“What should I do? We still have to go to work”: Latino immigrant perceptions of the COVID-19 pandemic and vaccine
Authors: Revens Keri Elliott , Caro Lennin , Guerrero Ordonez Sarai , Walsh Amanda , Alvarez-Orlachia Daniel 
Published: October 2023

Purpose
The COVID-19 pandemic disproportionately impacted Latinos across the United States though data on emerging immigrant communities is lacking. The purpose of this study is to better understand how Latino immigrants were impacted by the COVID-19 pandemic, allowing a community health clinic in Charlotte, North Carolina to quickly respond to their needs.

Design/methodology/approach
A mixed method, rapid appraisal using community-based participatory research approaches conducted in February to April 2021 by a team of bilingual researchers. Project consisted of a Spanish, electronic survey distributed through community leaders and in-person interviews conducted in Spanish at COVID-19 vaccine clinics. SPSS Version 26 was used for quantitative analysis. Ordinal and binary logistic regression tests were performed to assess the associations among several outcome and four predictor variables: documentation status, status of health insurance, level of trust in the vaccine and place of birth. Qualitative analysis used rapid appraisal and grounded theory approaches.

Findings
Latino immigrants experienced job and income loss, resulting in difficulty paying for food, housing and health care. Participants experienced emotional and financial stress and isolation from family. Undocumented immigrants were more likely to experience detrimental impacts than documented immigrants. Most wanted the vaccine but felt barriers like trust and insurance may prevent them.

Research limitations/implications
Findings from this study are locally relevant to Latino immigrants living in the Charlotte area of North Carolina and findings may not be generalizable to other Latinos. Participants were recruited through faith networks and those who are not connected may not be represented. In addition, interview participants were sampled during vaccination clinics and likely had positive views of the vaccine.

Practical implications
As a direct result of this project, community health clinic (CHC) held vaccination clinics to instill more confidence in the vaccination process. Spanish-speaking staff were available to assist with paperwork and answer questions onsite. The importance of familismo in decision-making and the reported presence of misinformation about the vaccine prompted CHC to continue providing accurate information about the vaccine in Spanish, and to strategize marketing materials to reflect a family-centric approach to better appeal to Latinos. Findings were used to obtain funding for expansion of clinical and behavioral health services in the community through mobile units, increasing accessibility for Latino immigrants.

Originality/value
To the best of the authors’ knowledge, this was the first study to examine the effects of the pandemic on a growing and disproportionately underrepresented group in an emerging immigrant state. Findings informed culturally competent COVID-19 vaccine clinics, marketing strategies and the expansion of medical and behavioral health services for a local community clinic.