Grassroots work increases vaccination rates in refugee communities

Naw Mu Chaw had questions about possible side effects of the Covid-19 vaccine.

Cha, a refugee who just arrived in the United States from Myanmar, is receiving medical care at a community health center near her home in Clarkston, Georgia, a town of about 14,000 people. Her English is limited, but the center has an interpreter to translate health information into her native language, Burmese.

His doubts began to fade when a health worker sent him a text message about the vaccine written in Burmese. He got vaccinated and then urged other refugees to get vaccinated too.

“Some people have underlying diseases, such as diabetes, and if they are [del virus]They can die,” he said. “If they have diabetes or high blood pressure, they should get vaccinated before other people.”

Public health officials and resettlement groups in the United States have used these types of community strategies to encourage newly arrived refugees and other vulnerable people to get vaccinated against Covid. And in places like Clarkston, health officials say these grassroots initiatives are working. The metro city of Atlanta—Georgia’s refugee resettlement center—has higher vaccination rates than any county or state.

In general, Covid has disproportionately affected refugees.

Newly resettled individuals may experience living or working conditions that increase their risk of contracting the virus. Some refugees come home with underlying medical conditions that increase their risk of serious illness, according to the Centers for Disease Control and Prevention (CDC). And in multigenerational households, it can be difficult to protect older family members living in cramped quarters.

Some refugees face other significant barriers to vaccination, such as language barriers, lack of transportation, and irregular work schedules.

“We want to make sure these epidemics don’t disproportionately affect communities of color, immigrants, refugees and other vulnerable people,” said Kat Kelly, director of immigration and refugee services at Catholic Charities USA, in Washington, Virginia. “If there are historically underdeveloped communities, they will be unserved in any kind of crisis. You have to build a sustainable infrastructure that will address these barriers.”

To build that infrastructure, CDC developed a toolkit for local health departments and community organizations that includes messages about COVID and vaccines in more than 30 languages. Guidelines for data collection and work policies for public health professionals, rehabilitation agencies, and employers were also established. And grassroots groups have recruited bilingual community workers to increase vaccination rates among refugees.

Unlike those who move to the United States from other countries of their choice, refugees moving to the United States are not required to receive vaccinations prior to travel. Once in the country, all refugees undergo a medical examination within 90 days of arrival. At that time, providers talk about vaccinations.

Among the groups cooperating with the vaccination drive against Covid is the International Rescue Committee, a global non-profit organization that provides emergency assistance to refugees and has relocated more than 28,000 people to the Clarkston area over the past 40 years.

Clarkston is known for its diversity, with large numbers of refugees from Myanmar, the Democratic Republic of the Congo, and Syria. Community health workers and grassroots organizations in the area have been instrumental in educating about the Covid vaccine and say their efforts have been very successful.

According to data compiled by the Georgia State University (GSU) Prevention Research Center, 70% of Clarkston residents were fully vaccinated by July. In DeKalb County, where Clarkston is located, that number was 62%. Georgia’s percentage, 57%, is the lowest in the country.

The Georgia State Center reported that Clarkston’s vaccination rate is more than 20 percentage points higher than other areas in DeKalb County with the same score on the Social Vulnerability Index, which evaluates communities based on factors such as socioeconomic status, housing density, availability of transportation and households. ; and race, ethnicity and language. According to Mary Helen O’Connor, the center’s deputy director, outreach efforts in Clarkston translate into higher immunization rates.

The GSU Prevention Research Center has recruited five community health workers, each fluent in a different language, to promote the benefits of vaccination against Covid. Two workers working in the Clarkston area are Kaiden Tun from Myanmar and Thomas Rodger from the Democratic Republic of Congo.

Roger said misinformation about the vaccine is a big problem in the Swahili-speaking community, especially among refugees from the Democratic Republic of Congo. Before resettling in Clarkston, Roger lived in a camp in Tanzania and said that the president of that nation, John Magufuli, who died in March 2021, denied the existence of Covid, and many people were exposed to this misinformation on Facebook. Some people watched YouTube videos in Swahili that linked the vaccine to satanic practices, Roger explained.

He wasn’t surprised that some people in Clarkston wouldn’t let him into their homes. At first people saw him as an outsider. His friends connected him to the vaccine and wondered why he was being paid to promote it. He developed strategies that worked best for the people he was trying to reach. To prove that the vaccines were safe, he used his phone to record vaccinations of well-known members of the community.

Tun, who texted Cha with information about the vaccine, found out when a family of Rohingya refugees — a historically oppressed family — recently attended a health fair and received vaccinations he couldn’t find.

“What surprised me the most was how receptive everyone was to our work,” Toon said. “Because I can’t imagine, with everything that’s been said about Covid since it started, how confusing it can be for the community, especially with the language barrier.”

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