Hispanic people across the United States continue to be especially underrepresented among those vaccinated, according to a New York Times analysis of state-reported race and ethnicity information. The Hispanic share of the vaccinated population is less than the Hispanic general population in all states with large Hispanic communities.

Barriers to vaccine access faced in many Hispanic communities — alongside the structural limitations communities of color generally face — stand in the way of higher vaccination rates, even as the vaccine becomes more widely available, according to public health experts and community health organizers.

There is limited access to the digital tools needed to secure an appointment, for instance, especially among those who are older and live in immigrant communities.

“Our folks don’t have emails, they don’t have computers at home,” said James Rudyk, executive director of the Northwest Side Housing Center in Chicago, which runs vaccine clinics in Belmont Cragin, a largely Hispanic neighborhood. “They have smartphones, but they are not navigating registration systems that want you to fill out pages and pages of information.”

And often information about vaccine eligibility and registration is only readily available in English.

“People didn’t even know that there was a vaccine when we talked to them,” said Gilda Pedraza, the executive director of the Latino Community Fund in Atlanta, which called hundreds of older Hispanic people in late February to organize a vaccine clinic, before the state health department had posted eligibility information in Spanish.

Counties across the United States with significant Hispanic populations are more likely to face technology and language barriers, as well as cost barriers to pursuing health care, and are less likely to have insurance.

Vaccine clinic organizers also report that Hispanic members of their communities, many of them uninsured, are unaware that the vaccine is free for all and have expressed concern about its cost. Some, especially essential workers with limited or no time off, say that they can’t miss work to get a shot or can’t afford to miss a day if they have side effects from the vaccine.

And while the Biden administration has stated that getting a vaccine will not affect a person’s immigration status, community health workers say this is still a major concern for immigrant families.

“Yesterday I received two calls from people who are in the process of trying to regularize their situation, and they were saying, ‘We would rather not have our vaccine, because what if they find out that we got it and it affects our immigration process?’ ” Pedraza said. “And I said, ‘You might not live to see your immigration process if you don’t get your vaccine.’ ”

A trusted health care provider who shares information about the vaccine can alleviate some of these barriers, according to public health experts. But Hispanic people are less likely to have an existing relationship with a health care provider. And counties with significant Hispanic populations are less likely to have dependable or regular access to health care.

Community health advocates who live and work in the neighborhoods they are helping to vaccinate are taking on some of this responsibility and sharing critical information about the vaccine.

“We had a nearly 20% no-show rate initially for our first day of second doses and we got that down to less than 2% with phone calls,” Rudyk said. “Lots of people thought one dose was enough.”

And while concerns about vaccine safety often come up, advocates say that talking through these fears, even if it takes time, helps people decide to get immunized.

“Seeing people like you, speaking like you, it is critical,” Pedraza said. “It is what changes behavior.”

States that partner with community-based organizations are administering the vaccine more equitably than others, said Rita Carreón, vice president of health at UnidosUS, a civil rights organization for Hispanic communities.

In the states included in The Times’ analysis, the gap between the Hispanic share of the general population and the vaccinated population has declined slightly since the start of the month. Widening eligibility for the vaccine in some states may be contributing to the narrowing gap, but public health experts say that barriers to access still play an outsized role in the disparity.

Federal efforts to close the vaccination gap for Hispanic Americans through community health centers, while limited in size, are having some success. While the Hispanic share of the U.S. population is about 18%, Hispanic people made up more than a quarter of those nationwide who received their first dose at a community health center, according to an analysis of federal data by the Kaiser Family Foundation.

METHODOLOGY:

The Times gathered race and Hispanic origin data for vaccinated people from state websites March 19 and March 20.

Race and ethnicity information is missing from a significant number of vaccination records across states, by as much as a third in some states. Subsequently, The Times removed from its analysis vaccination records with unknown or unreported race or ethnicity data. The Times excluded the District of Columbia as the ethnicity was unknown for half of its vaccinations.

States also vary in whether they include nonresidents among those vaccinated. States may or may not include people vaccinated by a federal program for long-term care facilities. The Times used population data from the 2019 American Community Survey. While some states include Hispanic people among racial categories, others report ethnicity separately. Total population figures were adjusted based on the method of race and ethnicity reporting in each state.

Surgo Ventures provided county-level data from its COVID-19 Vaccine Coverage Index, which identifies potential barriers to vaccine access. Indicators are based on the proportion of households that report various barriers, as follows. For the “access to information” indicator: no internet connection, no smartphone or limited spoken English; for the “health care cost barrier” indicator: no health insurance or not seeking care because of costs; for the “access to routine medical care” indicator: not making regular medical visits; and for the “regular doctor” indicator: no personal doctor or medical home.

Hispanic people across the United States continue to be especially underrepresented among those vaccinated, according to a New York Times analysis of state-reported race and ethnicity information.

Hispanic people across the United States continue to be especially underrepresented among those vaccinated, according to a New York Times analysis of state-reported race and ethnicity information. The Hispanic share of the vaccinated population is less than the Hispanic general population in all states with large Hispanic communities. Barriers to vaccine access faced in many Hispanic communities — alongside the structural limitations communities of color generally face — stand in the way of higher vaccination rates, even as the vaccine becomes more widely available, according to public health experts and community health organizers. There is limited access to the digital tools needed to secure an appointment, for instance, especially among those who are older and live in immigrant communities. “Our folks don’t have emails, they don’t have computers at home,” said James Rudyk, executive director of the Northwest Side Housing Center in Chicago, which runs vaccine clinics in Belmont Cragin, a largely Hispanic neighborhood. “They have smartphones, but they are not navigating registration systems that want you to fill out pages and pages of information.” And often information about vaccine eligibility and registration is only readily available in English. “People didn’t even know that there was a vaccine when we talked to them,” said Gilda Pedraza, the executive director of the Latino Community Fund in Atlanta, which called hundreds of older Hispanic people in late February to organize a vaccine clinic, before the state health department had posted eligibility information in Spanish. Counties across the United States with significant Hispanic populations are more likely to face technology and language barriers, as well as cost barriers to pursuing health care, and are less likely to have insurance. Vaccine clinic organizers also report that Hispanic members of their communities, many of them uninsured, are unaware that the vaccine is free for all and have expressed concern about its cost. Some, especially essential workers with limited or no time off, say that they can’t miss work to get a shot or can’t afford to miss a day if they have side effects from the vaccine. And while the Biden administration has stated that getting a vaccine will not affect a person’s immigration status, community health workers say this is still a major concern for immigrant families. “Yesterday I received two calls from people who are in the process of trying to regularize their situation, and they were saying, ‘We would rather not have our vaccine, because what if they find out that we got it and it affects our immigration process?’ ” Pedraza said. “And I said, ‘You might not live to see your immigration process if you don’t get your vaccine.’ ” A trusted health care provider who shares information about the vaccine can alleviate some of these barriers, according to public health experts. But Hispanic people are less likely to have an existing relationship with a health care provider. And counties with significant Hispanic populations are less likely to have dependable or regular access to health care. Community health advocates who live and work in the neighborhoods they are helping to vaccinate are taking on some of this responsibility and sharing critical information about the vaccine. “We had a nearly 20% no-show rate initially for our first day of second doses and we got that down to less than 2% with phone calls,” Rudyk said. “Lots of people thought one dose was enough.” And while concerns about vaccine safety often come up, advocates say that talking through these fears, even if it takes time, helps people decide to get immunized. “Seeing people like you, speaking like you, it is critical,” Pedraza said. “It is what changes behavior.” States that partner with community-based organizations are administering the vaccine more equitably than others, said Rita Carreón, vice president of health at UnidosUS, a civil rights organization for Hispanic communities. In the states included in The Times’ analysis, the gap between the Hispanic share of the general population and the vaccinated population has declined slightly since the start of the month. Widening eligibility for the vaccine in some states may be contributing to the narrowing gap, but public health experts say that barriers to access still play an outsized role in the disparity. Federal efforts to close the vaccination gap for Hispanic Americans through community health centers, while limited in size, are having some success. While the Hispanic share of the U.S. population is about 18%, Hispanic people made up more than a quarter of those nationwide who received their first dose at a community health center, according to an analysis of federal data by the Kaiser Family Foundation. METHODOLOGY: The Times gathered race and Hispanic origin data for vaccinated people from state websites March 19 and March 20. Race and ethnicity information is missing from a significant number of vaccination records across states, by as much as a third in some states. Subsequently, The Times removed from its analysis vaccination records with unknown or unreported race or ethnicity data. The Times excluded the District of Columbia as the ethnicity was unknown for half of its vaccinations. States also vary in whether they include nonresidents among those vaccinated. States may or may not include people vaccinated by a federal program for long-term care facilities. The Times used population data from the 2019 American Community Survey. While some states include Hispanic people among racial categories, others report ethnicity separately. Total population figures were adjusted based on the method of race and ethnicity reporting in each state. Surgo Ventures provided county-level data from its COVID-19 Vaccine Coverage Index, which identifies potential barriers to vaccine access. Indicators are based on the proportion of households that report various barriers, as follows. For the “access to information” indicator: no internet connection, no smartphone or limited spoken English; for the “health care cost barrier” indicator: no health insurance or not seeking care because of costs; for the “access to routine medical care” indicator: not making regular medical visits; and for the “regular doctor” indicator: no personal doctor or medical home.

The vaccination gap among Hispanic communities reflects barriers to access

After weeks of waiting, Judy Franke’s vaccine breakthrough came when her phone rang at 8 p.m. one freezing February night. There were rumors of extra doses at the Minneapolis convention center. Franke, 73, had an hour to get there. No guarantees.

“I called my daughter and she said, ‘I’m putting my boots on right now,’” said Franke, a retired teacher with a weakened immune system. “You need to go find the vaccine because the vaccine’s not going to find you.”

The clamor for hard-to-get COVID-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system.

They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow?

Some pharmacists have even given them a nickname: Vaccine lurkers.

Even with inoculation rates accelerating and new vaccines entering the market, finding a shot remains out of reach for many, nearly three months into the country’s vaccination campaign. Websites crash. Appointments are scarce. Severe weather like last month’s winter storms can wreak havoc on shipments. Many Americans have been left feeling like they are on their own.

“There are people who feel desperate, and this is what they end up doing,” said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “It’s ridiculous. It’s wholly unnecessary. There should be a way to do this that does not require us going down this path.”

The leftover shots exist because the Moderna and Pfizer vaccines have a limited life span once they are thawed and mixed. When no-shows or miscalculations leave pharmacies and clinics with extras, they have mere hours to use the vaccines or risk having to throw them away.

And so, tens of thousands of people have banded together on social media groups under one mantra: Better in an arm than in the trash. They trade tips about which Walmarts have extra doses. They report on whether besieged pharmacies are even answering the phone. They speculate about whether a looming blizzard might keep enough people home to free up a slot.

In Denver, suburban teachers stampeded a mass-vaccination site after they got an email saying they had an hour to claim 200 unused doses. In Massachusetts, hourslong lines wrapped around a DoubleTree Hotel after reports of extras ping-ponged across social media.

“It’s like buying Bruce Springsteen tickets,” said Maura Caldwell, who started a Minneapolis Vaccine Hunter Facebook group to help people navigate the search for appointments. The group now has 20,000 members. “It’s not easy. You can’t just sign up.”

Thousands of doses have already gone to waste because of power failures, paperwork mix-ups and a shifting jumble of state and local guidelines about what to do with leftovers. Earlier this year, health officials in California and New York state loosened their rules for who could be vaccinated when vaccines are about to expire.

Other health workers have distributed leftovers on their own. In Oregon, a vaccination team stranded on a snowbound highway went from car to car offering doses that would go bad in six hours. A doctor in Houston received national attention after he was fired for racing to inoculate 10 people — including his wife — before his vial of extra doses expired.

The pace of vaccinations has picked up to about 1.9 million doses per day, with more due as the single-shot Johnson &amp;amp; Johnson vaccine rolls out. But health experts said the scavenger hunt for leftovers highlights the persistent disparities in America’s vaccination rollout, where access to lifesaving medicine can hinge on computer savvy, personal connections and a person’s ability to drop everything to snag an expiring dose.

In Dallas, Kimberly White-Agent said she had struggled to find appointments for her brother and 83-year-old stepfather, even after city and federal officials opened a mass-vaccination site to serve their largely Black neighborhood. She resorted to putting them on wait lists and hoping an extra slot opened up.

“It’s like a mirage,” she said.

Some of the leftover chasers are not yet eligible to sign up for appointments. Others are old enough or sick enough to qualify, but said that overloaded vaccination websites and endless hold lines convinced them to abandon the official channels and search for themselves.

Gunnar Esiason, 29, has cystic fibrosis and said he was not about to wait until his New Hampshire vaccine appointment rolled around on April 21. So he started showing up at Walgreens pharmacies and state-run vaccination sites — wherever there was a whiff of an extra vaccine, until he got a tip that a Dartmouth medical center had a few extras.

“I knew I was going to a lot of ‘No’s,’” he said. “All I needed was one ‘Yes.’”

In Minnesota, Franke signed up for eight different vaccine lists managed by doctors, Walgreens, Walmart, even a state lottery, but said nobody called. Then last month, she got a tip that the mass-vaccination site at the convention center might have some extras.

There were about 20 other people already milling around in the lobby when Franke arrived, she said, and a health worker quickly emerged to inform them there were no leftovers.

But many in the crowd stuck around, and after a half-hour, the vaccination team allowed people 65 and older, teachers and emergency responders to get their shots. Franke lined up and said she cried with relief on the car ride home to the suburbs.

Ashok Shah, 77, a retired internal-medicine physician in Poughkeepsie, New York, tried to sign up. But failed again and again.

Shah said he and his 79-year-old wife spent weeks languishing on their county’s official vaccination lists. He would search fruitlessly for online appointments in the middle of the night, and put himself on informal wait lists kept by nearby pharmacies.

When it became clear there would be little progress, “We had to go looking,” he said.

In early February, with 6 inches of fresh snow on the ground and a nearly impassable mound plowed into the base of his driveway, he said a Rite Aid called with the news that they had one spare dose.

“I said, I’ll take it,” said Shah, who got his second dose Tuesday. “Come rain, come shine, come snow, I’ll be there.”

But leftovers are getting harder and harder to find. More people are looking, and the extras are dwindling as pharmacies and public-health agencies get better at matching each day’s available vials with their list of appointments.

Vaccine teams in Fairfax County, Virginia, fill up individual syringes from a shared supply of vaccines to make sure they are not cracking open new vials at the end of the day. Several cities have created special leftover lists to offer doses to police officers, teachers or older people. Columbus, Ohio, said its “no waste” list of 250 people is full.

At Discount Drug Mart, a chain of 76 pharmacies in Ohio, the vaccination teams add up their doses against no-shows throughout the day, and start reaching out early to the 25 people who are on their rolling standby lists. Rarely, someone waiting in the parking lot at 9 p.m. or calling on a whim may land a vaccine.

“It’s a priority to never waste a dose,” said Jason Briscoe, the company’s director of pharmacy operations.

Often, the hunt just amounts to days of frustration. Sara Stoltz has spent days driving around Dallas trying to get a leftover dose for her 64-year-old mother. They get turned away from pharmacies whose wait lists are already full at 200 people deep. They stop at every Walmart they can, only to learn that nobody missed an appointment.

“I keep hearing rumors,” Stoltz said, with no dose behind them. “It’s like one of those urban myths.”

After weeks of waiting, Judy Franke’s vaccine breakthrough came when her phone rang at 8 p.m. one freezing February night. There were rumors of extra doses at the Minneapolis convention center.

After weeks of waiting, Judy Franke’s vaccine breakthrough came when her phone rang at 8 p.m. one freezing February night. There were rumors of extra doses at the Minneapolis convention center. Franke, 73, had an hour to get there. No guarantees. “I called my daughter and she said, ‘I’m putting my boots on right now,’” said Franke, a retired teacher with a weakened immune system. “You need to go find the vaccine because the vaccine’s not going to find you.” The clamor for hard-to-get COVID-19 vaccines has created armies of anxious Americans who have resorted to hunting for leftovers on the fringes of the country’s patchwork vaccination system. They haunt pharmacies at the end of the day in search of an extra, expiring dose. They drive from clinic to clinic hoping that someone was a no-show to their appointment. They cold-call pharmacies like eager telemarketers: Any extras today? Maybe tomorrow? Some pharmacists have even given them a nickname: Vaccine lurkers. Even with inoculation rates accelerating and new vaccines entering the market, finding a shot remains out of reach for many, nearly three months into the country’s vaccination campaign. Websites crash. Appointments are scarce. Severe weather like last month’s winter storms can wreak havoc on shipments. Many Americans have been left feeling like they are on their own. “There are people who feel desperate, and this is what they end up doing,” said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “It’s ridiculous. It’s wholly unnecessary. There should be a way to do this that does not require us going down this path.” The leftover shots exist because the Moderna and Pfizer vaccines have a limited life span once they are thawed and mixed. When no-shows or miscalculations leave pharmacies and clinics with extras, they have mere hours to use the vaccines or risk having to throw them away. And so, tens of thousands of people have banded together on social media groups under one mantra: Better in an arm than in the trash. They trade tips about which Walmarts have extra doses. They report on whether besieged pharmacies are even answering the phone. They speculate about whether a looming blizzard might keep enough people home to free up a slot. In Denver, suburban teachers stampeded a mass-vaccination site after they got an email saying they had an hour to claim 200 unused doses. In Massachusetts, hourslong lines wrapped around a DoubleTree Hotel after reports of extras ping-ponged across social media. “It’s like buying Bruce Springsteen tickets,” said Maura Caldwell, who started a Minneapolis Vaccine Hunter Facebook group to help people navigate the search for appointments. The group now has 20,000 members. “It’s not easy. You can’t just sign up.” Thousands of doses have already gone to waste because of power failures, paperwork mix-ups and a shifting jumble of state and local guidelines about what to do with leftovers. Earlier this year, health officials in California and New York state loosened their rules for who could be vaccinated when vaccines are about to expire. Other health workers have distributed leftovers on their own. In Oregon, a vaccination team stranded on a snowbound highway went from car to car offering doses that would go bad in six hours. A doctor in Houston received national attention after he was fired for racing to inoculate 10 people — including his wife — before his vial of extra doses expired. The pace of vaccinations has picked up to about 1.9 million doses per day, with more due as the single-shot Johnson &amp; Johnson vaccine rolls out. But health experts said the scavenger hunt for leftovers highlights the persistent disparities in America’s vaccination rollout, where access to lifesaving medicine can hinge on computer savvy, personal connections and a person’s ability to drop everything to snag an expiring dose. In Dallas, Kimberly White-Agent said she had struggled to find appointments for her brother and 83-year-old stepfather, even after city and federal officials opened a mass-vaccination site to serve their largely Black neighborhood. She resorted to putting them on wait lists and hoping an extra slot opened up. “It’s like a mirage,” she said. Some of the leftover chasers are not yet eligible to sign up for appointments. Others are old enough or sick enough to qualify, but said that overloaded vaccination websites and endless hold lines convinced them to abandon the official channels and search for themselves. Gunnar Esiason, 29, has cystic fibrosis and said he was not about to wait until his New Hampshire vaccine appointment rolled around on April 21. So he started showing up at Walgreens pharmacies and state-run vaccination sites — wherever there was a whiff of an extra vaccine, until he got a tip that a Dartmouth medical center had a few extras. “I knew I was going to a lot of ‘No’s,’” he said. “All I needed was one ‘Yes.’” In Minnesota, Franke signed up for eight different vaccine lists managed by doctors, Walgreens, Walmart, even a state lottery, but said nobody called. Then last month, she got a tip that the mass-vaccination site at the convention center might have some extras. There were about 20 other people already milling around in the lobby when Franke arrived, she said, and a health worker quickly emerged to inform them there were no leftovers. But many in the crowd stuck around, and after a half-hour, the vaccination team allowed people 65 and older, teachers and emergency responders to get their shots. Franke lined up and said she cried with relief on the car ride home to the suburbs. Ashok Shah, 77, a retired internal-medicine physician in Poughkeepsie, New York, tried to sign up. But failed again and again. Shah said he and his 79-year-old wife spent weeks languishing on their county’s official vaccination lists. He would search fruitlessly for online appointments in the middle of the night, and put himself on informal wait lists kept by nearby pharmacies. When it became clear there would be little progress, “We had to go looking,” he said. In early February, with 6 inches of fresh snow on the ground and a nearly impassable mound plowed into the base of his driveway, he said a Rite Aid called with the news that they had one spare dose. “I said, I’ll take it,” said Shah, who got his second dose Tuesday. “Come rain, come shine, come snow, I’ll be there.” But leftovers are getting harder and harder to find. More people are looking, and the extras are dwindling as pharmacies and public-health agencies get better at matching each day’s available vials with their list of appointments. Vaccine teams in Fairfax County, Virginia, fill up individual syringes from a shared supply of vaccines to make sure they are not cracking open new vials at the end of the day. Several cities have created special leftover lists to offer doses to police officers, teachers or older people. Columbus, Ohio, said its “no waste” list of 250 people is full. At Discount Drug Mart, a chain of 76 pharmacies in Ohio, the vaccination teams add up their doses against no-shows throughout the day, and start reaching out early to the 25 people who are on their rolling standby lists. Rarely, someone waiting in the parking lot at 9 p.m. or calling on a whim may land a vaccine. “It’s a priority to never waste a dose,” said Jason Briscoe, the company’s director of pharmacy operations. Often, the hunt just amounts to days of frustration. Sara Stoltz has spent days driving around Dallas trying to get a leftover dose for her 64-year-old mother. They get turned away from pharmacies whose wait lists are already full at 200 people deep. They stop at every Walmart they can, only to learn that nobody missed an appointment. “I keep hearing rumors,” Stoltz said, with no dose behind them. “It’s like one of those urban myths.”

America’s most prized leftovers: COVID vaccines

The U.S. Centers for Disease Control and Prevention (CDC) has asked state public health officials to prepare to distribute a potential coronavirus vaccine to high-risk groups as soon as late October, documents published by the agency showed on Wednesday.

US CDC tells states to prep for COVID-19 vaccine distribution

US: States to brace for vaccine distribution by November 1