Abril Garcia has spent the pandemic cycling in and out of hospitals, sitting in waiting rooms a few feet from people being tested for the coronavirus. Garcia, a 28-year-old medical interpreter, never finds out if a result comes back positive.
She only knows that not taking the chances of getting sick means Spanish-speaking patients coming in for an ultrasound or mammogram run the risk of misunderstanding their doctor’s words.
With restrictive visitor policies, Garcia became one of their only advocates in a state where 464,606 Virginians are not English proficient. The U.S. Census Bureau estimates more than half are Hispanic, a population facing rampant misinformation and double the case rate of white residents.
Yet Garcia’s occupation that should have placed her among those first in line for a lifesaving vaccine is not listed in the state’s prioritization guidelines.
The American Translators Association wrote the Centers for Disease Control and Prevention on Dec. 17 and Jan. 22 asking for the federal agency to explicitly include on-site medical interpreters to prevent this from happening. They still aren’t.
“This whole issue really stems from people not really caring about language access or even understanding the importance of it,” said Garcia, a Henrico County resident. “So many doctors and medical providers, they think that it’s OK if they just speak a few phrases in Spanish and that that’s enough. ... that it’s OK if they just have a voice translator on their phone.”
Having an interpreter is required by law, but that doesn’t always happen, Garcia said. Some patients fear needing to call their children for help, which is prohibited by the Department of Health and Human Services for hospitals to allow unless in an emergency.
Under the Virginia Department of Health’s definition of contracted personnel in clinical settings — “critical to the ongoing operations of health system facilities” — medical interpreters such as Garcia are deemed health care workers in phase one of vaccinations, said agency spokes Logan Anderson. Only those who work remotely are not.
Some hospitals, however, have already vaccinated stay-at-home workers and hospital executives before “predominantly Black and brown medical interpreters who are actually in the field,” said Kelly Henriquez, a 31-year-old Spanish medical interpreter in Richmond.
Henriquez, who is white, said she is one of the few people in her Facebook support groups of at least 5,000 medical interpreters who have received a first dose. Most are Black and Hispanic, she said.
She was offered the vaccine in mid-January through a children’s facility she works with, but while the state health department has advised interpreters to work with employers to obtain a vaccine, Henriquez said her colleagues have had better luck crossing state lines for a shot.
And the hospitals and facilities Garcia jumps between daily, who she said can’t be named without violating her contract, told her they couldn’t vaccinate someone who was not an employee. Garcia said that complicates efforts for on-site medical interpreters already struggling to obtain one of Virginia’s 2.5 million doses. Most are hired through out-of-state agencies or on a freelance basis.
With no public data on how many medical interpreters have been vaccinated, it’s impossible to gauge how many are still waiting their turn.
State officials have said the vaccine uptake is highest among physicians, a predominantly white field that averages a yearly income of more than $200,000 in Virginia, or triple that of interpreters.
Incomplete VDH figures indicate 71% of people vaccinated have been white, a percentage that hasn’t changed since inoculations began.
Anika Hines, a health equity researcher at the VCU School of Medicine, said the vaccination hierarchy in place that benefits physicians but shuts out medical interpreters — even if unintentional — reflects the country’s neglect to address how ingrained structural racism and classism are institutions like the health care system.
Hines noted that the pandemic forcing a long-awaited acknowledgment of racial and ethnic disparities is “a step in the right direction. But again, we can do more. We can do better.”
“It’s difficult for a country who values this idea that every man is able to pull himself up by his bootstraps, when in fact, we put systems that basically prohibit certain groups and populations from accessing that type of opportunity,” Hines said.