Christine Wedja, left, was concerned about getting a COVID-19 vaccination until she spoke with Pauline Lumumba, a community outreach worker with Portland’s Minority Health Program. Derek Davis/Staff Photographer
Pauline Lumumba was among the first people in Maine to be offered the COVID-19 vaccine when the rollout began back in December.
As a medical interpreter working with immigrant and minority populations in Greater Portland, Lumumba had been on the front lines of the pandemic from the start. She didn’t believe social media posts that said the vaccine would harm people of African heritage. But like many people early on, she had questions and concerns about the vaccine’s safety and effectiveness.
“I did have a lot of questions due to what was on social media,” Lumumba said. “Is the vaccine safe? Is it really ready for people to be vaccinated? I didn’t trust websites saying it was against Black people, but I was one of the last people in my department to be vaccinated. I wanted to see how it affected others first.”
Now, Lumumba, a native of the Democratic Republic of the Congo who also works as a nutrition counselor, is among a small grassroots army of truth-tellers, trendsetters and leaders by example who are working to make sure Maine’s newest arrivals have factual information about the vaccine and ready access to area clinics.
They are affiliated with various nonprofit agencies, public health programs and community groups, some of them funded through the Maine Department of Health and Human Services. They are collaborating with Northern Light Health and MaineHealth, hospital-based networks that are leading the state’s vaccine rollout and have taken significant steps to encourage inoculation among immigrant and minority populations.
They are reaching out to people who often have public-facing jobs, larger families and shared living spaces, putting them at greater risk of contracting, spreading and dying from COVID-19, vaccine advocates say. The death rate is at least two times greater among Black, Hispanic and Native American people, according to the U.S. Centers for Disease Control and Prevention.
And they are gradually breaking through language barriers and countering misinformation and distrust perpetuated by false and inflammatory social media. Stories and memes that claim the vaccine will change people’s DNA and slowly kill them, especially people from Africa, or it’s really a GPS tracking device that will compromise their immigration status.
“We’re doing everything we can to make sure people get vaccinated,” said Nélida Berke, coordinator of the city of Portland’s Minority Health Program. “They have to get the message that the vaccine is safe so they can be vaccinated and be role models for their communities.”
Lumumba is one of 16 community health outreach workers in the Minority Health Program who are now dedicated to addressing vaccine reluctance and getting shots into the arms of newcomers in Greater Portland. Other agencies involved in the effort include Catholic Charities Maine, Maine Access Immigrant Network and Maine Immigrant Rights Coalition, as well as groups such as Unified Asian Communities, Presente Maine and the Congolese Community Association of Maine.
Christine Wedja, left, was concerned about getting a COVID-19 vaccination until she spoke with Pauline Lumumba, a community outreach worker with Portland’s Minority Health Program. Derek Davis/Staff Photographer
Detailed numbers were unavailable to show the demographics of Maine’s relatively small immigrant and minority populations or how many of them have been vaccinated so far. About 7 percent or 94,000 of the state’s 1.3 million residents identify as nonwhite and 3.6 percent or 48,391 are foreign-born, according to the U.S. census.
Still, vaccination among people of color appears to be lagging, in part because the rollout initially targeted older Mainers, and immigrant communities tend to be younger overall, with people ages 30 to 45 soon to become eligible and the focus of outreach efforts, vaccine advocates said.
Among 244,527 Maine residents who by Thursday had received the required one or two shots to be fully vaccinated, 4,774 people or 2.5 percent were Black, Asian, Native American or other people of color; 187,331 identified as white; and 52,422 didn’t identify race or ethnicity, according to the Maine Center for Disease Control and Prevention’s COVID-19 vaccine website.
Despite a lack of solid data, vaccine reluctance among immigrant and minority populations seems to be waning and willingness to be inoculated appears to be on the upswing as the vaccine supply increases, more people get vaccinated and more people become eligible, advocates say. Mainers age 50 to 59 became eligible last week, and everyone age 16 and older will become eligible April 19.
“We have hundreds ready to go when their age group becomes eligible,” said Chanbopha Himm, president of Unified Asian Communities in Maine. “We fought the myths with education. I was up every night, finding the facts and posting them (on Facebook). And we made sure our elders got vaccinated so others could see that it was safe.”
Himm is one of several “cultural brokers” in her organization who have helped more than 80 community members get vaccinated, providing assistance with registration, transportation and translation services throughout the process. Last week she left her finance position at Wex to take a job with the state’s COVID Response Team.
Torn Khorn, a Scarborough resident in her 90s, was eager to get the COVID-19 vaccination after getting help from Chanbopha Himm, a close family friend who answered her questions and helped schedule an appointment. Derek Davis/Staff Photographer
When Himm accompanied Torn Khorn, a Cambodian immigrant in her 90s, to be vaccinated at Northern Light Mercy Hospital in Portland, Himm took a photo of the momentous event and posted it on her Facebook page. Soon, community members were calling Himm, asking “How’s Grandma?” a ubiquitous term of endearment for female Cambodian elders.
“I told them, ‘Grandma’s OK. Grandma’s doing fine,’ ” Himm said. “They told me, ‘OK, then I want my shot, too.’ ”
Khorn has embraced her duties as role model, Himm said, telling everyone she knows that getting inoculated was a breeze. Her reasons for taking the vaccine are similar to any other grandmother.
“I’m getting old, Bopha,” she told Himm. “My fear was catching COVID and ending up in the hospital and not being able to see my children or grandkids, even my great-grandkids. I’ve lived through so much to get to America. A few side effects from the vaccine didn’t scare me.”
Himm said her group received a $12,000 grant from Maine DHHS to promote vaccine awareness and access. The department didn’t respond to a request for information about grant funding to community groups for this purpose.
Neither Maine DHHS nor Maine CDC responded to repeated requests to speak with someone about the state’s COVID-19 vaccine outreach efforts to immigrant and minority communities, and there appeared to be no office or staff dedicated to that purpose on their websites. An Office of Health Equity listed on the Maine CDC website was a dead link.
Torn Khorn, who is in her 90s and lives in Scarborough, was vaccinated against COVID-19 in February at Northern Light Mercy Hospital in Portland. She has become a role model among the Unified Asian Communities of Maine. Photo courtesy of Chanbopha Himm
“Maine DHHS continues to partner with new Mainer and immigrant leaders to support vaccination in diverse communities across Maine,” DHHS spokeswoman Jackie Farwell said in a written statement. “As part of this effort, which spans the full department, including Maine CDC, we are in the process of finalizing contracts with two dozen community agencies to provide education and outreach to increase vaccine confidence and support access to vaccination through registration assistance and other planning.”
Farwell said the department recognizes that these organizations are trusted voices within their communities and critical partners in ensuring that communities receive culturally and linguistically appropriate information about vaccines and reducing barriers to access through assistance with registration and cultural brokering.
Dr. Nirav Shah, director of the Maine CDC, also speaks regularly with new Mainer groups to answer their vaccination questions directly, most recently in a virtual chat hosted by Amjambo Africa, a free newspaper and website for and about new Mainers from Africa. When he spoke to members of Unified Asian Communities in Maine, more than 40 people participated, Himm said.
But many immigrants still have concerns about the safety and effectiveness of the vaccine, including unfounded fears promoted by false posts on social media, said Berke, an immigrant from Peru who has coordinated Portland’s Minority Health Program for more than a decade.
Some concerns are common among the general population, such as how much it will cost (it’s free for everyone, including undocumented immigrants), how they will schedule an appointment (it’s challenging for many people, including native English speakers) and whether they might contract COVID-19 from the vaccine (which is impossible).
Others have heard rumors that they might be injected with a GPS tracking device that will compromise their immigration status. Many have seen posts on social media claiming that the COVID-19 vaccine will change your DNA, including one meme that shows a woman clutching a child, wielding a machete and saying that her children won’t be test animals.
The baseless rumors trigger fears of government-backed medical treatment that traditionally has disregarded or taken advantage of minority populations, including here in the United States.
One of the most egregious was the syphilis experiment in Tuskegee, Alabama, that withheld treatment from 399 Black men for 40 years so researchers could study the effects of the disease, according to the U.S. CDC. Shocking news stories brought an end to the study in 1972 and led to a $10 million out-of-court settlement with survivors and family members.
That same year it came to light that thousands of Native American women had been involuntarily sterilized, either without their knowledge or under threat of losing government benefits, according to the American Journal of Public Health. American Indians in general have been subjected to repeated clinical mistreatment and unethical medical research throughout U.S. history.
Many immigrants have experienced or heard of similar horrors in their native countries. Some African immigrants have been vaccinated in clinical trials without giving fully informed consent, Berke said.
“They fear they will be guinea pigs for the vaccine here as well,” Berke said.
Berke and other vaccine advocates say lack of access to accurate information shouldn’t be construed as ignorance among immigrant and minority populations. Many immigrants are educated and simply want reliable information from a trustworthy source, she said, and it helps if it comes from members of their own communities.
“Because I have an accent, that doesn’t mean I’m ignorant,” Berke said. “I need the facts from a health care professional who is knowledgeable.”
That’s how it worked for Dalal Almosoodi, an Iraqi immigrant who is an Arabic interpreter and a community health outreach worker in Portland’s Minority Health Program.
“At the beginning I was really struggling with the decision because (the vaccine) was very new and it was difficult to get information,” Almosoodi said. Then, one by one, Almosoodi’s co-workers got vaccinated, especially her supervisors at Portland City Hall, Catholic Charities Maine and Spurwink, a mental health agency. So she got vaccinated, too.
“What really motivated me was trust,” Almosoodi said. That’s what she tries to instill in her clients as well, with one-on-one meetings and informational fliers she distributes through businesses in Portland, Westbrook and Biddeford that attract Arabic-speaking customers.
“My community has made a lot of progress, but there’s still a lot of misinformation,” Almosoodi said. “A majority are very well-educated, but the war caused a lot of trauma and they are very cautious. When someone they know and trust gets the vaccine, they are more willing. Just yesterday I was able to register three clients for the vaccine. It’s getting better every day.”
To improve access to accurate information about the vaccine and combat misinformation, MaineHealth and Maine Access Immigrant Network are collaborating to host regular “Ask the Doc” town meetings on Zoom in Somali, Arabic and French. They’re an outgrowth of similar meetings the health care network held for staff members in the early weeks of the vaccine rollout, and they have attracted participants from other countries.
Dr. Wollelaw Agmas is helping Maine Medical Center and MaineHealth provide information about and improve access to COVID-19 vaccines among immigrant and minority populations. Shawn Patrick Ouellette/Staff Photographer
“There’s a tremendous thirst for reliable information out there,” said Dr. Dora Anne Mills, who is the chief health improvement officer at MaineHealth, a former head of the Maine CDC and sister of Gov. Janet Mills.
Compared to printed handouts or video presentations, the Zoom meetings allow participants to interact directly with experts. “It’s much more dynamic when you have it live and people are able to ask questions,” Mills said.
Dr. Wollie Agmas, an infectious disease expert at Maine Medical Center in Portland, is one of the physicians who leads the “Ask the Doctor” online meetings. Early on, he was discouraged by the flood of inaccurate and misleading information he saw on social media, but he has seen the trajectory of the vaccine rollout shift as people increasingly seek trustworthy sources.
“You cannot just assume that immigrants don’t know anything,” said Agmas, a native of Ethiopia. “Many immigrants are highly educated, but they have a lot of fear and anxiety about the vaccine. Slowly, I think, that has been changing.”
MaineHealth also provides interpreter services for its call-in vaccine registration line and translations for online registration. And live interpreter services are available at each MaineHealth vaccine clinic in the form of portable screens that can be wheeled throughout the vaccination process.
Northern Light Health consulted with immigrant community leaders in planning its mass vaccination clinic at the Portland Expo, which opened March 2. Located just off Interstate 295 on the city’s downtown peninsula, it’s designed to be easy to navigate with directional signs in several languages.
“We wanted it to be inclusive, accessible and welcoming to all,” said Melissa Skahan, vice president of mission integration at Northern Light Mercy Hospital. “We wanted to identify both formal and informal leaders (in the immigrant communities) to help build vaccine confidence.”
Northern Light Health was unable to provide numbers on how many immigrant community members have been vaccinated at the Expo. However, Northern Light Home Care & Hospice has delivered vaccine to more than 60 non-English speakers through clinics held at several public senior housing sites, and it was scheduled to deliver nearly 100 additional doses at a clinic organized by the Maine Access Immigrant Network, spokeswoman Jacqueline Welsh said.
Skahan said she and her co-workers tapped and elevated relationships that Mercy had established with immigrant and minority populations before the pandemic but hadn’t fully developed. She expects the experience to have a lasting impact on how the hospital interacts with the wider community well into the future.
“How we engage with folks has shifted and we probably will have these relationships going forward,” Skahan said. “It presents an opportunity to continue working collaboratively to make sure all aspects of the health care system are equitable.”
For Pauline Lumumba, the community health outreach worker, the results of building confidence in the COVID-19 vaccine are clear. She sees it every time she registers someone to be inoculated. One of her latest converts is Christine Wedja, 70, also an immigrant from the Democratic Republic of the Congo.
Speaking in French and interpreted by Lumumba, Wedja said she was wary of the vaccine after reading social media posts claiming that it was designed to kill people slowly. That it was developed to reduce the world’s population, and was targeted especially to eliminate people from Africa. And like many people, she also questioned the effectiveness of the vaccine if she had to keep wearing a mask and social distancing after she got inoculated, something that is considered a precaution amid mounting COVID-19 variants.
Then, many people Wedja loves and respects got vaccinated, including her mother, her children and her English teacher. She called Lumumba and asked for her help to get vaccinated.
“They all said the vaccine is good,” Wedja said. “Now I’m not scared anymore. I am ready.”
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