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“None of their children had a well-child visit. None had a pediatrician. Some questioned, how were we supposed to know?”

On Friday, Aug 4, we brought the Denver Health VFC Mobile Vaccination clinic to Denver’s Barnum Elementary School. This was our first collaboration with the Denver Health at a pop-up vaccination site. The Denver Health Team was a delight to work with and connected well with Barnum’s principal, Ms. Gelmarie Ortiz-Nieves and her staff. The Barnum school liaison, Ms. Daisy Alvarez,  had done some work preparing for the clinic , encouraging families to come, so that was great! Denver Health brought candy, toys, swag for the kids to help them celebrate vaccination in an authentic community engagement way. Working with Colorado Access, I always emphasize to the vax/school teams how important authentic community engagement is in preparing for and operating vaccination clinics. We vaccinated children in 20+ families to be compliant with school requirements, with many children getting 3 or 4 vaccines at a time.

We did miss an opportunity to provide families with Covid-19 vaccinations for some reason. We also missed the golden opportunity to vaccinate the parents. If the kids are non-compliant, it’s a good bet their parents are behind on their vaccinations too. So let’s not miss this opportunity.  All school vax clinics should include parents. We’ll debrief this clinic this week and see how we can do this in the future.

Last June, pediatrician Dr. Josh Williams and I participated in a Denver Health Pediatric Grand Rounds, attended by over 160 other pediatricians. We discussed  strategies of authentic engagement especially in the community itself where people live:  how critical it is to build trust and acceptance for a health system that has too often mistreated Latinos. I asked the pediatricians, please from time to time, get out of your brick and mortar clinics and come into the barrio and get to know the community where they live. The engagement there will be more authentic than in the clinic. I emphasized that unless health providers, more doctors, pharmacists, public health providers do this, headway in health equity will continue to suffer. 

Well guess who came to the Barnum Elementary community last week? Pediatricians Dr. Josh Williams and Dr. Margaret Tomcho! I was delighted to see them, the first “Doctors into the Community.” And indeed the community loved them.  I felt a big chip of the iceberg of suspicion/mistrust that has separated doctors from this Latino community was chipped away that day.  

There was a lesson for the doctors that surprised them, too. I interviewed all the families who had kids at Barnum. None of their children had a well-child visit in the past year and none had a pediatrician. Some questioned, how were we supposed to know to take our kids to well-child visits? Welcome to the hood, Josh and Margaret!

At Barnum both doctors witnessed the melting of mistrust when meeting with the Latino community where they live. See pics below.

We’re working to bring more “Doctors into the Community.” Dr. Williams felt compelled to go beyond the clinic walls to form meaningful relationships in the community and reach those who can’t come in routinely or don’t at all. Dr. Tomcho also appreciated forming authentic relationships outside of the traditional clinical setting to partner with the community on their terms. We wish more doctors would also feel inspired to follow the lead of Dr. Williams and Dr. Tomcho. Because the statistics call for understanding barriers:

  • Barely 50% of Colorado Latinos have received a dose of Covid-19 vaccine compared to almost 80% of non-Latino whites.
  • Covid-19 has been the top cause of death among Colorado Latinos.
  • Latino children have lower flu vaccination rates than non-Latino children.
  • 32% of Colorado Latinos are uninsured making navigating the traditional health system in traditional settings more difficult.

Our Denver schools where Latinos are:  

  • What’s the major demographic? In Denver 25% of students are non-Latino white. They go to schools that are largely white. The remaining schools, like Barnum, have student bodies that are predominantly of color, Latinos 72% , Blacks 14%. Many of them non-compliant for vaccination. And most likely their parents are behind too.
  • Less than 38% of Colorado school children 5-11 have received at least 1 dose of Covid-19 vaccine.
  • Only 46% of Colorado students attended a school with adequate protection from vaccine-preventable disease. Uptake for all school-required vaccines has declined statewide.
  • Only 87% of Kindergarten and 92% of K-12 Colorado kids are in compliance with school immunization rules in 2021-2022, a decrease of 5.2% and 2.2% respectively from 2020-2021.
  • Colorado Kindergarteners are 44th out of 50 in the nation for MMR vaccination.

These stats cry out for Colorado health providers to engage the Latino community where they live to get at the root barriers of this sad condition in Colorado.

Also, 

  • On August 7 we’ll be at Fulton Academy of Excellence with CAHEP and CDPHE volunteer nurses for our second “One School One Vaccine at a Time” visit. We’ll be administering Covid-19 as well as adult and children vaccinations that will get more Fulton Academy children to be compliant with state requirements, and get as many of their parents vaccinated as we can too! (The golden opportunity I talked about above.)
  • As noted in the last report, I spoke at the Aug 2 segment of the  2023 Anschutz Alumni Virtual Summer Series. My topic was ” Latino Health Care: Why Should I Care About Cultural Validation?”   That no family that we interviewed at the Barnum School vax clinic had a pediatrician or had taken their kids to a well-child visit underscores why we should care, better than me just talking about it!  A few of the comments after I spoke:
  • “…I am also Undocumented, and I related to your story as you shared some of the experiences that we face as immigrants. I appreciate your sense of warmth, understanding and respect towards our community- especially the urgency of being an advocate for us. I look forward to bringing you to our campus to inspire and motivate students with similar identities to continue in their health-related careers.”
  • The Program Director Continuing Nursing Education commented: “Julissa provided a thoughtful, engaging presentation which captured and held the audience’s attention.  Clearly, she is passionate about her work and this subject.  She is able to convey her enthusiasm to the audience while providing concrete suggestions for delivering culturally sensitive, effective healthcare.”
  • “…I appreciate that you recognize your own limitations in engaging with other communities. It really highlights the difficulty of this work! Thank you for sharing that experience…I’m shy, and I’m atheist so “getting out in the community” or going to church freaks me out but I’m interested in getting involved.” 

As a STRIDE board member, I’m working to bring STRIDE mobile clinics to Douglas County Schools to support its “Conecciones” program. That’s Douglas County School District/Douglas County Health Department connecting with Spanish speaking families starting with childhood vaccines. I love STRIDE’s Executive Director focus, “… breaking down barriers to community partnerships, as healthcare can no longer exist in a silo. Success will only come from partnerships, i.e., school districts, counties, faith-based institutions, etc.” Just as we did last week with Denver Health at Barnum Elementary!

To help more Latino families be more aware of the gifts of vaccination, we’re getting the word out through media that Latinos listen to/watch, Spanish language radio and TV. Like:

  • Tigre Radio every first Monday of the month. On Aug 7 I’ll interview Dr. Jose Martinez-Gamba of  Diversus Health Colorado Springs (mental health and well-being for all) and explore how they work with Latino families. Dr. Gamba is a child psychiatrist and a native of Paraguay. 
  • Through Julissa Soto Consulting working with Vaccinate Your Family on a Spanish-language Commercial that will air onTelemundo ColoradoKBNOLa Invasora Radioto raise awareness for the importance of COVID vaccination for kids under 5, as well as a reminder of the importance of all routine vaccines for kids. The theme is “El Contagio puede ser grave si no vacunas a tus hijos contra el COVID-19  (Contagion can be serious if you do not vaccinate your children against COVID-19). You can also listen to the attached Spanish language radio commercial.