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How Promotoras Help Maryland Close the Latino Vaccination Gap: Shots



Promotora Gladis Lopez engages community members on June 23 at the Crossroads Farmers Market located on the border of Takoma Park and Langley Park, a suburban area of ​​Maryland with a large Latino population.

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Promotora Gladis Lopez engages community members on June 23 at the Crossroads Farmers Market located on the border of Takoma Park and Langley Park, a suburban area of ​​Maryland with a large Latino population.

Ian Morton / NPR

At 72, Dolores Fontalvo is part friendly neighbor, part psychologist. She is also a mainstay in the state of Maryland’s successful effort to close the immunization gap between its white and Latino residents.

Fontalvo is one of dozens of volunteers promoters – literally, health promoters – with CASA, a Latino and immigrant advocacy group. The job involves visiting high traffic areas like malls and farmers’ markets in the heavily Latino neighborhoods of DC’s suburban Maryland With her long swinging braid and smiling eyes behind a mask, she spends her days in approach other Latino immigrants who, like her, speak primarily Spanish, to make sure they know where and when to get the COVID-19 vaccine.

These days, Fontalvo says, many people are hungry for information or have already obtained their pictures. But sometimes she encounters misinformation. “People hear negative rumors like, oh, the vaccine has a microchip or the vaccines kill people,” Fontalvo tells me in Spanish.

His answer to that? “We are all vaccinated and we are all healthy. Nothing has happened to us.”

Promotora Dolores Fontalvo (right) says helping people in her community is what gets her out of bed every day. This includes people like Antonia Aquino (left) who have sought information to help her grandson get vaccinated, after surviving his own COVID-19 crisis.

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Promotora Dolores Fontalvo (right) says helping people in her community is what gets her out of bed every day. This includes people like Antonia Aquino (left) who have sought information to help her grandson get vaccinated, after surviving his own COVID-19 crisis.

Maria Godoy / NPR

In Maryland, like the rest of the United States, vaccination rates for Latinos lag behind rates for whites. But in recent weeks, many states have seen an increase share of vaccines goes to Hispanics.

Last week, 50% of Maryland’s Latin American population had received at least one dose of the COVID-19 vaccine, making it one of the few states to take that step, according to the Kaiser Family Foundation. And public health experts say the promotora model of community outreach has been key to Maryland’s success.

“When you can get the vaccine from someone in your community, someone you know and have had a relationship with, you are more likely to do it,” says Neil sehgal, an assistant professor of health policy in the School of Public Health at the University of Maryland who has studied the state’s response to the pandemic.

CASA promoters have seeded this relationship with the Latino community for decades, with awareness of long-term issues like diabetes and HIV.

Promotoras engage community members at the Crossroads Farmers Market on June 23.

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Promotoras engage community members at the Crossroads Farmers Market on June 23.

Ian Morton / NPR

Fontalvo has been doing the job for almost 18 years. She says she often meets people who are in pain because they lack support. I witnessed this one day in June, when a woman named Antonia Aquino approached Fontalvo outside a Latin grocery store in Langley Park, Md., Asking where she could send her grandson. to get vaccinated. Suddenly, Aquino collapsed crying as she remembered her own fight with COVID-19 last year, which brought her to the hospital.

“I said goodbye to my children. I lost my job,” Aquino told Fontalvo. She said she now faced a pile of unpaid bills, with nowhere to turn for help – and that she wanted her grandson to be protected. Fontalvo comforted Aquino, encouraging him to consider better days ahead, and then gave him the phone numbers to call for financial and mental help.

Throughout the pandemic, CASA promoters have provided this type of vital support to a reeling community, said Dr Michelle LaRue, director of health and social services at CASA.

“Our community has suffered not only from COVID but also from all the social consequences that have come with COVID, so housing insecurities, food insecurities, financial insecurities due to job losses or reduced hours,” said LaRue. .

She says the promotoras have helped spread the word about how to prevent COVID-19 and where to get tested. They also put people in touch with desperately needed resources like food and rent assistance. And very early on, CASA recruited sponsors to participate in COVID vaccine trials.

“We use it to promote vaccines,” says LaRue. “So we know for a fact that this vaccine works on us, and to try and address some of those trust issues that our community may have.”

Promotora Cindy Escobar says she started volunteering with CASA after noticing misinformation and lack of information about COVID-19 vaccinations circulating in her community.

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Promotora Cindy Escobar says she started volunteering with CASA after noticing misinformation and lack of information about COVID-19 vaccinations circulating in her community.

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But it’s not just trust issues that explain the nationwide Latino vaccination gap, says Samantha artiga, vice president and director of racial equity and health policy at the Kaiser Family Foundation. She says Latinos have faced a range of barriers to getting vaccinated. Many do not have paid vacation, transportation, or the Internet.

“Some people fear getting vaccinated in terms of negative consequences on immigration status,” notes Artiga. She says surveys have also revealed larger gaps in information among Hispanic adults about where to get the vaccine and if they’re eligible, as well as language barriers.

Cindy Escobar, 24, has been working as a promotora for only a few months. She says she decided to take the job after getting the shot and found herself answering questions from friends and family about where they too could get the shot. “That’s what drove me in there, wanting to help them,” she said.

Promotora Ana Parada engages community members at Crossroads Farmers Market.

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Promotora Ana Parada engages community members at Crossroads Farmers Market.

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When Maryland formed its Vaccine Equity Task Force in February to help overcome some of these issues, it quickly turned to CASA and its promoters, said Brigadier-General Janeen Birckhead, who leads the working group. She says the task force focused on the DC suburb of Maryland because the Latin American population had been hit so hard by COVID, and wanted to capitalize on the trust CASA had already built.

Birckhead says promoters have played a critical role in expanding access to vaccines. Not only are they spreading the word, but they also help staff at bilingual clinics in neighborhoods with high Latin American populations that are open after hours and at night so people can go after work.

“It’s this fieldwork that we need to keep doing to get into the community,” Birckhead said. “The voice of trust, the person you might know or the person you can trust, and they’re getting the message out to you about the vaccine.”

Gladis Lopez has been raising awareness as a promotora for over a decade. Originally from Colombia, she says she knows how difficult it can be for immigrants like her to navigate life in the United States without English skills. She says that’s why the work she does is important.

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Gladis Lopez has been raising awareness as a promotora for over a decade. Originally from Colombia, she says she knows how difficult it can be for immigrants like her to navigate life in the United States without English skills. She says that’s why the work she does is important.

Ian Morton / NPR

Sehgal of the University of Maryland says the promotora model is also increasingly being used in other places, including southern California. But the way Maryland’s CASA program works – with its strong partnerships with community clinics, county leaders, and the state’s Vaccine Equity Task Force – stands out.

“Nationally, I think CASA and its partners are really leading the way,” he says.

He would like to see increased government support for the promotora model continue beyond the pandemic to address other health disparities.

Promoter Dolores Fontalvo says she will be ready. She says helping people is what gets her out of bed every day. When I ask her how long she plans to stay at work, she says, “Until my body gives in.”



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