As the coronavirus pandemic continues to surge across the United States, a vaccine has been touted as a return to normal life, but many advocates are concerned that undocumented immigrants are being left out of the conversation.
Many industries are reliant on undocumented labor, and the limited access to a vaccine could cause complication in those fields. There is particular concern among advocates and experts about restaurant work, farm work and work in meat processing and packaging plants.
In farm work and meatpacking, it's estimated that at least 50% of the workforce is undocumented. Nationwide, undocumented workers make up 10% of all restaurant employees in the country, but in major cities, that number reaches up to 40%. The Centers for Disease Control and Prevention (CDC) announced in November that they had found workers of color in the farm work and meatpacking industries had been "disproportionally affected" by COVID-19.
Early in the pandemic, worker illnesses and outbreaks at some facilities led to closures and some shifts in the food supply chain. At one food plant in Iowa, more than 700 workers tested positive; at a second in Indiana, more than 900 workers contracted the virus. A federal wrongful death lawsuit filed in November alleges that executives at a Tyson Food Plant organized a group bet about how many workers would contract the virus and neglected safety protocols.
"Workers were encouraged to come in regardless of what was happening on the pandemic front," Julia Gelatt, a senior policy analyst at the Migration Policy Institute, told TODAY Food. "These are low-paid jobs and they don't usually come with a lot of benefits, so workers don't have a lot of, or maybe any, paid leave to take time off if they think they're getting sick."
Teresa Romero, president of United Farm Workers, pointed out that undocumented workers have not been receiving stimulus checks or other aid, so their financial stability is dictated by their ability to work.
Gelatt said farmworkers may be less at risk on the job because the majority of their work is outdoors, but living conditions, typically provided by farm owners, create an environment for COVID-19 to spread.
"Food industry work does leave workers more vulnerable to the virus," said Gelatt. "Meatpacking workers are shoulder to shoulder on an assembly line, and field workers are living in housing provided by growers, with people sleeping in the same room, and we know that close contact is the main way that COVID-19 spreads."
A vaccine rollout that doesn't reach communities in need
As the vaccine is distributed across the country, the process has been criticized for being slow, disjointed and difficult to navigate. In mid-December, the CDC Advisory Committee on Immunization Practices (ACIP) recommended that those working in food production be included in the phase 1b vaccination stage, but appointments to get those vaccines have been few and far between.
Even accessing online information may be complicated by lack of computers, internet access or digital literacy.
"The process is opaque for all of us, and it's that much harder for immigrants," said Randy Capps, Director of Research for U.S. Programs at the Migration Policy Institute.
Complicating matters further is the remote nature of some food industry work, such as on farms, and the difficulty in finding a vaccination site. Dr. Ranit Mishori, the senior medical advisor at Physicians for Human Rights added that the process is even worse for undocumented immigrants, who may have language barriers or be unable to wait on line for hours.
"They don't have health insurance. They're not able to take time off, even when they're sick, let alone for when they're not sick and can work, to get vaccinated," Mishori said.
Romero and Gelatt suggested that targeted messaging towards undocumented communities would be ideal, but many states and counties are not putting out that messaging, leaving advocacy groups to fill the gaps.
Some doctors, like Dr. Walt Newman, a family physician in California, are putting plans into place to go to local farms and vaccinate workers there. In previous years, he and the "Stanford Flu Crew" have distributed over 50,000 flu shots, but so far, they haven't heard any information about when they might get doses of the COVID-19 vaccine.
"We have the dry ice. We have the coolers. We're ready to go," Newman told TODAY. "I tell everybody, you give us a vaccine tonight and we could deliver it tomorrow. We've done it so many thousands of times. … We literally have hundreds of medical students from Stanford University eager to give the vaccines at the worksite. We're raising our hands. Here we are, just waiting for the state and county to give us vaccine."
Fears of tracking and deportation
Experts and advocates said that a major concern was trying to work with communities who may not place much trust in the state governments handling the vaccine rollout, suggesting that many undocumented immigrants might be skeptical about returning to the same site at least twice to get their full dose of the vaccine; both the Moderna and Pfizer-BioNTech candidates require two injections several weeks apart.
"You're not expected to give information such as your legal status or your exact address, but you are expected to give enough information so people can follow up with you, so you can come and get a second vaccine," Mishori said. " … There's a lot of mistrust in that community because of everything that's been going on for many years, but particularly the last four years, with the anti-immigrant rhetoric and ICE (Immigration and Customers Enforcement) deportations."
"There have been situations where people went to pick up their kids at school and were confronted with an ICE raid," Mishori continued. "How can we convince these populations that that's not going to happen when they're invited to a mass vaccination site?"
Capps said that some of these issues had already surfaced earlier in the pandemic with testing and contact tracing efforts.
"Giving your full name, address, date of birth, and all that sort of information was necessary for testing and tracing was difficult, because if you're an unauthorized immigrant and you mostly know other unauthorized immigrants or you know several of them … then you're in the position of outing other people," Capps said. "You've got the issue of family members, too … They don't want to reveal the presence of other unauthorized household members."
Public messaging from politicians has complicated the issue: On Jan. 4, Nebraska governor Pete Ricketts said that he did "not expect that illegal immigrants" working in the state's meatpacking plants would be eligible for the vaccine, stating that meatpacking workers are "supposed to be legal resident(s) of the country."
It's estimated that 66% of meatpacking workers in the state are immigrants, and according to the Migration Policy Institute, undocumented immigrants make up the majority of the workforce at some facilities in the state. Nebraska has more employees in the meatpacking industry than any other state.
"If people get the message that unauthorized immigrants are not supposed to get the vaccine, that may create a lot of fear and a lot of deterrents for getting the vaccine," said Gelatt.
The statement was revised after widespread backlash; the governor's communications director wrote on Twitter that the state would "prioritize citizens and legal residents ahead of illegal immigrants," leading to concern from advocates.
Other states have been more welcoming: New York State governor Andrew Cuomo said in December that he had worked with dozens of organizations to reach an agreement with the federal government where no "identifiable information from undocumented individuals" will be collected "as part of the federal vaccination distribution program." States are allowed to set their own rules for COVID-19 vaccination priorities.
How could the food supply chain be affected?
When meatpacking plants closed earlier in the pandemic, it led to an increase in meat prices and some shortages. While many facilities have recovered since then, continued circulation of the virus among workers could cause future problems, especially if undocumented workers do not feel comfortable seeking out the vaccine.
Gelatt said that it would be difficult to estimate just how much impact the lack of a vaccine would pose workers in the food industries, but said that consumers and business owners alike should recognize the benefit of vaccinating workers who are already at higher risk for illness.
"Imagine what would happen if this population of essential workers is not able to do that work, to harvest and prepare our food," said Romero. "It is important, not only from the humane point of view, but from the point of view of, 'What would happen to agriculture and the meat industry' if they're denied vaccination?'"
Mishori said that having swaths of the population not being vaccinated due to legal status would only continue the pandemic.
"Nobody will be safe until everybody's vaccinated, and by everybody, I don't mean just citizens or just people with a green card, it means everybody who is currently in the United States, regardless of their legal status," Mishori said. "If there are pockets where people are not immunized, that is a public health hazard to everyone. Given that these individuals are some of our most important workers, we need them to be healthy and vaccinated."
Until more vaccines are available, workers will continue to harvest and package food for the rest of the country, relying on masks and whatever social distancing is possible to keep them safe from the virus.
"The people who put food on our tables are considered essential workers," Romero said. "They need to be taken into account and be at the top of the list of the workers that get the vaccine."