Language barriers make access to the vaccine difficult


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In January, the Virginia Department of Health website assured English-speaking readers that the COVID-19 vaccine “will not be necessary for Virginians.”

But the Spanish translation, via a Google Translate widget at the top of the page, said something else: the vaccine “won’t be necessary” or “won’t be necessary” instead of not obligatory.

Sharp-eyed students at George Mason University caught the confusing translation and brought it to the attention of their professor, who alerted the state health department. The phrase was quickly corrected and the website now has professional translation of the COVID-19 information material. The incident was the first reported per The Virginian-Pilot diary.

While the mistake was a temporary disgrace to Virginia’s vaccination campaign, the faulty translation is emblematic of a much bigger problem in the country’s launch: getting a vaccine in the United States poses several obstacles to people who do not speak English.

The lack of linguistic access to vaccine information was not necessarily the result of poor pandemic planning. In 2020, the Trump administration removed language access protections that had been written into the Affordable Care Act (ACA).

Since the passage of the Civil Rights Act in the 1960s, federal laws have protected people from discrimination based on their country of origin. Decades later, the ACA took these protections and applied them specifically to health care.

Under section 1557 of the ACA, any federally funded health organization had to include a slogan in meaningful documents in the 15 major languages ​​of the state in which they worked that notified people who were entitled to an interpreter. and free assistance in their own language. .

“This was withdrawn in August 2020 and in December 2020 we started developing a massive vaccination campaign,” said Denny Chan, a lawyer and advocate for equity for the California nonprofit Justice, in Aging. “Some of these things shot us in the foot.”

Hispanics currently have the highest rates of new COVID-19 cases in the United States and many are lagging behind with the deployment of vaccines.

Whites make up about 61% of the population, but they make up 68% of those who are fully vaccinated. Only 9% of those who are fully vaccinated are Hispanic, although Hispanics make up nearly 17% of the total U.S. population, according to data of the Centers for Disease Control and Prevention (CDC).

About one-third of all people who identify as Hispanic in the United States have limited English proficiency, in accordance with the Pew Research Center.

According to U.S. Census data, 25 million people of all racial and ethnic groups, or 1 in 13 in the United States, cannot communicate well in English.

Justice in Aging and the Nonprofit Center for Medicare Advocacy demanded the U.S. Department of Health and Human Services in February to restore language access protections.

Chan said health care providers can still deliver language care to patients who need it. They are not prevented from doing this.

But the law set a minimum of requirements that were not in place when officials built the infrastructure and logistics behind the massive deployment of Operation Warp Speed ​​vaccines.

“If you are not required to the same degree to make sure people know their rights to interpreter services or have translated documents,” it is not prioritized, Chan said. “At various points in the process, we’ve seen the language access piece fall apart.”

State sites had variable translation help

A WebMD / Medscape review of vaccine search engine websites available through the health departments of the 50 states found that most offered a language translation, but there were three states that at the time of the review had no language assistance in your vaccination seekers: Alabama, New Jersey, i South Dakota. New Jersey has a tab to translate the website into Spanish, but it didn’t work in several different web browsers at the time we reported the story.

In Arizona, residents can arrange vaccinations by registering in a Spanish language patient portal, after giving the state personal information such as an email and a phone number, but the health services department more accessible vaccine finder page, which shows a map of vaccination sites across the state, is not translated into Spanish.

In Arizona, approximately 1 in 3 people is Hispanic. Those of the State vaccination data show that 48% of people who have had at least one dose are white, while 12% are Hispanic.

Georgia had no language translation vaccine finder until a coalition of Latin community advocates wrote a letter to the governor to complain. Now the site is translated, but only into Spanish, still excluding people who speak other languages.

Even, which is the national site to which CDC links, is not translated into other languages.

There is a Spanish language version from, hosted by media company Univision. But it is nowhere mentioned by the English site VaccineFinder, not even by the CDC Spanish translation from their vaccine information page links to the English site VaccineFinder.

The Kansas Department of Health directs people to and the Spanish-language site hosted by Univision.

Translation software has problems

Many other county and state health department websites rely on Google Translate to make their information available to people with a limited level of English.

Google Translate can be useful, but only if someone has a high reading level. It can also be very literal, sometimes not distinguishing the verb book of the noun book, for example, which can confuse the meaning of a sentence.

The other problem with trusting Google Translate is technical. Software can be problematic for vaccine finders because it only recognizes and translates text. It doesn’t translate the maps or graphs that many states have built to direct people to vaccination sites.

“It’s about making vaccination the easiest and most accessible for people, right?” said Barbara Baquero, PhD, associate professor of health services at the University of Washington in Seattle and vice president of the Latin caucus for the American Public Health Association.

“Creating to ask Google Translate to do all the work in the state on the website is negligent,” he said.

Kathy Zeisel, a lawyer at the Center for Children’s Nonprofit Law in Washington, DC, agrees.

Washington, DC, enacted a law in 2004 that requires access to the district’s most common languages: Spanish, Chinese, Vietnamese, Korean, French, and Amharic. On April 8, the center sent a letter to Mayor Muriel Bowser saying a Google Translate button didn’t make the district’s vaccination website accessible enough for people who don’t speak English well.

Since then, the district has agreed to provide professional translations for site information.

While language is only one facet of the problems that contribute to vaccination disparities, it is critical, Baquero said.

“Is language the center of this right?” she said. “We see a lot of difficulties that started with access to the language.”

Sites with incomplete information

Fernando Soto, a journalist who founded the website Nuestro Estado (“Our State”) to bring news in Spanish to South Carolinians, has seen these difficulties first hand.

“Latinos have wanted to get the vaccine,” Soto said. “It has become a problem of how can I get the vaccine.”

Soto learned from so many of his readers that they were having trouble signing up for the vaccines that he started putting his phone number on social media to help people sign up.

He says he has helped more than 60 people book appointments and has seen the difficulties they encountered at every step of the process.

“All the available record is now in English or, if there is a Spanish version, there is a language that excludes a large part of the population,” he said.

Some of the most common problems you’ve seen are sites that neglect to say the vaccine is free or ask for a Social Security number to be registered, even though it’s not necessary for vaccination.

The South Carolina Department of Health and Environmental Control (DHEC) has a website to look for vaccines that can be translated into Spanish, but sometimes links to sites that are only in English, such as the main page for Prisma Health vaccine sites, a large health system in the state.

Recently, Soto enrolled dozens of people for an emerging DHEC-run clinic and then came forward to help you with another hurdle: vaccination sites often have little or no language translation for people once they get there.

Consent forms and vaccination cards have Spanish translations, but he said there was no one to guide people through the process or explain that they had to wait 15 minutes after their shootings so they could be monitored in case. there were adverse reactions.

People who identify as Hispanic make up nearly 6 percent of South Carolina’s population, but have received less than 2 percent of the state’s vaccinations, Soto said.

Laura Camarata, a researcher at the Children’s Law Center in Washington, DC, has been helping people who don’t speak English well to sign up for the vaccine. He has been listening to many of the same things. Even if you can sign up for an appointment, it is very difficult to get information once there.

“Will the vaccine interact in any way with this condition or with this medication? Is it really questionable that, unfortunately, because of the language, those people were not in a position to ask at the clinic,” he said.

At least one clinic, Bread for the City, decided to opt for the Washington, DC vaccine registration system, to better care for its own patients. When Bread for the City appeared as a vaccination site in the district’s vaccine finder, it was the white, wealthier people who booked appointments. Thus, the administrators of the clinics opted for the system and began to proactively call their patients, offering them the first doubts. They said it worked much better.

In addition to language issues, people who do not speak English are still wary of the rules of public office established during the Trump administration. Under public charge rules, once someone accepts federal benefits, immigration authorities counted them negatively when considering citizenship applications.

Public charging rules they were abandoned by President Joe Biden on March 9, more than three months after the vaccine was launched. But people are still afraid that if a vaccine is obtained – a federal advantage – it will count against them in the eyes of the immigration authorities.

“People say blacks and browns, you know, doubt it. The reality is that it’s a minority in our community that doubts and then it’s an important part of people concerned, not necessarily about the COVID-19 vaccine. [but] about the system around it, ”said Gilda Pedraza, executive director of the Latino Community Fund in Atlanta.

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