Working as an oncology nurse navigator (ONN) during the COVID-19 pandemic has been a stressful and challenging experience for many reasons. ONNs play a vital role in promoting health and preventing upward trends of the disease by providing education to our patients and their family members. As a bilingual ONN at the Levine Cancer Institute and working very closely with our Spanish-speaking cancer patients, I have heard their most common misconceptions and fears about the COVID-19 vaccine. It is well known that health disparities are higher in vulnerable communities, and that the COVID-19 pandemic has made this even worse. According to the CDC, the rate of COVID-19 cases among Hispanic persons was 1.5 times higher than among non-Hispanic persons.1 Lower rates of vaccination among the Hispanic population could be problematic and put people at a higher risk for the virus. Debunking misinformation and mistrust among this vulnerable community is imperative for our public health. Healthcare professionals need to recognize some of the most common COVID-19 misconceptions in the Hispanic community and provide education and information to prevent any further confusion. By providing education to vulnerable people, we can help eradicate their mistrust and fears regarding the COVID-19 vaccine.
Some of the most common fears among these patients include being asked for immigration status, social security number, and proof of health insurance when visiting a COVID-19 vaccination site.
Common Fears
Some of the most common fears among these patients include being asked for immigration status, social security number, and proof of health insurance when visiting a COVID-19 vaccination site. In addition, they worry that if they provide their demographics to the staff, this information could be shared with immigration authorities such as Immigration and Customs Enforcement. Conspiracy theories regarding the COVID-19 vaccine are also a problematic issue within the Latino community. Often, people are getting their vaccination information from social media platforms like WhatsApp, Messenger, and Facebook. These social media platforms are commonly used within this community to communicate with their loved ones in their native country at an affordable price. This makes them vulnerable to all the misinformation that is distributed through these apps. They have expressed concerns that a microchip could be injected; or that the vaccine could negatively impact their fertility; or that receiving the vaccine could lead to complications such as deformities in unborn babies. Due to the language barrier, there is also a lack of knowledge about where to receive the vaccine. Because of the disinformation and fear, most of my cancer patients have stated that “they want to wait” before proceeding with the vaccination.
Providing accurate and reliable educational resources in Spanish is critical to overcome these misconceptions. Patients often rely on the healthcare professional’s recommendation about the vaccine, especially if they have already built a rapport with them. Trust is key to overcoming this barrier. Reassuring patients that vaccination sites and test sites have nothing to do with immigration can eradicate some of their fears. Linguistics, culture, immigration status, lack of knowledge, low health literacy, and financial barriers are all factors that could prevent Latino patients from seeking vaccination. I try to close this gap by providing my patients with information on familiar vaccination sites within the community, such as grocery stores, organizational buildings, and community healthcare centers, to help build their trust and help reduce the risk of confusion and concerns.
Barriers and Access to Healthcare
Logistical barriers and access to healthcare are an important part of my patient assessment when providing COVID-19 vaccine education. Hispanic patients are essential workers in the workforce and have a limited ability to get time off. To accommodate their schedules, it is important to provide patients with vaccination sites that have extended hours. Transportation is one of the biggest barriers to healthcare within this community. Coordinating transportation resources to assist patients is critical to a patient’s ability to receive a vaccination. I have learned that providing essential information to my patients about the vaccine being free and accessible regardless of health insurance status or immigration status is very important. Reminding them that enforcement activities should not be conducted at vaccination sites or clinics helps reduce misinformation, fears, mistrust, and common misunderstanding among these patients.
Cultural Beliefs and Religions
Most cultural beliefs and religions have no prohibitions against vaccinations. However, some could play a major role in vaccine hesitancy. It is important that I respect and understand their religion and beliefs regarding vaccination compliance when I provide education to my patients about the COVID-19 vaccine. Providing resources and educational material through trusted resources and working in collaboration with community religious leaders could help increase the vaccination rate in this community.
Addressing Barriers
As an ONN who works very closely with Hispanic patients, I understand the importance of addressing potential barriers to vaccination facing my patients. I realize that knowledge and education are the keys to improving vaccination rates. However, addressing these barriers and eliminating misinformation have been ongoing issues during this pandemic. Therefore, continuing to engage community leaders and healthcare systems is crucial. Atrium Health has developed strategies to address some of the barriers that have impacted the Hispanic community during these unprecedented times. Importantly, ONNs must continue to provide outreach services and methods of engagement within the Latino community to be highly effective.
Reference
- Centers for Disease Control and Prevention. Risk for COVID-19 Infection, Hospitalization, and Death by Race/Ethnicity. Centers for Disease Control and Prevention. www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html. September 15, 2022.
