ÓRALE COVID-19! Vaccination: An Initiative to Increase COVID-19 Vaccination in Yolo, Madera, Fresno, Stanislaus Counties in California

Latinos have disproportionately suffered from COVID-19. In California, Latinos make up 39% of the population but 46% of deaths and more than half of all cases. Agricultural employees are essential workers and the risk of SARS-CoV-2 transmission is high because social distancing and masking are difficult especially in very hot weather. In addition, the risk of SARS-CoV-2 transmission within households is high as one-third of agricultural employees live in crowded and multi-family housing (>1 persons/room). In these households, self-isolation or quarantine is simply not feasible when a family member has been exposed. Non-pharmaceutical interventions such as testing, social distancing, quarantine, and isolation have played a critical role in mitigating the impact of COVID-19. However, despite being at increased risk of infection, testing rates among Latinos is lower compared to Whites and Latinos are more likely to be positive when tested and to require higher level of care at the time of positive test. In the US, nearly 13% of Hispanic or Latino have received at least one dose, and 10% have been fully vaccinated, despite eligibility open to all on April 19th, 2021. There is a major gap in COVID-19 vaccination among underserved and/or vulnerable Latino population. This study proposed a three-tiered approach to address barriers to COVID-19 vaccination in predominantly Latino counties in California, Yolo, Fresno, Madera, and Stanislaus. ÓRALE COVID-19! was proposed to overcome motivational and logistic barriers to testing by decreasing the time from symptoms, to seeking testing, to securing testing, to receiving test results, to consult about self-isolation, quarantine, and increase the proportion who successfully self-isolated and quarantine. The aims of this study were: (1) reduce vaccine hesitancy, improve vaccine update while continuing to promote testing with culturally and linguistically appropriate targeted communication and incentives guided by trusted community partners, (2) Develop a literacy-supported decision making process to reduce vaccine hesitancy, improve vaccine update while continuing to promote testing, and (3) evaluate the impact of interventions on vaccine hesitancy, uptake of vaccine and testing through robust statistical and mathematical models that provide a flexible framework to evaluate different scenarios of vaccine rollout. The study leveraged strong community partnerships, expertise of collaborators with local CEAL member to incorporate CEAL-developed resources that strengthened the implementation of the interventions, strong team organization, survey development expertise, translation of materials that were critical for communication and dissemination, robust data capturing, harmonization, statistical, and modeling support, evaluation unit, and testing data that was integrated to vaccination efforts to allow for a comprehensive characterization and evaluation of interventions on vaccine hesitancy and uptake. Vaccine prioritization and access to regular testing to Latino farmer worker communities that experience structural barriers such as overcrowded housing and have strong cultural values on support of large extended facilities is critical to reduce the burden associated with COVID-19.