FEATURE: Community members experience barriers and hesitancy to getting vaccinated

The causes of poor vaccine access and hesitancy in the Asian community

By Kiana Marsan

Although people of color have disproportionally made up COVID-19 cases and deaths since the start of the pandemic, many Black, Brown, and Asian communities across the country are struggling to receive the vaccine support they need.

“It’s tough when the states and the U.S. really did not lead with equity in terms of prioritizing certain populations that are most vulnerable, including BIPOC (Black, Indigenous and people of color),” said Dr. Oswaldo Grenardo, cochair of the Colorado Vaccine Equity Taskforce, for The Denver Post. “Now we’re in catch-up mode.”

In Colorado, Asians make up 3.12% of the population with a vaccination rate of 3.05%. As for Hawaiians and Pacific Islanders, they comprise 0.12% of the population and are being vaccinated at a rate of 0.25%. While the state appears to be successful in closing the racial health disparity between whites and Asians, these statistics collapse the AAPI community into a monolith and do not reflect attitudes regarding vaccine access and hesitancy held by those who have yet to receive COVID-19 immunization.

“Distinct groups are often lumped into a single ‘Asian’ category in public health databases, if they are counted at all,” writes Darius Tahir and Mohana Ravindranath for Politico. “Advocates say that could conceal disparities, prevent public health departments from mounting targeted outreach and even exclude some groups from vaccine research.”

The barriers that Asians experience to accessible healthcare are numerous and rooted in histories of exploitation, colonization, and racism. Immigrants and refugees—such as Cambodians, Vietnamese, and Burmese—are the lowest-income groups in the AAPI community, making them least likely to receive the vaccine.

Challenges include difficulty finding access to transportation or not feeling safe enough to visit unfamiliar cities given the rise in police presence and anti-Asian violence. If they work a minimum wage job, they may not have the means to take time off for multiple doses or recover from side effects in the days after. Finding information about the vaccine may require English literacy which they do not have, and undocumented migrants may fear being turned over to ICE.

“There are cultural and language barriers that can result in a potential lack of access to information,” said Stacey Shigaya. She is program director of Sakura Foundation, a nonprofit that sustains and celebrates Japanese American heritage, culture, and community. From her observations, efforts have been made by local health and Asian organizations to reach out to the Asian community by hosting vaccine clinics at Tri-State/Denver Buddhist Temple and Simpson United Methodist Church, whose congregation is predominantly Japanese American.

These obstacles to vaccination mean that in places like Hawaii, where Asians make up 41% of positive cases, they initially received less than 9% of doses. In Alaska, Asians are 11% percent of deaths but 5% of vaccinations. Some states, like Florida, have collected no demographics at all on vaccination rates in Asian communities.

These realities have deathly consequences when research has proven that Asians are twice as likely to test positive, 60% more likely to be hospitalized, and 50% more likely to die to COVID-19 than white folks. These statistics increase with age, putting unvaccinated Asian elders most at risk of contracting the virus.

But even if Asians had widespread means to access the vaccine, this

Most Cited Barriers Were Logistics

wouldn’t necessarily promise higher immunization rates. Many are disillusioned with the U.S. medical system, as it has historically disenfranchised people of color. When an Asian immigrant has escaped violence and conflict that was backed by the American government, it makes sense for them to be wary of what was once their colonial power.

“For people of color, there may be a lack of trust as a result of a history of betrayal,” said Shigaya. “This is one of the reasons why there has been a push to have family physicians provide the vaccine shots, so that families can have conversations with someone they trust.”

For the US to reach herd immunity, people of color must be made a priority in local, state, and federal vaccination plans. They must be provided with targeted, timely, and relevant information about what getting the vaccine looks like for them and their families. At present, Colorado has not made any tangible plans for outreach to BIPOC communities known.

The vaccine is free for anyone to take, and it does not require proof of health insurance or any form of identification. While some may experience side effects such as shortness of breath or headaches, it is unlikely to result in long-term health consequences. Anyone is eligible to receive the Pfizer, Moderna, or Johnson & Johnson vaccine, all of which feel similar to getting a flu shot. For a comprehensive list of vaccination sites in Colorado, visit covidcheckcolorado.org/

find-our-sites-vaccinations.

Recommendations to increase vaccination rates Get Involved!

To better understand barriers to vaccine uptake in the AAPI community

Data disaggregation remains the best approach to addressing inequity in the AAPI community. When all subgroups are combined, vulnerable populations continue to be hidden and disparities perpetuated. Asian Avenue Magazine is partnering with June Homdayjanakul from the Colorado School of Public Health to conduct research to fill this gap.

Their work will address the gap in much needed data on barriers to vaccine uptake, sources of hesitancy, and opportunities to better reach the various subgroups within the AAPI community.

The results of their research will be used to inform public health practice, develop messaging that is more salient to specific subgroups, and better direct resources to appropriate communities. If you are interested in learning more or want to partner in this research project, please contact June at Kamonthip.homday janakul@cuanschutz.edu.