Rural Imperial County defies odds of COVID with one of California’s highest vaccination rates

Imperial County public health staff administer the vaccines in March. Photo courtesy of the county

Imperial County learned early on what it meant to be a COVID-19 hotspot. The virus bulldozed through agricultural county last spring and then again in winter. About one in six residents has been infected and 745 people have died.

But the Imperial County has a statistic that gives hope to local health officials: 86% of its eligible population has been vaccinated with at least one dose. It’s one of the best vaccination rates in California, eclipsed only by Marin and Santa Clara counties and tied with San Francisco. Statewide, the rate is 74%.

Additionally, Imperial was one of 11 counties as of mid-July where more than half of its residents on Medi-Cal, the state’s health insurance program for low-income people, have been vaccinated. This is a sign that it is doing better than most counties in protecting its underprivileged residents from COVID-19.

In many ways, Imperial defies the odds: Despite its remoteness and extreme poverty, which are often associated with poorer health outcomes, most of its 186,000 residents appear determined to keep the virus at bay.

“In general, there is a correlation with income and vaccination rates, but I think the Imperial County data tells us that it can be overcome, it just takes effort,” said Fabian Rivera-Chavez, assistant professor. of Pediatrics and Biological Sciences at the University of California, San Diego.

The reasons for the high percentage of residents vaccinated at Imperial are not well understood. But local experts and health officials say one of the key factors is its strong network of nonprofits, clinics, hospitals, and farm employers who have personally reached out to people to provide them. vaccines.

Located far from the most populous areas of California, residents of Imperial Oil over the years have come to rely on their local network to overcome health problems.

“In our world, we learn from others. I think of the small communities, we are used to working closely together and that has translated into our efforts and our response, ”said Rosyo Ramirez, deputy director of the Imperial County public health department.

The county has administered 227,700 doses of COVID-19 vaccines. “There’s no way we could have done it on our own,” Ramirez said.

Imperial has the highest proportion of residents vaccinated in the entire southern half of the state. About 73% of Los Angeles County residents and 50% of Kern County residents, for example, received at least one injection, compared to Imperial’s 86%.

The Imperial County has a lot to do against it when it comes to controlling a pandemic.

El Centro, with a population of 44,000, is the largest city in the Imperial Valley. Photo by Shae Hammond for CalMatters

More than one in five people live in poverty, one of the highest rates in the state. About 85% of its population is Latin American, a group that statewide continues to fall behind on vaccines; 46% of Latinos in California have yet to receive a first dose, state data shows.

It’s also sparsely populated – 43 people live per square mile, compared to its next door neighbor, San Diego County, which has 793 people per square mile, and Los Angeles, with 2,744.

This means that not having access to a car at Imperial can pose significant challenges and limitations for people seeking to get vaccinated.

Being a border county, Imperial Oil also has a large binational population, which means people can work on one side of the border and live on the other. This comes with its own unique logistical challenges in controlling and tracking the spread of the virus.

The Imperial Valley was desert, inhabited by humans, until it was transformed around the turn of the 20th century when a canal diverted water from the Colorado River to irrigate crops. Since then, it has grown into a leading producer of vegetables and livestock, valued at over $ 2 billion annually, led by livestock, alfalfa, lettuce and broccoli. Its largest city is El Centro, which is home to 44,000 inhabitants.

The Imperial Valley was wasteland before a canal delivered water from the Colorado River for irrigation. Today, desert lands like this are surrounded by lush, irrigated fields. Photo by Shae Hammond for CalMatters

A personalized approach to vaccinations

Reaching people in remote towns that are several miles apart is difficult to reach, but it seems to be paying off in Imperial County.

Rosa Diaz, CEO of the Imperial Valley LGBT Resource Center, said her organization has focused on some of the more rural communities, such as Ocotillo, Bombay Beach, Niland and Seely, where populations range from 200 to 1,000. . When the weather permits, his team sets up canopies in these towns to provide vaccine education and information on how to register, and to survey people to find out if they have bedridden family members who need transportation, Diaz said.

For four months this year, a medical team from the El Centro Regional Medical Center, one of two hospitals in the region, has settled down every Friday at the Imperial Valley Mall. They were administering between 600 and 1,000 doses per day – on the busiest day they had nearly 2,000 people, CEO Adolphe Edward said.

When vaccines became more available to farm workers in the spring, Shelby Trimm, executive director of the Imperial Valley Vegetable Growers Association, spent days on the phone coordinating with farm labor contractors so that they send field workers to vaccination clinics.

Lots of farm workers have to show up at different job sites, so going through contractors was a good way to capture more people, Trimm said.

“You had these buses full of field workers who showed up to the vaccination clinics,” Trimm said. “The goal was really to make things as easy as possible. “

The Imperial Valley is one of California’s most productive agricultural areas, known for livestock, alfalfa, and vegetables. Rows of crops grow near Brawley in this photo taken on February 5, 2021. Photo by Shae Hammond for CalMatters

Trimm said local providers have also set up clinics at the border to provide doses to farm workers and others who come to Imperial to work.

The county offers vaccines to people who work at Imperial and live on the Mexican side. But its vaccination data only reflects doses given to people with addresses and zip codes in the United States, county public health officials said.

“If they work here, they affect our community,” Ramirez said. “From the start, we understood that it was important to get them vaccinated.”

Although there is no county data to show the vaccination rate by area, Trimm said there was not much resistance or reluctance to the vaccine among farm workers.

“At this point you have had COVID or a loved one who did,” Trimm said. “So many people have seen family members die or get sick. It can’t get any worse than that. So if there was a way to save themselves, people did.

Edward from the medical center agrees that many county residents may have felt pressured to get the vaccine because the virus struck near their homes. “People have gotten serious about it,” he said.

Imperial County may have more natural immunity due to its high infection rate.

“A county that has been hit hard like Imperial is also likely to have a higher rate of natural immunity,” said Rivera-Chavez of UCSD. And when people who have natural immunity get vaccinated, they acquire what’s called “hybrid immunity,” which can provide even stronger protection, he explained.

Hospitalizations are increasing

Still, as long as some residents aren’t vaccinated, there is a risk, Edward said. Over the past two weeks, Imperial Oil’s COVID hospitalizations have fallen from eight to 16 on average between July 29 and August 11. Hospital admissions in California have increased at about the same rate.

This shows that there is still work to be done. More than half of Imperial County residents are on Medi-Cal. And while Imperial is ahead of most other counties with 50% of its Medi-Cal members vaccinated, that means there is another half that fell into the gap.

Earlier this month, the state announced it would deploy $ 350 million in incentive payments for health insurance plans to increase immunization among their Medi-Cal members across the state. Funding for health plans is contingent on meeting specific immunization goals, and a certain amount of money could provide direct incentives to people, like grocery gift cards.

“I’m glad people are getting vaccinated, but we can’t stop there,” Edward said. “I think a lot of people are running out of energy … but we know the remaining people are the hardest to reach.”

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