The U.S. has endured the loss of approximately 1 million people due to the COVID- 19 pandemic. Since late 2020, safe and effective vaccines to reduce the severity of COVID-19 and prevent other negative outcomes, such as health complications, have been widely available. As new variants of COVID develop and since the protection offered by the initial vaccine wanes over time, the Center for Disease Control and Prevention (CDC) recommends that vaccinated individuals receive timely booster doses.

Under 67% of the population in Pennsylvania has been fully vaccinated (Pennsylvania Department of Health, May 2023) and fewer than 17% of these vaccinated residents have received the recommended updated booster dose that was approved in September 2022. Some subpopulations, like immigrant and refugee communities residing in the U.S., represent a large percentage of individuals who continue to have incomplete or no vaccination. The subsequent impact in this vaccine disparity has led to increased mortality and negative health outcomes.

So, why does this discrepancy of complete vaccination still exist among immigrant/refugee populations in the U.S.? Since the beginning of the pandemic, immigrants/refugee communities across the U.S. have been particularly vulnerable to contracting and spreading the virus for various reasons including: designation as “essential workers,” limited healthcare access, working and living in densely populated environments, and language barriers. Unsurprisingly, the vaccine disparity among the population has overlapping factors with the existing vulnerabilities to the virus. For example, individuals in the larger immigrant and/or refugee community continue to face language barriers that increase the likelihood of uncertainty, confusion, and misunderstanding around vaccine information. As a result, misinformation about the virus and vaccines can persist and continue to circulate without proper clarification. For some individuals who are undocumented, fears related to vaccination may perceived as a threat to their immigration status. Many individuals in the community may not know that the COVID vaccination is free and healthcare coverage is not required to obtain vaccination.

As social workers who work directly with the subpopulation of immigrants and refugees that may be “vaccine hesitant,” we have an ethical responsibility to educate and empower individuals to make informed decisions about their health. There are several ways in which social workers can support them, including: providing accurate data in a comprehensible language and format, validating and addressing vaccine hesitancy, connecting individuals to vaccine resources, addressing logistical barriers to vaccine sites, advocating for equitable access, and offering a space for emotional support.

The National Association of Social Workers (NASW), together with the University of Texas/Austin, have been partnering since 2021 on a comprehensive initiative to promote COVID-19 vaccine confidence. Connect to End COVID-19 (link) equips social workers with valuable tools and information to engage with vulnerable and at-risk subgroups, including immigrant/refugee communities, in increasing vaccine confidence. The initiative includes national webinars and NASW chapter-hosted virtual trainings (with up to 5 CEUs), as well as informational resources. A key focus is training social workers in how to deploy Motivational Interviewing and other modalities in helping clients process their vaccine decision. Our conversations regarding COVID-19 vaccination are not intended to coerce individuals into getting vaccinated. Instead, we should aim to meet clients wherever they are in their vaccination journey, and provide the individuals we work with the necessary resources to make informed decisions about their health and well-being. By doing so, we hope to create a positive ripple effect throughout the larger community.