Almost two years since the beginning of the COVID-19 pandemic, we have confronted the illness and loss of millions of lives and the sad and dangerous reality of having a health care system and a society full of moral gaps, inequities, and disparities. This unprecedented and complex situation challenged all of us on many levels. While facing high levels of unexpected fear, uncertainty, and distress, the well-known socio-cultural and demographic differences became more evident, bringing devastating consequences.
However, not everything was negative. The science, as well as the health care workers, demonstrated being up to the challenge. Altruism, hope, dedication, and commitment were transformed on clinical improvements and scientific development. New treatments were discovered, preventive measurements were proven critical, and a vaccine was finally available, bringing some light at the end of the tunnel.
However, not all these advances could erase the health care gap, and we have continued evidence of important disparities that principally affect minorities. Differences have resulted from socio-demographic characteristics, cultural backgrounds, literacy, and even political beliefs. Society has been divided between those that trust science, and the health care system, and those that are skeptical or afraid, and refuse to follow preventive measures and recommendations that could save their own lives and the lives of those around them.
In the U.S., the Latinx community represents one of the minorities that have been significantly affected by the COVID-19 pandemic. As a reference, approximately 62 million Latinx live in the U.S. One in six adults and one in four children in the U.S. identified as Latinx. Data from the CDC reveals that the Latinx population accounts for 24.4% of infections while representing only 18.5% of the U.S. population. These levels are proportionally higher than those seen in the Black (11.6%), and white (55.6%) while representing respectively 12.5% and 60.1% of the U.S. people.
Several aspects have accounted for this situation, including misinformation, lack of understanding or trust, socioeconomic status, low health literacy, and reduced access to health care. In addition, factors such as migratory status, work conditions, and lack of medical insurance have acted as important deterrents to visiting hospitals, getting tested, and receiving vaccines. Indeed, even though vaccines are currently broadly available, and their effectiveness to reduce deadly disease and safety have been proven, we are still witnessing the high levels of disbelief and hesitation and the low compliance in the Latinx group.
Some of the concerns reported by the Latinx community include the possible harmful effects of the vaccine, listing unfounded theories as DNA changes, infertility, cancer, and the use of tracking devices, among others, to justify their fear and lack of compliance.
By December 2021, 73.8% of people have been fully vaccinated in the U.S. However, based on the CDC’s vaccine administration data, only 44.8% of Latinx have received the full dose. In addition, while 89.1% of those above 65 years old have received the booster, only 58.6% of Latinx versus 70.4% of Non-Hispanic white have received this required third dose.
This lack of compliance is critical, especially if we take into consideration the increased risk of morbidity and mortality associated with the lack of vaccination. Based on CDC data from October 2021, unvaccinated people have 5 and 10 times more risk of testing positive and 14 and 20 times more risk of dying than someone fully vaccinated without and with the booster dose respectively.
Many efforts have been dedicated to reducing the hesitance, mistrust, and fear while increasing the levels of vaccination compliance in the Latinx population. Some examples are health campaigns supported by Latin institutions and medical societies, educational materials in Spanish, and social media diffusion using influential Latinx representatives. All of those have focused on providing transparent, truthful, reliable, and at the same simple information adapted to the language, health literacy, culture, and social background, of the Latinx community.
Because of these efforts, we have seen some improvement in the levels of compliance. The latest CDC reports accounting for the last 14 days show that the incidence of full vaccination and booster in the Latinx community has increased to 22.5% and 11% respectively. While this data demonstrates that the initial vaccination hesitancy is slowly being reduced, we are still far from a reasonable target that will significantly protect the Latinx community, especially now that we face a new COVID-19 variant.
Indeed, during the last few weeks, Omicron has become the number one variant in the U.S., representing more than 73% of cases. This variant, which seems to be less aggressive for those fully vaccinated (especially with the booster), is still very contagious (more than delta); therefore, it spreads faster in the community. Those not yet fully vaccinated are at high risk of being exposed, getting seriously ill, and even dying. Then, it is not surprising that currently, non-vaccinated patients account for the majority of hospital and ICU admissions due to COVID-19.
Knowing that an important number of Latinx are not yet fully vaccinated and understanding the health care gaps and social disparities that affect this group, it is reasonable to assume that the Latinx community will be disproportionately affected by the pain and sorrow of the new wave of the COVID-19 pandemic. More efforts and resources need to be designated to continue educating and empowering the Latinx community to comply with vaccination and other well-proven preventive measures that will protect them from COVID-19 and its devastating consequences now and in the future. In addition, medical schools, societies, and other related health care institutions need to become more socially and culturally aware and advocate for a diverse, inclusive health care system that promotes equity and reduces disparities.
Miriam Zylberglait Lisigurski is an internal medicine physician. Ricardo Correa is an endocrinologist.
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