Challenges and Recommendations for COVID-19 Vaccine Roll Out in Asian American Communities in Virginia

NAKASEC (National Korean American Service & Education Consortium) Virginia prepared this brief memo about how Asian American communities are understanding COVID-19 vaccine rollout and recommendations on messages they will likely need to hear and tactics to ensure maximum vaccine uptake.

NAKASEC Virginia fully embraces and actively supports strategy to specifically focus on Latinx and Black communities because overall statewide, these two communities have been disproportionately impacted. Ultimately, Asian Americans communities would also benefit from these strategies because we face the same risk factors. Nearly half (42%) of Asian American community members directly know someone who contracted COVID-19. Many Asian Americans work in specific industries that generally have lower pay – such as retail, restaurants, and service – and are less likely to be able to work from home. Our communities live in multigenerational homes and, depending on socioeconomic status, also live in places that are more densely populated. Lastly, certain Asian American ethnic groups have been found in other states to be disproportionately impacted and it would be reasonable to assume that those trends would also hold in Virginia. For example, in California, Filipino Americans represent 35% of COVID-19 deaths among Asians in California even though Filipinos are 25% of the state’s Asian population.

Our intent with this memo is not to suggest that Asian American communities are homogenous; rather it is our best attempt to uplift Asian American experiences to inform the statewide campaign to stop the spread of COVID.

Overall, Asian Americans in Virginia are very willing and ready to receive COVID-19 vaccination as a step towards protecting others and decreasing risk of mortality in their immediate and greater communities. Additionally, Asian Americans typically trust the validity of information from health authorities, such as providers and public health organizations, regarding health information. However, community members are more likely to trust and engage with the information they can access – in a language they can understand in complexity – regardless of the source or accuracy of the information because it is information they can understand. Community members even directly reported an increased likelihood of getting vaccinated if information was available in one’s language. Similarly, Asian Americans are more likely to engage with and trust family members, particularly: siblings, spouses, and adult children.

However, challenges exist that create apprehension or direct barriers to receiving the vaccine.

• The primary concerns are fear of side effects and overall safety of the vaccine.
  • Mainly, the perceived level of risk is unknown because the vaccinations are so new and there is no evidence yet to predict all possible long-term side effects.
• This high uncertainty makes it difficult for community members to confidently make (what feels like) an informed choice, especially individuals with high-risk health conditions and those who are older.
• Yet, Asian Americans are also concerned that if they opt-out at their first phase of eligibility (to wait and see what happens with side effects), they may not have another opportunity to receive the vaccine.

There is also general confusion related to the logistical process of vaccination:

• Language access: NAKASEC VA was informed by health departments across the state that Virginia would have an online process for vaccine sign-up, and that this process would be in English only. Although each locality is handling vaccination appointments differently, options statewide for non-English or limited-English speakers are either heavily limi ted or not available at all.
• Priority groups: Similarly, many community members are confused about the eligibility criteria, especially those with confounding eligibility (example: someone who is young but has a BMI of 33), and are not sure when they can expect to receive the vaccine or if they will have multiple opportunities to receive the vaccine in later phases.
• Cost: There is also confusion around cost, and many community members are unaware that vaccination is free – regardless of provider or coverage level (even uninsured people can get the vaccine for free).
• Immigration status: Asian Americans are unclear if their immigration status will affect their eligibility to be vaccinated, and how receiving vaccination could impact their future plans to pursue citizenship. Some community members have assumed they are automatically ineligible to receive vaccination because they are not citizens and do not plan to pursue vaccination at all, while others are waiting until “all citizens have been vaccinated first.” In short, Asian American immigrants are unaware that their immigration status does NOT affect their eligibility.

Recommendations:

• Develop multilingual short videos (including but not limited to subtitles in Korean, Vietnamese, Cantonese, Farsi, Hindi) that explicitly address the concern of side effects and safety of the vaccine to be released as soon as possible and can be easily shared over social media and other platforms, like Facebook, WhatsApp, and Kakao. Perhaps a video of an Asian American being vaccinated who is explaining what is happening, what precautions are being taken because the vaccine is new, and the potential side effects.
• Include Asian American models (beyond health professionals) in visual communications related to vaccine roll-out (not only limited to materials for Asian Americans).
• Partner with Asian ethnic media outlets in earned and paid media campaigns. Organize an Asian ethnic media specific press conference or briefing about vaccine roll-out, starting in Phase 2 and especially for Phase 3 to maximize uptake among critical populations.
• When partnering with Asian American organizations (including faith, business, and community), share multilingual resources that have been professionally translated (in other words, no Google translate).

Methodology: In December 2020, NAKASEC Virginia designed and circulated an anonymous survey focused on understanding Asian American communities’ knowledge of and attitudes towards COVID-19 vaccinations with the goal of providing critical information and recommendations for vaccination roll-out (particularly in the general population, and not priority groups). Information for this memo additionally comes from direct conversations with dozens of Asian Americans who have called our office to obtain more information about how to access the COVID-19 vaccine.