RALEIGH — As a housekeeper, Ana Huerta has spent the pandemic disinfecting and cleaning surfaces in homes and factories and is unable to work from home.
Huerta, a Mexican immigrant, wants to be vaccinated to avoid bringing the coronavirus home to her two small children, but she has worried that lacking legal immigration status could prevent her from getting the COVID-19 vaccine.
"It would make no sense to not vaccinate someone over legal status if the point is to get rid of the virus," said Huerta, 38, in Spanish to The News & Observer. "I think that would be selfish, or even racist."
North Carolina plans to vaccinate frontline essential workers like Huerta in Group 3 — meaning, those who work with the public and are at higher risk of being exposed to COVID-19. That includes teachers, first responders and those who work at grocery stores.
North Carolina's estimated 325,000 unauthorized immigrants — many who work in those fields — could be eligible to next get the vaccine. The state is currently making its way through Group 1 (healthcare workers and nursing home residents and staff) and Group 2 (anyone 65 years or older).
While the timeline for Group 3 depends on how fast doses can be administered, which has been slower than expected, health leaders and immigration advocates are working now to ease the potential concerns and distrust around the vaccine.
'Fear' an issue
Hesitancy is common among Latino communities and especially among people living in the United States without legal status.
"Fear is always one of the biggest issues," said Lariza Garzón, executive director of the Episcopal Farmworker Ministry, an immigrant labor advocacy group.
People may be wary of getting vaccinated after hearing about testing sites with a police presence, Garzón said. She often sees those same fears keeping people from seeking help during hurricanes.
"When they see the police car right in front of the door, they turn around and they decide to stay at home — even if it's not safe," Garzón said.
Those concerns are in addition to the general worries about the safety of the vaccine itself.
Latinos, in particular, often live in multi-generational homes and are uninsured or lack sufficient access to health care, which makes them more susceptible to illness if they can't receive treatment.
"We can't divide between citizens and non-citizens, permanent residents and non-permanent residents," said Dr. Viviana Martinez-Bianch, a Duke Health doctor and adviser to state officials. "We are vaccinating to get to herd immunity. If you're on the soil of the United States ... they should all receive the vaccine, irrespective of what their legal status is."
The state's inclusive vaccination directives stand to benefit its agricultural industry, where a significant number of immigrants work.
At least 4,346 virus cases and 21 deaths among workers in meat-processing plants have been reported by state health officials since the start of the pandemic last March, with cases peaking last summer.
In the state's data on outbreaks in congregate-living facilities, there are over 4,000 cases and 17 deaths connected to migrant farmworker housing across North Carolina tobacco and produce farms.
Karina Moreno works in Chatham County at the Mountaire Farms poultry plant, where several COVID-19 clusters — translating to hundreds of individuals — were reported last summer.
Moreno, 25, said that North Carolina's inclusion of all workers is good for the large portion of Latino immigrant workers at the plant. She said many coworkers got sick from the coronavirus and were hospitalized last year.
"If they want people to stop getting sick," Moreno said, "(no state) should say that only people who are citizens can get it."
Mistrust of the vaccine
But Moreno is reluctant to take the vaccine herself, out of distrust of the government and fear of the vaccine's side effects.
"To be honest with you, it doesn't sit well with me," she said.
The CDC reports common side effects include pain and swelling at the site of the shot with the potential for fever, chills, fatigue and headaches. But the CDC said the side effects are "normal signs" and should be temporary.
Fears may still remain of being billed for vaccines, as Garzón said some have been for COVID-19 testing. And she said many question the vaccine's safety due to a general distrust of a medical system that often has failed them.
Puerto Ricans were medically experimented on by the United States in the past, she added, creating a similar reluctance to vaccines that is common among some Black people. And few undocumented people have access to a doctors who might assuage these concerns.
Garzón suggests that state health officials should invest in educational outreach campaigns targeted at those in the country illegally. Governments can build deeper bonds with immigrant communities by "just acknowledging some of the mistrust."