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CIANA Explains: COVID-19 Vaccine Equity

Pictured above: On December 14th, 2020, a nurse in Queens becomes the first person to receive a COVID-19 vaccine in the US.

The Current State of Vaccine Equity

The unequal distribution of COVID-19 vaccines is a significant social justice issue that can carry longstanding and pervasive consequences. Not only is the issue of vaccine equity a worldwide problem, with developing countries (often the most hard-hit by the virus) not having the vaccines or infrastructure to carry out rapid vaccination campaigns, but it is also an issue within the United States and NYC.

Nationwide, communities of color (including immigrant communities) have received smaller shares of the vaccine, or are getting vaccinated at rates lower than their representation in the general public. This trend is also prevalent in NYC, as minority groups are getting vaccinated at much lower rates than White people, despite greater COVID exposure and lower access to medical care. NYC Department of Health data, as of April 2021, shows that communities of color, in the Bronx, Queens, and Brooklyn, all have darker colors representing comparatively higher COVID-19 positivity rates. These very communities that have been the most hard-hit by the virus and need the most resources are those that are least vaccinated.

A major reason for these COVID and health disparities is institutional racism. Not only do minority communities often lack access to healthcare and vaccines (often having to drive for miles to get vaccinated because vaccines are not readily available within their communities) due to government neglect, they are also underrepresented in research and often misdiagnosed due to biases in medical education and treatment. Deep embedment of discriminatory practices across the healthcare system has led to higher rates of illness and death among communities of color across a wide range of health conditions, even prior to COVID-19.

Vaccine hesitancy: Misinformation, mistrust, and fear

Not only does institutional racism lead to a lack of access to vaccines for minority and immigrant communities, but it also leads to increased vaccine hesitancy. Misinformation about COVID-19 and vaccines through false media campaigns has gained footing in communities with language barriers and histories of mistrust in government officials, where finding truthful information is a greater challenge. Publications of misinformation find ways into conversations and become propagated by trusted individuals in the community. From CIANA’s own outreach in Queens, we have encountered false vaccine narratives gaining popularity among communities (for example, that getting the vaccine causes HIV).

Additionally, with the Janssen (Johnson & Johnson/J&J) vaccine’s the lower success rate (potentially explained by the fact that it was tested during a nationwide surge of COVID when Pfizer and Moderna were not) and extremely rare complications, vaccine hesitancy and fear increased. However, data shows that the J&J vaccine prevented 100% of virus-related hospitalizations and deaths, and the pause on the J&J vaccine has since been lifted after meeting the standards of a thorough safety review.

While some of the hesitancy to get the vaccine is rooted in misinformation, there is also a factual basis to the mistrust communities of color harbor against the medical field. Historical exploitation, such as the Tuskegee syphilis experiment and targeted anatomy dissections from the government and medical systems has increased mistrust, manifesting in vaccine hesitancy among minority, and especially Black, communities. Not to mention how the aforementioned discrimination against people of color in medical research and treatment plays a role in mistrust.

Fear of immigration policies and enforcement has played a significant role as well. When the legality of Public Charge was in debate, many immigrants worried that getting healthcare would limit their ability to get a green card or citizenship. Now, even though the Public Charge rule is no longer in effect, the back-and-forth between courts instilled fear and confusion that still remains. Many undocumented immigrants fear that if their personal information is obtained during vaccinations, they might be targeted by immigration enforcement agencies. While ICE has issued a statement confirming that they will “not conduct enforcement operations at or near vaccination sites,” fears still run deep. ICE has a history of raiding safe zones such as churches, and conducting nationwide sweeps through immigrant popular cities, not upholding past promises.

There is confusion regarding if the vaccine is available to immigrants, including those undocumented. Many individuals worry about the vaccine’s cost and impact on immigration status, and there are instances where some immigrants have also been “accidentally” denied COVID-19 vaccines for not being able to produce social security numbers, which is not required according to official guidelines. Not only is everyone (including undocumented immigrants) eligible for the vaccine, the vaccine is free, there are many acceptable forms of identification that (undocumented) immigrants may bring to show their eligibility, and getting the vaccine will have no impact on your immigration status (Public Charge does not apply, and there are strict laws protecting the privacy and confidentiality of your personal information). Read more at the NYC COVID-19 Vaccine page.

Promoting equity moving forward

To mitigate inequity in vaccine distribution, governments, organizations, and individuals alike should take action. In communities where the likelihood of being vulnerable to COVID-19 is high, there is a greater need for outreach in minority and immigrant communities in order to curb fears and misinformation, and provide greater vaccination opportunities.

In order to reduce vaccine hesitancy and bring trust to under-vaccinated populations, New York City sought to prioritize vulnerable communities when the vaccine was first introduced and in limited supply. Many vaccination sites were schools, churches, and community centers in low-income neighborhoods of color. Much of the staff administering the shots (and organizations partnering with the government for vaccine outreach) were of color as well, and spoke languages other than English to communicate effectively with vaccine recipients regarding their questions and concerns. Bridging racial disparities must be of utmost priority, in vaccine access and beyond.

Community-based organizations can promote vaccine (and overall health) equity by connecting patients with COVID-19 care, providing assistance for appointment bookings, and communicating through the languages and forms that fit their community needs. As part of the NYC Test & Trace Corps, CIANA has focused on making vaccine appointments with underserved immigrant communities, many of whom are skeptical about getting vaccinated. CIANA has done extensive outreach across Queens, from NYCHA public housing complexes to Corona and Jackson Heights, where fears of the vaccine range from concerns about side effects to concerns over immigration status. Together, we’ve made nearly 150 vaccine appointments for some of New York’s most vulnerable residents.

Public information campaigns are publishing question and answer guides around the vaccine, geared towards immigrants and minorities, especially as these groups are more likely to be exposed to the virus. Further information on how a vaccine does not break the Ramadan fast, and privacy laws forbidding immigration enforcement agencies to access personal/vaccine information continue to be shared. In addition, The Conversation: Between Us, About Us, has taken the initiative to challenge misinformation by providing video conversations with Black doctors, researchers, and nurses with facts about the vaccine for Black communities.

Receiving a vaccine is a crucial tool to curb the pandemic and protect yourself against COVID-19. We at CIANA are committed to helping you and your family book appointments through our partnership with NYC’s Test and Trace Corps. Call us at 718-545-4041 to schedule an appointment. Additionally, a number of city-run vaccine sites are now taking walk-ins for individuals ages 16 and up. Find a site near you.


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