“I ran in there; I was so excited,” Castro said of receiving the vaccine at a clinic offered by UCHealth and Sunrise Community Health. “If you know me, you know how much I hate shots, but I’m proud to say I got it.”

As a social worker at Sunrise, a network of health care clinics in northern Colorado, Castro spends hours listening to people. He knows many Hispanic people are skeptics who have fear based on misinformation.  For Castro, who nearly died from COVID-19, the safe and effective vaccines seem heaven-sent.

“Every day I’m reminded what I went through,” Castro said. “COVID-19 not only messed with me physically — months of follow-up with my providers and damage on my lungs — but it messed with me mentally, and I was diagnosed with PTSD after my release.”

Educating the Hispanic community on safety and need for COVID-19 vaccines

Castro, 35, has a girlfriend and two kids. He strives daily to help his community understand how to be safe during the pandemic, navigate health guidelines after contracting COVID-19 and filter misinformation about the COVID-19 vaccines. He’s heard outlandish concerns, including talk that vaccines make women sterile or even alter a person’s genetic makeup. Both are false.

Nearly a year has passed since Castro contracted COVID-19. Even now, he measures his progress in “grains of sand.’’ He is still afraid to be around people who are not wearing masks and he fears large groups of people. After his release from UCHealth Medical Center of the Rockies, Castro’s father and mother, both in their 60s, contracted COVID-19.

His father, who has diabetes and has struggled with ailments brought on by the chronic disease, spent two weeks in a coma, during which time he suffered a stroke.

“He was even worse than I was — I was prepared to say good-bye,” Castro said. “Once he woke up, it took another two weeks before he was able to somewhat have a conversation. We were told because of COVID-19, the coma and his stroke, they didn’t know if he was ever going to be his normal self.”

While his father fought for his life in the hospital, his mother quarantined at home.

“As sick as she was, she won’t admit how hard it hit her,” Castro said. “She’d say she didn’t have time for this, she had to keep pushing the family forward.”

Castro did not go near his parents after his release from the hospital. He made sure he stayed away from them in order to keep them safe. His father stays home because of his diabetes, but his mother works at the local JBS meat processing plant in Greeley.

Starting in April, JBS had one of Colorado’s largest and deadliest workplace COVID-19 outbreaks with 291 workers sickened and six deaths. The situation highlights why Hispanic and lower-income families have been struck so hard by the pandemic.

Latinos and lower-income families hit hard by pandemic

“They can’t afford to take time off,” Castro said of his clients at Sunrise, where at least 50% of clients are Hispanic. Most live below the federal poverty level – $26,200 annual income for a family of four. More than half speak Spanish as their first language; a large refugee population in Weld County speaks East African languages.

“They are barely able to afford appointments and medications, and now we tell them they need to take two weeks off (if asked to quarantine.) They don’t have vacations or time off,” Castro said.

Dr. Mark Wallace, chief clinical officer of Sunrise, said Hispanics and Weld County has been hit hard by the pandemic.

According to the Centers for Disease Control and Prevention, Hispanic or Latinx persons represent 1.7 times the COVID-19 cases of White, non-Hispanic persons. Hispanics are 4.1 times more likely to be hospitalized from COVID-19 and 2.8 times more likely to die from the virus, according to the CDC.

Weld County has been one of the hardest-hit counties in Colorado by the pandemic. Nearly 8% of the county’s 324,492 population has had COVID-19 and 189 people have died.

Like Castro’s mother, many Weld County residents work at jobs considered essential and therefore have a greater risk of exposure. Hispanic families often live in multigenerational homes. Wallace said there is a communication gap and mistrust between government agencies and residents.

Understanding cultural differences and communication barriers during a pandemic

Reaching this population is difficult under normal circumstances, but the virus has brought new challenges.

“On a fundamental level, the words we started to use: isolation and quarantine, those are hard for those who speak English to even understand the difference and definitions. It’s part of the language of health and public health but we have to make it culturally relevant,” Wallace said.

In addition, Eastern African and Asian families have a custom of eating communal meals, which are placed in the center of a table, for everyone to enjoy. Wallace’s staff worked hard to explain that quarantine didn’t just mean sleeping in separate rooms, but also not eating communal meals together.

“They have some customs that we have to be certain that we use words and translations so that their actions will match what we are trying to get across,” Wallace said. “We did a lot of work quickly at the beginning of this pandemic to make our information culturally understandable.”

His clinic also had to recognize the role poverty plays in communication.

“If a family needs to isolate, but that family also lives in a home with 900 square feet with nine people, it’s a very different definition. We have to talk about everyone wearing a mask, how to safely share communal bathrooms. We did a lot of work on not giving recommendations that they couldn’t do, and then getting upset that the virus spread throughout their family,” Wallace said.

Access to COVID-19 testing and vaccines for all

Making testing and vaccination clinics accessible is also a big consideration.

“We found if we were not in the neighborhoods where families lived, then it was hard for them to get to these sites,” Wallace said. “That’s where we must work across different community agencies.”

Sunrise recently teamed up with UCHealth to host a three-day COVID-19 vaccine clinic where 1,000 of Sunrise’s 70 and older clients received their first vaccinations.

Among them was 83-year-old Adela Garcia. She has more than 30 grandchildren and said she was excited to get the vaccine in order to keep herself healthy. She also has relatives who have suffered from COVID-19.

“I’m very happy but a little nervous,” Garcia said while waiting for her vaccination. She worried she might have a rare allergic reaction to the vaccine, but after receiving the shot, she said she felt fine.

“I feel good,” she said. “Actually, the vaccine didn’t hurt but my arm is just a little sore.”

Marina Lopez, 85, also came to the clinic for her vaccine.

“I got the call last week, I had been waiting for it and was really happy,” she said.

Pablo Juarez was delighted to escort his grandparents, Jesus and Cruz Barrandey, to the clinic so they could receive the vaccine that protects against contracting COVID-19. The Barrandeys are citizens of the United States and have a small ranch in Chihuahua, Mexico. Juarez is use to spending time in the summers there with them but hasn’t been able to because he wanted to keep his grandparents safe during the pandemic.

Castro, the social worker, said that the sooner families are vaccinated, the quicker they’ll be able to spend time with each other.

“It’s time to take control, to push forward, to get the shot and maybe this time next year, we’ll have spent the holidays with our families,” Castro said.

Health care experts say it is no time to be lax on taking precautions such as wearing a mask, washing your hands, staying 6 feet apart from people outside your household and avoiding large crowds. (Read more about the dos and don’ts after getting a COVID-19 vaccine.)

“It’s time to be kind to one another — to take care of ourselves but more importantly to take care of those around us,” Castro said. “My kids almost lost a father. I almost lost a father.

“Try your hardest to make sure you follow these protocols because it might be someone you care about that might not make it. I don’t want anyone to experience that or face what I went through.”