Johnson & Johnson pause may not affect Colorado’s vaccine equity efforts. But other issues persist.

A pause on Johnson & Johnson doses will do little to alter the course of Colorado’s COVID-19 vaccination campaign, Gov. Jared Polis’ office says. The single-dose option has recently accounted for only about 9,000 doses delivered to the state each week, “a drop in the bucket,” said Rick Palacio, who is helping lead vaccine equity efforts from the governor’s office.

Johnson & Johnson is just a fraction of vaccines that Colorado receives for distribution across the state. Still, the one-and-done option is especially appealing to some clinics administering the coronavirus vaccine in underserved areas where people might be less likely to return for a second dose.

Alex Sánchez, founder and executive director of Voces Unidas de las Montañas, runs clinics focused on closing the equity gap. He spends his work week crisscrossing rural Colorado to make sure shots get into arms and vaccine rollout runs smoothly for the area’s Latino population. Sánchez’s work is part of an effort to reach out to groups of people with disproportionately lower vaccination rates. 

“We’ve been literally doing large scale drive-through or walk-in clinics at churches, at community centers,” Sánchez said. “We use members of the community as volunteers, and it’s community driven.”

Public health officials say community-based groups like Voces Unidas are crucial to ensuring vaccine equity. While most vaccines go to state-run vaccination sites, Colorado sets aside 15% of vaccines it receives for “equity allocation.” Much of this goes to organizations such as Voces Unidas that host or, in some cases, run vaccination sites.

However, some organizations that run clinics say the state doesn’t provide enough additional support, which leaves them responsible for vaccinating underserved communities. Several are turning to outside sources of funding. And although the state has had an equity plan for vaccine rollout since the start of the year, lagging rates persist.

 As of April 12, over 2.1 million Coloradans have been vaccinated with at least one dose — nearly 39% of the population. Of that percent, Black Coloradans only account for 2.48% of the vaccinated population while making up 3.92% of the state’s population. The numbers are worse among Hispanic Coloradans. About 8.25% of those vaccinated are Hispanic despite that demographic making up 21.69% of the state’s population.

Why turn to community-based groups?

Voces Unidas is a Latino advocacy organization active in Garfield, Eagle and Pitkin counties. Organizations like it possess community connections that public health departments and hospitals can miss. When Latino Coloradans go to a Voces Unidas site, chances are the environment will feel familiar.

“We even serve them tamales and hot chocolate and all that kind of good stuff that we typically do, because we want them to feel at home with us,” Sánchez said.

Sánchez said he’s grateful that the governor acknowledged and is responding to vaccine inequities. But he added that groups like Voces Unidas aren’t service-based organizations and can lack the financial resources to cover the costs of hosting or running sites. 

“The state has never provided a single dollar to us in terms of support so that I can pay for the additional staff that I’ve had to hire,” Sánchez said. “Not a single cent that I’ve received from government to be able to pay for all the tents and all the vendors that I have to hire to be able to put forth all the infrastructure that we have to build at every single clinic.”

The Center for Health Progress, a health advocacy organization that serves Fort Morgan and Pueblo, has also run into challenges. While they don’t run sites themselves, they’ve had to figure out how to confirm around 120 appointments a day for a mobile vaccine clinic they host. 

Preparation includes recruiting volunteers, conducting outreach and providing onsite translators. Standing up clinics can even require advocacy groups to make arrangements for transportation and child care for individuals who need it, all for free. 

“2020 was really hard for us,” said Sarah McAfee, director of communications at the Center for Health Progress. “We all ran our wells dry, we’ve got nothing left and now we’re being asked to do [the state’s] job for [them].”

Representatives for the Colorado Department of Public Health and Environment say that the state is making every effort to assist those clinics.

“Once they are approved to host a clinic, we have a conversation with them and just try to understand what they need,” said Brandy Emily, deputy director of the immunization branch at the CDPHE. “Do they have volunteers that can do traffic control and brief people or do they need us to supply that? Do they have people in their organization that are vaccinators or do they need us to support that?”

Palacio, working out of the governor’s office, said vaccine equity is a process that doesn’t happen overnight. He added that the state is providing support as needed and different communities have different needs. 

“There’s no one size fits all for any of our equity clinics,” Palacio said. “To some clinics we offer more services and some less, depending on the needs of our partners in the community.”

How are community-based groups keeping things running? 

Sánchez said Voces Unidas is partnering with cities like Glenwood Springs while drawing on local volunteers. It also recently received $85,500 from Together We Protect — a nongovernmental partnership organized to create a COVID-19 Vaccine Equity Fund for Colorado.

The Caring for Colorado Foundation coordinated 14 foundations “to ensure access to the vaccine for Coloradans who face barriers to this critical health care service due to race and/or their socioeconomic status.” On April 8, it announced a total of $2.51 million is being distributed to 48 community-based groups.

Some organizations have sought help from the governor, hoping to get access to some of the $6 billion Colorado received in last month’s federal stimulus package.

“The good news is that we have all this stimulus money coming in, and so that would be a great way to apply that,” McAfee said. “If we really want to vaccinate everyone, we’re going to need a lot more resources.”

In the long term, Sánchez fears that Voces Unidas will be perceived as responsible for vaccinating Latinos in the region in the place of traditional health care systems. He says they are creating more access points, but the bulk of responsibility rests with public health departments.

“We’re showing the (health care) ecosystem that if you reduce barriers like language access, technology access and if you implement common sense,” Sánchez said, “best practices that work for Spanish-dominant bilingual communities, that you can vaccinate Latinos proportionate to the population.”