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The first doses of the COVID-19 vaccine were given in the U.S. on December 14.

USA TODAY

As the COVID-19 vaccine makes its way throughout the United States, immigration activists and lawmakers are rallying to ensure that the 11 million undocumented immigrants at the heart of the nation’s food production and service industry sectors are not left out.

Experts say it is unlikely that health officials will discriminate against undocumented Americans. But after years of isolationist and punitive immigration policies from the Trump administration, many immigrants – whose physical and fiscal health has, along with many people of color, been disproportionately hurt by the pandemic – might be unwilling to come forward and get vaccinated. 

In July, Beatriz Gutierrez’s entire family – including her four children, ages 9 to 17, and her partner, who is a landscaper – caught COVID-19. While none were hospitalized, the illness resulted in her partner losing his job and bills piling up.

Though the disease creates natural immunity, the federal Centers for Disease Control and Prevention says people who have had COVID-19 “may be advised” to get the vaccine because of the severe health risks associated with the virus and the possibility of reinfection.  

“We don’t want to take the risk if it’s going to cause us problems,” such as deportation, says Gutierrez, 36, a stay-at-home mother in Phoenix. “But otherwise, I am ready to take it.”

Beatriz Gutierrez, 36, of Phoenix is one of more than 10 million residents of the United States who is undocumented. She is eager to get the COVID-19 vaccine after she and her entire family caught the virus last summer. But Gutierrez also is concerned that getting the shots might expose her and her family to unwanted attention from immigration officials. (Photo: Thomas Hawthorne, Arizona Republic)

For Gutierrez, who had two friends die from the virus that has killed nearly 313,000 Americans, the vaccine means a chance for health and job security.

And it should not come with concerns about being put in the crosshairs of immigration officials, said Cara Christ, director of the Arizona Department of Health Services.

“Vaccines are one of those things we make available no matter if you’re a winter visitor or if you’re visiting from another country,” Christ said. “We want to make sure we’re protecting everybody.”

Deadly discrimination: ‘An unbelievable chain of oppression’: America’s history of racism was a preexisting condition for COVID-19

COVID-19 has been particularly merciless to Black, Hispanic and Asian Americans for reasons that include poverty, preexisting health conditions and front-line jobs. That demographic includes many immigrants, and the vast majority of those undocumented workers hail from Mexico and Central America. Many of them are crucial to farming and meatpacking, and their illness and death represent both a human tragedy and an economic blow.

“The vaccine must be fully available to undocumented Americans. If not, it will put all of us at risk,” said Manuel Pastor, head of the Equity Research Institute at the University of Southern California in Los Angeles, which uses data and analysis to dissect equity issues. 

“Imagine restaurants reopening when you haven’t also included the entire staff in your vaccination efforts,” Pastor said. “Because undocumented residents, due to their work status, our health insurance system, the perceived danger of approaching our government and economic distress, are less likely to access vaccines, it is imperative that we make them free and deliver them through trusted vehicles.”

Personal information not required for COVID-19 vaccine

Over the past four years under President Donald Trump, immigrants have faced everything from raids by immigration enforcement authorities to a Public Charge rule that threatens future citizenship for using public benefits.

As it stands, polls show that roughly 40% of Americans say they won’t get the vaccines, two of which, Pfizer and Moderna, have a very high effectiveness rate but were developed in a record time of less than a year. If millions of immigrants also hesitate for other reasons, the virus could linger.

Some Trump administration officials have suggested that providing information such as a birth date, driver’s license or passport number would help track the vaccine rollout and its success. That sort of mandate would freeze out many immigrants, said New York Gov. Andrew Cuomo in a Dec. 1 letter to Health and Human Services Secretary Alex Azar. Cuomo added that his state would not comply with such a request.

Vice President Mike Pence receives the COVID-19 vaccine Dec. 18. (Photo: Associated Press)

Days later, Azar said that while such information would be helpful, “we don’t require that personally protected information be provided” to get a shot.

The nation’s undocumented workers intersect with American lives through their jobs as cooks, food servers, health care providers, hotel and hospital housekeeping workers, elder caregivers, nannies, farmworkers and meatpackers.

Conservative and liberal immigration groups alike agree undocumented Americans should not be excluded from the vaccine because of their status. 

“Public health experts should determine who should be prioritized for the vaccine,” said Ira Mehlman, spokesman for the Federation for American Immigration Reform, a staunchly conservative group that advocates for a moratorium on immigration. “That means people at greatest risk, and at the greatest risk of infecting others.”

Don Kerwin, executive director of the nonpartisan think tank Center for Migration Studies in New York, said that “not vaccinating a group because of their immigration status would be both inhumane and counterproductive from a public health perspective.”

But, he said, there will be “a need for significant outreach tailored to immigrant communities, in a broad variety of languages and on various media. But we’re not seeing that yet.”

Immigration activists nationwide are aware their constituents need to get the message that getting a COVID-19 vaccine will not make them a target of federal officials. But so far they have not seen anything from government officials in the waning days of the Trump administration.

In this 2018 file photo, U.S. Immigration and Customs Enforcement officers arrest an undocumented Mexican immigrant during a raid in the Bushwick neighborhood of Brooklyn, New York. (Photo: John Moore, Getty Images)

“The new administration has to do everything possible to let undocumented immigrants know it’s safe to get this vaccine and that any information they provide, even a cellphone number, won’t be used against them,” said Sulma Arias, director of immigrant rights at Community Change, a national group based in Washington, D.C., focusing on racial and economic equity.

Tiffany Tate, executive director of the Maryland Partnership for Prevention, a nonprofit that provides local and national support for immunizations, said the key to getting undocumented workers to get the vaccine will be in the hands of “trusted partners in the community, people they’ve turned to over the years for flu shots and the like.”

“Where is the advertising, educational materials and campaigns coming from the highest levels?” Tate said. “We have those disproportionately affected by this virus saying they might not accept the shot. That’s concerning.”

Public Charge rule, while in limbo, creates biggest fear

Some grassroots efforts to win the trust of undocumented Americans are revving up.

In Phoenix, employees at the NHW Community Health Center will be told not to ask about immigration or health insurance status when administering the vaccine, said CEO Walter Murillo. He also plans to develop a campaign that assures people their personal information will not be shared with immigration officials.

“We need to assure the public that getting vaccinated is a way to help not just ourselves, but our neighbors,” Murillo said.

The biggest hurdle is addressing fears stoked by the Trump administration’s 2019 Public Charge rule. Although its implementation has been challenged in court, immigration experts say undocumented workers should assume for now that it remains enforceable.

The rule authorizes officials to consider immigrants’ use of certain public benefits, including Medicaid, when deciding whether to grant them green cards. Immigrant advocates have alleged the rule is intended to have a chilling effect, because undocumented people are generally ineligible for the benefits affected by the rule.

The rule’s mere existence has caused some immigrants to not seek any sort of health care for fear of recriminations, said Tara McCollum Plese, chief external affairs officer of the nonprofit Arizona Alliance of Community Health Centers.

Plese said many undocumented people, who often live in “mixed status” families with legal residents and U.S. citizens, are afraid to visit clinics because they worry it will hurt not only themselves but also their families. Persuading undocumented immigrants to step forward now will “be essential” to the overall success of the COVID-19 vaccine program, she said.

In California, home to about 2 million of the nation’s undocumented workers, state lawmakers are working to ensure that food supply workers are prioritized for the vaccines.

“Vaccination will only work if two things happen,” said California Assembly member Eduardo Garcia, who co-wrote a bill spotlighting the health needs of the state’s food supply workers. “One, if farmworkers feel confident and safe in taking it. And two, if we’re doing it across the board irrespective of an individual’s immigration status.”

Diana Tellefson Torres, executive director of the United Farm Workers Foundation, said the organization recently held a virtual town hall during which farmworkers could ask questions about the vaccine.

Workers from around the country asked about the vaccine’s cost, safety and its rapid development, she said. Some asked what documentation they would need to receive the shot, she said.

The UFW Foundation, which has been helping farmworkers during the pandemic with food, masks and financial assistance, is developing responses to those common concerns along with Radio Campesina, a nine-station radio network across four states with a largely Spanish-language audience.

The organizations also hope to promote vaccination by sharing testimonials of workers who receive the shot, as well as those of high-profile leaders of the farmworker movement.

“These people should be allowed the opportunity to protect themselves and their community,” Torres said.

California is home to about 800,000 agricultural workers who fuel a $50-billion-a-year industry. The United Farm Workers estimates that up to 70% of the state’s agricultural workers are undocumented. 

California’s Community Vaccine Advisory Committee, which was convened to ensure the vaccination is distributed and allocated equitably, is in the process of recommending culturally competent ways to reach out to the state’s undocumented communities regarding the shot, said Orville Thomas, director of government affairs at the California Immigrant Policy Center and member of the committee.

Thomas said he is unaware of any efforts at the national level to explicitly exclude undocumented people from vaccine distribution. But, he said, many of the Trump administration’s policies have had such a chilling effect on undocumented people that their participation in the vaccine remains in doubt.

California and the nation, Thomas said, needs to invest in finding ways to encourage undocumented people to “come back out of the shadows, and say, ‘Yeah, I have the ability to get the vaccine.’”

Follow USA TODAY national correspondent @marcodellacava, as well as Arizona Republic immigration writer @azdangonzalez and Palm Springs Desert Sun immigration writer @rebeccaplevin, both part of the USA TODAY Network

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