Completing the pandemic puzzle: N.C. health departments work to vaccinate Hispanic community

May 7, 2021

North Carolina hopes to lift many COVID-19 restrictions in less than a month, if enough people can get vaccinated.

Since the first vaccines started rolling out, local groups knew focusing on historically marginalized populations was going to be a key in clearing that hurdle, so as doses, providers and access have grown, so has the share of Hispanic residents getting their shots. 

Cristina Cardenas, health access coordinator for Western Carolina Medical Society, was part of a panel discussion in January discussing what it would take to successfully reach out to people of color, a necessary piece to solve the pandemic puzzle. 

Months later, she said she absolutely feels like the county, and other organizations like WCMS and the Mountain Area Health Education Center are doing a good job reaching out to the local Hispanic community and getting shots in arms. 

At WCMS, that meant going to churches and mobile home parks alongside MANNA Food Bank, talking with folks about the vaccine, answering questions and encouraging them to talk to their doctors or health professionals, she said. 

"I like the fact that we didn't stick to one location," Cardenas said. "We went out into the community." 

That was what they thought was needed initially, she said, and now, they're seeing results. 

"The amount of people that came out was far more than we were expecting," Cardenas said, even though the pause on Johnson & Johnson's single-dose vaccine cooled the enthusiasm some. 

Local health departments and other groups have been working to reach a portion of the community underrepresented in early vaccination eligibility groups, including Buncombe County's two-week partnership with the Mexican Consulate, YMCA, Project Access and A-B Tech, as well as outreach to Costa Farms to reach migrant farm workers, according to Public Health Director Stacie Saunders. 

Buncombe Health and Human Services administered 450 vaccines through that partnership, and while its early equity dose allocations from the state were 300 per week, that has changed over time, and currently the county is able to accommodate most equity events with its existing inventory, Saunders said. 

"COVID-19 disproportionately impacted historically marginalized communities including Black/African American and Latinx communities," she said. "(The) vaccine is our best shot in further protecting ourselves and those we care about."

Systemic racism and inequities it brings in housing, employment, income and more lead to worse health outcomes for Latino, Black, Indigenous and people of color, said Zo Mpofu, Human Services Program Consultant with Buncombe County. 

Next up for the county, Saunders said, are continued efforts to make it easier to get the vaccine with walk-up availability at A-B Tech and working with local growers and farmers going into the harvest and planting season.

The county also hopes to reach out to places people are already going, she said, such as workplaces and food distribution sites, as well as reaching out to connect to whole families and reach younger people. 

Cardenas participated in MAHEC's final vaccination clinic at UNCA, which offered walk-up appointments for the one-dose Johnson & Johnson vaccine, where she said, "We had a tremendous turnout."

Cardenas, who also serves as an interpreter at Buncombe County's and MAHEC's vaccination sites, said that even with the lull from the pause of the Johnson & Johnson vaccine, "a lot of the people who were very hesitant ended up showing up with two or three family members."

They were expecting about 50 people, Cardenas said, and about 130 showed up. 

But the sunsetting of those larger events also presents a problem, Cardenas said, for folks who may have trouble getting to vaccination sites thanks to work schedules or a lack of transportation. 

People have reached the point where they want to get vaccinated, and they're trying, she said, but she hopes the lack of transportation and accessibility doesn't become an issue. 

Cardenas noted WCMS offers taxi rides for folks who need transportation. Clients can call 828-274-6989, and WCMS will get a taxi to them. 

Andrew Mundhenk, communications manager for the Henderson County Department of Public Health, also noted challenges presented by a population with a large portion involved in daily work schedule where it can be hard to find good times for vaccinations, as well as a migrant labor force that's very mobile. 

Saunders said accurate information about vaccine efficacy, safety and what's required to get one remain a challenge, including that citizenship or documentation isn't a requirement.

Another challenge is the concern that COVID-19 vaccines were made with aborted fetal cells, something that's not the truthshe said.

Henderson county attributes much of its recent improvement in reaching Hispanic communities to Blue Ridge Health, Mundhenk said, which has strong connections to Hispanic workers and an extensive Migrant Farmworker Outreach program. 

He said the county is seeing more of its Hispanic residents showing up at large-scale community events and that the health department continues to do neighborhood outreach. 

"All vaccine providers, including the Health Department, continue to explore options in order to make access easier for historically marginalized populations while continuing to advocate about the benefits of being vaccinated," Mundhenk said, including education and outreach to businesses and other organizations. 

Employers are getting in on it, too, he said, providing time for employees to get their vaccinations. 

He said it will take time, but the health department is optimistic that a proportional level of county residents across all demographics will get vaccinated. 

By the numbers

The state Department of Health and Human Services tracks demographic data for residents who’ve been vaccinated, with breakdowns by age, gender, race and ethnicity, comparing the shares of vaccinated people with those groups as represented in the general population.

Statewide, as of May 6, more than 4.1 million people have received at least one dose of a COVID-19 vaccine, 39.5% of the state's total population and just under 50% of the state's adult population. 

Of those, 67.8% have been white, compared to making up 71.7% of the state’s population as a whole. Black North Carolinians make up 16.6% of vaccinated state residents and 23.1% of the population.

By ethnicity, 6.6% of those vaccinated in the state are Hispanic, though 9.8% of the state’s population is Hispanic.

Non-Hispanic North Carolinians make up 84.7% of those vaccinated and 90.2% of the state’s population.

The numbers are closer in Buncombe County, where almost 122,000 people have received at least one dose, 5.1% have been Hispanic, compared with 6.8% of the county’s population.

Of Buncombe residents, 6.8% are Hispanic, and 5.7% of those vaccinated are Hispanic.

While 11.6% of those vaccinated have ethnicity data missing or undisclosed in the county, of the remainder of those vaccinated, 83.4% are non-Hispanic, a group that makes up 93.2% of the county’s population.

Looking at the week-by-week breakdown shows how efforts have ramped up.

For the first three months of vaccinations, from mid-December to the first week in March, Buncombe County averaged 2.3% of vaccinations going to Hispanic residents, though missing data ranges from 0% to 51% during those weeks. 

For the nine weeks ending with the week of May 3, the average is 8.56%, with a peak of 12% the week of April 19, according to state data, which shows between 8-10% of data missing for those weeks.  

Statewide, the share of vaccinations going to Hispanic residents per week has ramped up in recent weeks as well, from 5% at the beginning of March to 16% the week of May 3, the highest so far. 

In Henderson County, where 10.3% of the population is Hispanic, more than 47,000 people have received at least their first dose of the vaccine, 6.1% of whom are Hispanic, though 10.5% of that data is missing or undisclosed. 

Mundhenk said the county is slightly behind in being proportional with vaccination among Hispanic populations, though he also pointed out that since eligibility for essential workers opened in March, the weekly share of vaccines going to Hispanic residents has climbed. 

According to state data, the past three weeks have seen 23%, 12% and 18% of vaccinations going to those Hispanic Henderson County residents, which he said shows rates are "trending in a very favorable way."

Derek Lacey covers health care, growth and development for the Asheville Citizen Times. Reach him at or 828-417-4842 and find him on Twitter @DerekAVL.