Anti-immigrant discourse complicates covid vaccination in southern states

In East Tennessee, doctors have seen first-hand how tough immigration policy can affect the health and well-being of a community.

In 2018, federal agents raided a meatpacking plant in Morristown, in the Tennessee Valley, and detained about 100 workers suspected of being undocumented.

In the weeks that followed, dozens of immigrant families who had found work at those plants sought sanctuary in churches and stopped going to medical appointments.

The reason? Immigration agents were guarding the clinics.

“We didn’t want people to come in for care because there were ICE officers in our parking lot,” said Parinda Khatri, clinical director for Cherokee Health Systems, a non-profit provider in Hamblen County.

As Tennessee, like other states, embarks on the daunting task of vaccinating millions of residents against COVID-19, many health officials find the task difficult, due to widespread mistrust of government and law enforcement among undocumented immigrants, a population estimated at 11 million nationwide.

The challenges are particularly critical in the South, where large populations of undocumented immigrants help maintain thriving agricultural and food-processing industries, even as many state and local Republican leaders, empowered by the Trump administration’s anti-immigrant rhetoric, denounce them as criminals and ask to limit their path to citizenship.

The confluence of these aggressive attitudes and a highly contagious virus has raised concern in some states: they fear that the low vaccination of undocumented immigrants will jeopardize efforts to achieve herd immunity.

“We can never overcome this pandemic if the undocumented are left out,” said Dr. Sharon Davis, medical director of the Los Barrios Unidos community clinic in Dallas, which serves 28,000 patients, most without papers.

Davis recognized the challenge this poses in a state like Texas, where the Republican Party’s state platform calls for the immediate removal of all “illegal aliens.” Like other clinic directors in many southern states, Davis said implementing vaccination plans in immigrant communities is a “don’t ask, don’t tell” policy.

“We live in Texas, so you don’t even mention it,” he added. “We are talking about the uninsured and the Latino population with the highest morbidity and mortality, who we are trying to care for.”

In the Dallas-Fort Worth area, home to one of the nation’s largest undocumented immigrant populations, the death rate of middle-aged Latino men is eight times that of their non-Latino white counterparts.

Epidemiologists say the disparity is not surprising, given that large numbers of undocumented Central and South American workers are in jobs deemed essential in the pandemic, including agricultural work, meat processing and food service, and most do not have health insurance. .

To compound the risks, many work in conditions conducive to viral spread, standing shoulder to shoulder along conveyor belts at vegetable packinghouses, washing dishes in restaurant kitchens, stocking supermarket shelves, and cleaning rooms. of hotels.

At the end of the day, many return to barracks or small houses that house several generations of families.

“If they don’t work, they don’t eat,” Davis said. “We have had patients who beg us not to do the test, because then they cannot go to work.”

Davis was one of the medical directors who said that the mass vaccination sites many states are using – giant tents with uniformed National Guard personnel and medical personnel with iPads – scare immigrant families.

“They ask ‘what documents do we have to show?’” Davis said. “The fear of deportation is huge and very real.”

And it’s not unfounded, advocates noted, after four years in which former President Donald Trump slashed legal and illegal immigration through mass arrests and deportations, travel bans and severe asylum restrictions.

President Joe Biden has vowed to repeal many of those rules, but advocates say support for more drastic measures is strong among some immigration agents and local agents, potentially making life difficult for many immigrants.

Davis added that beyond the fear of harassment or arrest, public health officials are dealing with misinformation. “They are hearing horrible stories on social media,” he noted. “They think there is a microchip in the vaccine and they will be traced.”

Even some immigrants with papers have reservations about receiving a vaccine provided by the government. The Trump administration lobbied to derail the citizenship of any immigrant who used taxpayer-funded public services, including health care.

In December, the Justice Department withdrew the rule, but there is confusion and clinic directors say patients will prioritize their green cards over most anything.

Low vaccination rates among immigrant populations are already evident. In Mississippi, for example, the Department of Health reported that fewer than 2,800 Latinos had been vaccinated the week of February 8, about 1% of all vaccines administered so far.

Tennessee provides an excellent example of the tensions underlying the launch of the vaccine.

Republican Gov. Bill Lee made headlines in May when he allowed the state Health Department to share the names and addresses of those who tested positive for COVID with police.

Separately, the Nashville city health department provided local police with the addresses of people who tested positive or who were in quarantine.

Both actions were criticized and eventually ended, but Lee defended them, saying they were appropriate “to protect the lives of law enforcement officials” and that they complied with federal health privacy rules. The city subsequently sought to reassure its “diverse immigrant communities” that the information would not be shared with federal immigration authorities.

Alabama, like Tennessee, has a history of strict rules regarding immigration, such as a 2011 law prohibiting undocumented immigrants from receiving almost all public benefits, including most non-emergency medical care.

Velvet Luna, a 26-year-old RN, has built her life in Ozark, Alabama, a small town in Wiregrass, a region known for its poultry processing facilities and large populations of Hispanic and Vietnamese immigrants.

Luna enrolled in the Deferred Action for Childhood Arrivals (DACA) program, an Obama-era initiative that grants temporary status to undocumented youth who were brought into the country as children. According to the National Center for Immigration Law, nearly 500,000 immigrants eligible for DACA are essential workers.

Luna, who speaks with a soft southern accent, used to talk about her immigration status, but said that in recent years, men who flirted with her immediately changed their attitude if they knew her immigration status. “They said ugly, hurtful things, ‘You are the reason our country is in decline. You have to go'”.

As a nurse at an area hospital where she volunteered for the covid unit, Luna has received both doses of the vaccine, but understands the risks that undocumented families weigh; neither of her parents, who live nearby, have papers. “It’s okay to be afraid, and it’s a brave decision to go get vaccinated and protect your family,” she said.

Even opponents of immigration acknowledge that the pandemic has united the destiny of everyone living in the country, regardless of how they arrived.

“The main thing is to vaccinate as many people as possible,” said Mark Krikorian, executive director of the Center for Immigration Studies, a conservative group that strongly advocates for restricting immigration. “Your immigration may catch up with you one day, but it won’t be today.”

The Biden administration has said that ICE will not operate at or near the vaccination sites. “ICE does not conduct or will carry out operations in or near health care facilities, such as hospitals, doctor’s offices, accredited health clinics, and emergency or urgent care facilities, except in the most extraordinary circumstances,” according to a statement from the Department of Homeland Security on February 1.

State health commissioners have also tried to calm nerves. “We do not deny the vaccine to anyone who shows up at our sites and is in the phase that is being vaccinated,” said Dr. Lisa Piercey, commissioner of the Tennessee Department of Health. “This is a federal resource, and if you are in this country, you have a vaccine.”

Advocates, however, said obstacles persist in convincing immigrants that the information will not be used against them. The Centers for Disease Control and Prevention (CDC) expects providers who administer vaccines to upload patient information to state registries, including TennISS in Tennessee or ImmTrac2 in Texas.

Tracking systems allow providers to make sure patients return for their second dose and to identify any adverse reactions.

Providers try to explain that this information is used for health initiatives, not immigration.

“Patients, particularly those with an immigrant background, are very sensitive to sharing family details,” Brian Haile, executive director of Neighborhood Health, a community clinic in Nashville, wrote to Tennessee health officials in December. “If we ask them to provide this information to providers they don’t know, they will be even more reluctant to vaccinate their families.”

In Hamblen County, Khatri said he is trying to persuade workers on tomato and tobacco farms, and meat processing plants, hot spots for coronavirus outbreaks, to trust his clinic to not only administer the vaccine but also to handle confidential data.

“They want to go to a trusted group,” said Khatri, whose clinics are approved to distribute the vaccine but have not yet received any doses.

Helena Lobo, who coordinates Hispanic outreach at Cherokee Health, said that for some immigrants, the choice may be between their health or staying hidden.

“If they have to risk their immigration status to receive the covid vaccine, they will not apply it. I don’t blame them, ”Lobo said. “They wonder: ‘What is my biggest risk? Being deported or having covid? ‘

* Sarah Varney writes for Kaiser Health News