone call later, Coto had a vaccine appointment. Now her daughter is telling everyone she knows about the group.

“I tell all my friends,” said the 53-year-old immigrant from El Salvador. “They help, they’re very nice, and they do everything.”

Guevara is one of hundreds of people finding elusive vaccine appointment slots with the help of strangers. Grassroots volunteer corps — powered by people with time, tech savvy and a computer at their fingertips — are popping up in major metropolitan areas where thousands of people are competing for the same appointment slots. Their altruism offers an antidote to the actions of vaccine line jumpers.

“I would like to take away the stigma that appointments are not available and that they are impossible to get,” said Rhea Hoffman, a 34-year-old former teacher in the Coachella Valley who has been helping people get vaccinated. “I can probably get you one within 48 hours if you qualify, and it’s not a problem — just give me a second.”

The volunteers reinforce local governments in helping disadvantaged people get vaccinated. In California, county officials are running hotlines, organizing mobile clinics, hiring community health workers and teaming up with faith communities and community organizations to get people signed up for an appointment or vaccinated on the spot.

Barbara Ferrer, Los Angeles County’s public health director, gives big kudos to the “awesome” volunteer groups. “It makes my heart feel good that people are stepping up and helping people who really have been struggling to get those appointments,” Ferrer told KHN at a news briefing.

The L.A. County neighborhoods hit hardest by the coronavirus are also the ones with the lowest vaccination rates. In poorer areas like Pacoima, San Fernando and Hawaiian Gardens, for example, as of Feb. 20, while in wealthy Bel-Air, Century City and Beverly Hills, one-third of residents had been vaccinated. Statewide statistics show similar disparities.

Rhea Hoffman runs the volunteer site VAXIE.info with a friend to help people in the Inland Empire sign up for vaccination appointments. Hoffman says she can spend up to 10 hours a day booking appointments for others ― and is grateful for the opportunity to give back after a year of shuttered pandemic life. (Stori Hoffman)

The volunteer groups are vital to expanding vaccines to low-income, disabled and isolated people, said Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County. Her group represents 64 community clinics and health centers that have all pivoted to getting people vaccinated in some way, either by directly administering shots or helping people navigate registration systems. (The clinics hope to eventually be compensated for this extra work.)

“We need all hands on deck to help people get access to this vaccine,” McCarthy said. “Folks are getting left behind already, and it’s projects like this that help us begin to catch up.”

Volunteers have joined the effort after seeing how hard it was to book appointments for themselves, parents or grandparents. They get a kick out of helping people, and joining like-minded altruists on social media helps them get more efficient at the process.

It’s an easy conversion from “caring about your parents and learning these skills, to caring about someone else’s parents or grandparents,” said Liz Schwandt, a 45-year-old early childhood program director at a Jewish preschool in Los Angeles. She co-founded , the group that made Coto’s appointment, and now has about 100 vetted volunteers who have booked at least 300 appointments directly through the group’s system, and up to 4,000 through their individual efforts.

Schwandt said she didn’t take on this mission out of anger and doesn’t cast blame on the vaccine rollout or public health workers, who she said work diligently to protect people’s health. It was simply that she saw a need and could fill it.

“These technology barriers are real, and every shot that gets into someone is potential protection for their life and their family,” she said.

To get help from Schwandt’s group, Los Angeles residents can leave a , availability and other details on a Google form. Then a volunteer picks up the case, finds an appointment and calls to confirm.

The most skilled vaccine bookers have memorized the days and times certain sites release a new batch of appointments and stay up to date on new developments through Facebook groups or other social media.

Beverly Hills couple George and Cathi Rimalower, whose grandchild attends Schwandt’s school, have been pulling late nights to get appointments for others. They were still in their pajamas at 11:30 a.m. on a recent day after waiting until 1 a.m. for a batch of appointments to drop.

“In my case, there’s no excuse for me, as a retired person with the available resources to help people, to just sit around and do nothing,” said George Rimalower, 69, who ran a translation company with his wife. Rimalower, born in Argentina, responds mostly to requests that come in from native Spanish speakers.

“It’s nice to give money, and that’s always helpful,” said Cathi Rimalower, 67. “But it really feels good to give some time, too.”

The couple are teasingly competitive about their work. So far, each has booked about 60 appointments.

George and Cathi Rimalower ― seen during a pre-pandemic visit to the Taj Majal in Agra, India ― have a friendly competition going to see who can secure the most vaccination appointments for those in need. As of March 5, they were tied at around 60 people each. (George Rimalower)

Hoffman, the Coachella Valley booker, had spent most of the pandemic supervising her two kids’ online schooling while volunteering as a Zoom moderator for a community college class for elderly people. When vaccines finally came online, it took her four days to make appointments for her parents. Seeing how tough the process was, she asked her class if they needed help; most students raised their hands.

Hoffman and a friend who worked in marketing and graphic design to advertise their volunteer services. Hoffman estimates the two have booked 350 appointments. They’ve talked with a Coachella City Council member to strategize how they can expand and help in a more official way.

Many of these volunteer organizations are focusing on getting minorities or those from underserved communities into certain vaccine locations and appointment slots.

In Chicago, 26-year-old Brianna Wolin said the 45 “Chicago Vaccine Angels” on her Facebook group have scheduled over 750 vaccine appointments for seniors and others, while keeping equity in mind.

“We will not book people who live in a northern suburb to come down to the southwest side of Chicago, where they would have never stepped foot until there was an opening for a vaccine that they so desperately wanted,” she said.

“After a year of caring so much about yourself and your own needs and your own safety, it feels darn good to do something for others,” said Wolin, a graduate student studying prosthetics and orthotics.

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