The Power of Collaboration

Migrant Farmworker Vaccination Campaign Series: Post 3

Through a new partnership with the University of Vermont Extension, Bridges to Health Program, a team of medical students and residents have been fanning out across the state to vaccinate migrant farmworkers, first with the influenza vaccine in the fall and winter of 2020 and then with the COVID-19 vaccine when it became available in the spring of 2021. Their efforts have resulted in over 260 people receiving the flu vaccine on 53 farms across eight counties. To date, nine students and six residents – with support from the Vermont Department of Health – have administered over 300 COVID-19 vaccines. The organizations are working together for a common cause: to create more equal opportunities for health for workers who are critical to sustaining Vermont’s food system and agricultural landscape… (more background info provided at end of post).

This is the final post of a 3-post series, written by Class of 2024 medical student Kiana Heredia, reflecting on her time working on the campaign.

A group of seven people including UVM Larner Med medical students and UVM Medical Center employees pose holding brown paper bags with red hearts and the words "Thank You" drawn on them in a dairy barn in Vermont.
A group of seven people including UVM Larner Med medical students and UVM Medical Center employees pose holding brown paper bags with red hearts and the words “Thank You” drawn on them in a dairy barn in Vermont. Class of 2024 medical student Kiana Heredia is second from left. Photo credit: Dr. Benjamin Clements.

So much of Vermont’s agricultural industry depends on the labor of migrant workers. These workers make up the fabric of our community and yet during the COVID-19 pandemic they are some of the most at-risk and hardest to reach populations. Given the long list of barriers that may dissuade migrant workers from accessing health services and particularly the COVID-19 vaccine, vaccine hesitancy among migrant workers can easily intensify. These barriers might include obstacles surrounding accessibility, such as navigating online appointment registration or travelling far distances to vaccination sites, spread of misinformation, as well as taking time off from work and suffering loss of income. Language barriers also limit comprehension and raise doubts, especially in relation to the trust between migrant workers and healthcare providers.

As with many of the health disparities we see, if we do not continue to vaccinate those who are being disproportionately affected by COVID-19, we will continue to see disproportionate health outcomes. And so, as a medical student, I was more than eager to get on farms when the time came around be a part of a larger concerted effort to address some of these barriers. On the farms, I saw just how transformative a trusted healthcare team could be in lessening some of the health inequities our communities face.

In one instance, two farm workers were particularly hesitant to receive the COVID-19 vaccine. After careful and honest discussion by one of the on-site physicians and outreach staff members, one worker decided to get vaccinated after the healthcare team shared stories of patients who have suffered long term illness after battling COVID-19. Not long after, the other farm worker decided that he too wanted to receive the vaccine after hearing that his colleague changed his mind.

As I conversed with one of the farm workers in his native tongue, I saw the power of close cooperation with trusted community members. We were not only able to reduce some of the hesitancy regarding the vaccine, but we were also able to ensure that these vulnerable groups were heard and understood. Through language, storytelling and listening, we provided equitable access to medical care to these individuals. With this type of concerted effort, we can continue to make progress in lessening the health disparities our communities face in Vermont.

…continued from intro…

“The goal of the partnership between the College’s Global Health program and Bridges to Health is to bring preventive health care to this population with limited healthcare access,” says Ben Clements, M.D., assistant professor of family medicine.

When COVID restrictions curtailed international global health education plans for medical students, leaders began to search for similar learning opportunities in Vermont. Affordable health care access for migrant workers is precluded by persistent health inequities connected to immigration status, transportation, language, and occupation, all challenges that medical students learn about and play a role in addressing. Students learn a variety of skills, like how to work with interpreters, while developing a sense of cultural humility and a better understanding of rural and agricultural health.

“Our next step after our vaccination campaign is to offer on-farm general health screenings for conditions like diabetes, hypertension, obesity, depression, substance use disorders and sexually transmitted infections,” Clements says. “This will involve several of our rising second-year students and some fourth-year students serving as teaching assistants. Family medicine and emergency medicine residents will also be joining us.”

Read the first post in the series, titled “The Importance of Preventive Care,” by Elena Martel ’22

Read the second post in the series, titled “Local Global Health,” by Prasanna Kumar ’22

What are your thoughts about this topic?