April 23, 2021 – The Virginia Department of Health’s website in January reassured English-speaking readers that the COVID-19 vaccine “will not be required” for Virginians.
However, the Spanish language translation via a Google Translate widget at the top of the page said something else as well: the vaccine “no sera necesario” or “will not be required”.
Sharp-eyed students at George Mason University noticed the mangled translation and brought it to the attention of their professor, who alerted the state health department. The wording was corrected quickly and the website now has a professional translation of its COVID-19 information materials. The incident was first reported by The Virginian Pilot newspaper.
While the mistake was a temporary embarrassment for Virginia’s vaccination campaign, the mistranslated symbolizes a much bigger problem with the country’s inauguration: vaccination in the US has several hurdles for people who are not fluent in English.
Lack of linguistic access to vaccine information wasn’t necessarily the result of poor pandemic planning. In part, it was intentional. In 2020, the Trump administration removed voice access protection, which was incorporated into the Affordable Care Act (ACA).
Since the passage of the Civil Rights Act in the 1960s, federal laws have protected people from discrimination based on their country of origin. Decades later, the ACA adopted these safeguards and in certain ways applied them to health care.
The law states that any health organization that receives federal funding must include a slogan on key documents in the top 15 languages of the state they have worked in, to let people know that they have a right to an interpreter and free Have support in their own language.
“That was stripped in August 2020, and we launched a massive vaccination campaign in December 2020,” said Denny Chan, attorney and justice advocate with the California nonprofit Justice for Aging. “Some of it shot us in the foot.”
Hispanics have the highest rate of new COVID-19 cases in the United States, and many are left behind by the introduction of the vaccine.
White people make up about 61% of the population, but make up 68% of those who are fully vaccinated. Only 9% of those fully vaccinated are Hispanic, although they make up nearly 17% of the total US population, according to the CDC.
About a third of all people who identify themselves as Hispanic in the United States have limited English language skills, according to the Pew Research Center.
US census data shows that 25 million people of all races and ethnic groups, or 1 in 13 in the United States, are unable to communicate well in English.
Justice in Aging and the nonprofit Center for Medicare Advocacy sued the Department of Health and Human Services in February to restore security to language access.
According to Chan, healthcare providers are still free to provide voice assistance to patients who need them. You are not prevented from doing so.
However, the law laid down a number of requirements that were not met when officials built the infrastructure and logistics for the massive rollout of Operation Warp Speed vaccines.
“Unless you have to equally ensure that people know their rights to interpreting services or have documents translated,” it is not a priority, Chan said. “At several points in the process, we saw the voice access piece fall apart.”
State websites had different translation aids
A WebMD / Medscape review of vaccine finder websites available through health departments in all 50 states found the majority offered language translation. However, there were three states that did not have language assistance for their vaccinators at the time of the review: Alabama, New Jersey, and South Dakota. New Jersey has a tab for translating the website into Spanish, but it was not working in several different web browsers at the time of this reporting.
In Arizona, you can make vaccination appointments by registering through a Spanish-speaking patient portal after providing the state with personal information such as an email address and phone number. However, on the more accessible site of the Ministry of Health’s vaccine finder, a map is displayed of vaccination sites by the state, not translated into Spanish.
In Arizona, roughly one in three people is of Spanish descent. The state’s vaccination data shows that 48% of people who received at least one dose are white, while 12% are Hispanic ancestry.
Georgia didn’t have a language translation on its vaccine finder website until a coalition of supporters of the Latino community wrote a letter to the governor complaining. Now the site translates, but only into Spanish, with no people speaking other languages.
Even VaccineFinder.org, the national website referred to by the CDC, is not translated into other languages.
There is a Spanish language version of VaccineFinder.org hosted by the media company Univision. But it is nowhere mentioned on the English VaccineFinder site, and even the Spanish translation of the CDC’s vaccine information page references the English VaccineFinder site.
The Kansas Department of Health is redirecting staff to both the VaccineFinder.org website in English and the Univision website in Spanish.
Translation software has problems
Many other county and state health department websites rely on Google Translate to make their information available to people with limited English language skills.
Google Translate can be helpful, but only if someone has a high reading level. It can also be very literal – sometimes, for example, it cannot distinguish the verb book from the noun book, which can confuse the meaning of a sentence.
The other problem with relying on Google Translate is a technical one. The software can be problematic for vaccine seekers as it only recognizes and translates text. It doesn’t translate the maps or charts many states have created to guide people to vaccination sites.
“It’s about making vaccination as easy and accessible to people as possible, isn’t it?” said Barbara Baquero, PhD, an associate professor of health services at the University of Washington in Seattle and vice president of the American Public Health Association’s Latino Caucus.
“I think it’s negligent to ask Google Translate to do all of the work for the state on the site,” she said.
Kathy Zeisel, an attorney for the Children’s Rights Center in Washington, DC, agrees.
Washington passed a law in 2004 requiring access to languages for the most widely spoken languages in the district – Spanish, Chinese, Vietnamese, Korean, French, and Amharic. On April 8, the DC Language Access Coaltion sent a letter to Mayor Muriel Bowser saying that a Google Translate button made the district’s vaccine website inaccessible enough for people who do not speak English well.
The district has since agreed to provide professional translation of information on the website.
While language is only one facet of the problems that lead to vaccination differences, it is fundamental, Baquero said.
“Language is at the center of this right?” She said. “We see a lot of difficulties that started with voice access.”
Websites with incomplete information
Fernando Soto, a journalist who founded the Nuestro Estado (“Our State”) website to bring Spanish-language news to South Carolinians, has seen these difficulties firsthand.
“Latinos wanted to get the vaccine,” said Soto. “It has become a problem how to get the vaccine.”
Soto heard from so many of his readers that they were having trouble signing up for vaccines that he started posting his phone number on social media to help people sign up.
He says he helped more than 60 people book appointments and saw the difficulties they encountered at every step of the process.
“All of the registry that is available now is in English, or if there is a Spanish version, there is a language that excludes a large segment of the population,” he said.
Some of the most common problems he’s seen are websites that don’t state that the vaccine is free or that require a Social Security number to register when vaccination doesn’t require it.
South Carolina’s Department of Health and Environmental Control (DHEC) has a vaccine-finding website that can be translated into Spanish. However, sometimes it contains links to websites that are only available in English, such as: B. the main vaccine web site for Prisma Health health system in the state.
Soto recently signed up dozens of people for a DHEC-operated weekend pop-up clinic and then showed up to help with another hurdle: vaccination centers often have little to no language translation for people when they get there.
The informed consent forms and vaccination cards have Spanish translations but there was no one to walk people through the process or explain that they had to wait 15 minutes after their shots so they could be monitored for side effects.
People who identify themselves as Hispanic make up nearly 6% of the population of South Carolina but have received less than 2% of state vaccinations, Soto said.
Laura Camarata, an investigator at the Children’s Law Center in Washington, DC, has helped people who do not speak English well sign up for the vaccine. She heard a lot of the same things. Even if they can register for an appointment, it is really difficult to get information there.
“Is the vaccine going to interact with this condition or drug in any way? Really questions that unfortunately these people were unable to ask in the clinic because of the language,” she said.
At least one clinic – Bread for the City – has decided to disable the vaccination registration system in Washington, DC to better care for its own patients. When Bread for the City was listed as a vaccination site in the district’s vaccine finder, white, wealthier individuals were the ones booking appointments. Therefore, the clinic administrators have logged out of the system and proactively called their patients and offered them their first dibs. They said it worked a lot better.
In addition to language problems, people who are not fluent in English are still wary of the rules put in place during the Trump administration. Under the rules on public fees, immigration authorities have rated this negatively when considering citizenship applications once someone has accepted federal benefits.
The public prosecution rules were abandoned by President Joe Biden on March 9, more than three months after the vaccine was introduced. But people still fear that a vaccine – a federal benefit – will speak against them in the eyes of immigration authorities.
“People say black and brown people are hesitant, you know. The reality is that it is a minority of our community that is hesitant and then a significant portion of the people who are concerned, not necessarily about the COVID-19 vaccine . [but] about the system around it, “said Gilda Pedraza, executive director of the Latino Community Fund in Atlanta.
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