The nation's food supply depends on farmworkers. Why are so many still unvaccinated?

Daniel Gonzalez
Arizona Republic

AGUILA — Victor Espinosa, a 49-year-old farmworker, was spraying water on a dusty cantaloupe field at the end of his work day when he got a call from a co-worker.

Oye! the coworker told Espinosa in Spanish. They are giving vaccines over at the community center. I just got mine. Better hurry if you want one.

It was not an opportunity Espinosa wanted to miss. As soon as Espinosa finished his shift, he rushed back to the farm barracks, showered, and threw on clean shorts and a T-shirt. He and two other co-workers, including one with a car, headed to the community center, a short 5-minute drive away.

Espinosa expected to find a line at the Aguila Community Center, a rustic one-room building in the center of this small farming community about 90 miles northwest of Phoenix.

Instead, Espinosa and his two-coworkers arrived during a lull in traffic. A team of staff and volunteers from the University of Arizona College of Public Health sat waiting at tables. They had come from Phoenix to administer the Moderna version of the COVID-19 vaccine to the farming community.

Espinosa and his two co-workers were in and out of the vaccine site in less than 30 minutes. 

They headed back to the farm with one shot done and one more to go on their way to  becoming fully vaccinated.

"This was super good," Espinosa said afterwards. "It would have been hard for us to go out looking for the vaccine. Blessed be God that they came here to Aguila."

The nation's food supply depends on more than 2 million farmworkers such as Espinosa. Yet they are among the hardest of essential workers to get vaccinated for a variety of challenges, including the remoteness of farms from vaccine sites, long work hours, transportation, immigration status, language barriers, and lack of health insurance.

In Yuma County, which had one of the highest COVID-19 rates in the world, tens of thousands of migrant farmworkers left Arizona for California at the end of the winter vegetable season earlier this year without getting vaccinated because of shortages in the vaccine, according to farmworker advocates.

The best way to get farmworkers vaccinated is to bring the shot to them by organizations that are trusted, farmworker advocates and health care professionals say.

But in Arizona and across the nation, there are few mobile vaccine units that drive out to farming communities. The ones that do are stretched geographically thin, farmworker advocates and health care experts say. 

The University of Arizona Health Sciences' mobile vaccine unit, for instance, covers all of Maricopa County and tries to reach all underserved populations, not just farmworkers. At 9,200 square miles, Maricopa County is one of the largest counties in the U.S. and is as big as New Hampshire.

"Without reaching out, these things don't happen," said Alma Ramirez, a health education and promotion professional who was in charge of the recent University of Arizona College of Public Health event that administered vaccines to farmworkers in Aguila. 

Her team brought 100 doses of the vaccine that day, and administered 55 shots to members of the small community, many of them farmworkers. The team was scheduled to return to Aguila on May 21 and May 31 to give shots directly to 450 farmworkers at Martori Farms.

"If these people hadn't come out to do this, some people would have gone without (the vaccine). I'm sure of it," added William Dudley, who manages the Aguila public library and helped promote the vaccine event on the library's Facebook page.

Vaccinating farmworkers present challenges

Farmworkers often work in rural areas six or seven days a week from sunrise to sundown. They work in jobs picking vegetables, milking cows, and doing other agricultural tasks that make it especially hard to travel to sites where the vaccine is available, typically in urban areas far away.

Farmworkers in Aguila, for instance, must drive 26 miles to Wickenburg, or two hours to the Phoenix area,  to get a shot. 

Most farmworkers in Aguila don't own cars, Espinosa said.

The vast majority of farmworkers in Arizona and in the U.S. are Latino immigrants, who often don't have health insurance, may not speak English, or are afraid to get registered for the vaccine because of their legal status.

Espinosa, who is from Tlaxcala in central Mexico, works in the U.S. from January to October on an H2A temporary agricultural worker visa. There has been some confusion over whether H2A workers and undocumented workers are eligible to get the vaccine.

The Department of Homeland Security has said everyone living in the U.S. should have access to the vaccine, including undocumented immigrants. But there have been instances around the country where undocumented immigrants have been mistakenly denied the shot. And some politicians have said people in the country illegally should not be eligible for the shot.

On April 13, federal health agencies called for a pause in injections of Johnson and Johnson's coronavirus vaccine amid safety concerns, which also has hampered efforts to get farmworkers vaccinated.

The pause particularly affected hard to reach populations, including farmworkers. Some health care clinics in Arizona and other states had been reserving doses of the J&J vaccine for farmworkers because it requires only one shot. Returning for a second shot is especially difficult for farmworkers. The pause has since been lifted. Appointments for some farmworkers slated to get the J&J shot had to be cancelled, and now have to be rescheduled.

A lack of information and misinformation has made many farmworkers hesitant to get the vaccine, adding to the challenges of getting farmworkers vaccinated, farmworker advocates and farm owners say.

At one large dairy farm in Maricopa County, managers offered $100 bonuses to persuade more workers to get the shot. Another farm gave workers gift cards.

Meanwhile, farmworkers have been hit disproportionally hard by the new coronavirus pandemic. They often work in conditions where physical distancing is difficult, and face pressures to remain on the job. They are often reluctant to get tested or quarantine when sick for fear of losing pay, and often live in crowded housing, where the virus is easier to spread. 

"Farmworkers are essential workers who have been on the frontlines of the pandemic and they have been disproportionately impacted by COVID and so it's important that they get protected," said Alexis Guild, director of health policy and programs at Farmworker Justice, an advocacy group. "And the reason they are frontline essential workers is because their work is crucial to us to ensure we have a stable food supply."

There are about 2.4 million farmworkers in the U.S., according to Farmworker Justice, citing data from the Department of Labor's National Agricultural Workers Survey. About 75% are immigrants, mostly from Mexico, and about half of all farmworkers are undocumented, according to Farmworker Justice.

At vaccine sites, workers usually ask for ID and health insurance information, even though the vaccine is free to everyone. That also creates a barrier for farmworkers, especially for undocumented farmworkers, said Armando Elenes, secretary treasurer of United Farm Workers, a labor union.

"When they're asking for information, it's a turn off for a lot of workers," Elenes said. "It's just like, oh, wait a minute, what's this information going to be used for? Who's going to have access to this information, et cetera."

Data on COVID-19 rates and deaths among farmworkers is hard to come by because the data is not easy to collect.

A project by Purdue University to quantify the risks on the supply of agricultural products estimates that more than 584,000 out of a total 5.8 million farmworkers and agriculture producers in the U.S. have contracted COVID-19. The estimate includes more than 7,187 out of 58,000 year-round farmworkers and agriculture producers in Arizona.

COVID-19 outbreaks have forced farms and meat and poultry plants to reduce operations or shut down temporarily. The outbreaks have resulted in the loss of production at a time when widespread shutdowns of schools, businesses and universities have lowered demand. The lowered demand has caused the prices of many agricultural products to fall, including corn, dairy, beef and pork, according to the National Center for Farmworker Health.

A study by University of California Merced that examined death records found a 56% increase in deaths among working-age farmworkers in California in 2020 compared to an average of  the two previous years.

The study concluded that the increase in deaths among farmworkers in California was related to the COVID-19 pandemic.

The 56% increase amounted to a total of 447 farmworker deaths on top of the 792 farmworker deaths in an average year in California, said Alicia Riley, a professor at the University of California — San Francisco who worked on the study.

Although the study was limited to working-age farmworkers in California, Riley believes a similar study in Arizona likely would show a similar increase in deaths among farmworkers because of the pandemic. 

She pointed out that thousands of farmworkers, mostly from Mexico and Central America, migrate seasonally from Arizona to California and other Western states following the crops and face many of the same barriers to accessing health care.

"I would expect the same exact thing to play out in Arizona... to the extent that the Arizona population is similar to California, it's probably going to be similar because it's the same barriers and the population can be exploited in the same ways," Riley said. "I would actually worry that it might be worse in Arizona because California has been even stronger in some of its workplace protections."

Dr. Cecilia Rosales, associate dean and professor at the University of Arizona Mel and Enid Zuckerman College of Public Health, said part of the problem is there are not enough efforts to bring the vaccine to farmworkers.

"It's true that they have to have more vendors, more people, more organizations that are willing to go to these farms," said Rosales, who oversees the U of A mobile vaccine units. "But at the same time, we have to be able to go onto the forums. So in other words, owners need to make it known that they have farmworkers and they gave us permission to go onto the farms."

The efforts to vaccinate farmworkers have not been systematic, but they are improving, Rosales said.

"There is no method to the madness," she said.

Distribution of the COVID-19 vaccine also has been politicized, which has further complicated efforts to get farmworkers vaccinated, Rosales said.

"These are folks that we should have been vaccinating a long time ago," Rosales said. "They are the ones who put food on your table, for heaven's sake."

In February, Rep. Debbie Lesko, R-Ariz., drew outrage after she said during a congressional hearing that American citizens should get the vaccine before people who are not in the country legally and implied that Hispanics are not Americans.

Lesko made the comments during debate over a COVID-19 aid package in support of an amendment by Republicans to prioritize Americans. The amendment failed on a party-line vote.

In a statement to The Arizona Republic, Lesko acknowledged her words "could be misinterpreted." But she said she continues to stand behind her position that undocumented immigrants should not receive vaccines ahead of citizens. 

"Arizona seniors are in desperate need of COVID-19 vaccines. I stand by my support for the amendment that puts American citizens and legal residents first before illegal immigrants to get the COVID-19 vaccine," the statement said. "Taken in context, my remarks clearly were aimed at ensuring that seniors receive taxpayer-funded vaccines before illegal immigrants. During debate on the amendment, after being interrupted several times, I said something that could be misinterpreted, but it certainly was not my intent."

Everyone residing in the state is eligible for the vaccine regardless of immigration status, Rosales said.

"During a pandemic, this is especially critical because farmworkers and the undocumented, they are our essential workers, who are vulnerable and susceptible to hospitalization, morbidity and mortality due to COVID," Rosales said. "So if we leave them unvaccinated, they also are also going to contribute to community spread. So we want to vaccinate them. Regardless of their status."

State did not act on early pleas to designate farmworkers in top tier of essential workers, advocates say

Yuma County is known as America's winter salad bowl. More than 90% of the lettuce and broccoli and vegetables consumed during the winter months in the U.S. come from the fertile land around Yuma in southwestern Arizona.

Every fall, as many as 50,000 seasonal farmworkers flock to Yuma to help plant and harvest the crops. They leave at the end of the winter vegetable season in late March and early April and migrate to California and other Western states for the spring planting season.

In December, as a COVID-19 outbreak in Yuma County soared to one of the highest rates in the world, farmworker advocates said they pleaded with state health officials and Gov. Doug Ducey to designate farmworkers in the top tier of essential workers so that they could get first priority for the vaccine as soon as it became available.

Farmworker advocates said they were in a race against time. Harvest season ends in late March and early April and they wanted to vaccinate as many farmworkers as possible before the majority of migrant farmworkers left Arizona and returned to Mexico or headed to California and other states.

Farmworker advocates said their request fell on deaf ears.

Before farmworkers became eligible for the vaccine, Ducey opened COVID-19 vaccine eligibility to all residents 16 and older starting on March 24. By then, the majority of the 50,000 seasonal farmworkers who had been working in Yuma County had already left without getting the vaccine, Amanda Aguirre said. She is president and CEO of the Regional Center for Border Health, a nonprofit organization that provides health care to low-income people in Yuma County, including farmworkers.

Aguirre estimates that only about 10% of migrant farmworkers received the vaccine before leaving Arizona.

"We were concerned that farmworkers were leaving the area at the end of the peak season, which is early April, and leaving with no vaccine after having been here all this time without getting vaccinated and, of course, transported in crowded buses and working very close to each other," Aguirre said. "The local farmers were also concerned."

In January, nearly a dozen Yuma County farmers and farm groups sent a letter to  Ducey and Cara Crist, the Arizona Health Services Department director, urgently asking that more doses of the COVID-19 vaccine be designated for Yuma County to cover 40,000 seasonal farmworkers plus a “significant number” of winter visitors.

The letter said farmworkers and winter visitors had been overlooked when early allocations of the vaccine were made for Yuma County based on census data that failed to account for season farmworkers and winter visitors.

"As you are aware, the Yuma area now has one of the highest contagion rates in the world," said the letter, obtained by The Arizona Republic. "We are reaching out to you to ensure that this at-risk and essential population of our county are accurately counted in your allocation metrics, and the appropriate number of COVID-19 vaccinations are allotted to Yuma County."

John Boelts, one of the Yuma County farmers who signed the letter, said the group also sent letters to Arizona's two U.S. senators, Democrats Mark Kelly and Kyrsten Sinema, and to the head of the Centers for Disease Control and Prevention.

"We missed out on an opportunity to get probably 15 to 20 thousand workers that spend five months of the year here," Boelts said in an interview. He owns and operates Desert Premium Farms, a vegetable farm in Yuma County. "They should have had an opportunity to get in line and get the vaccine."

Steve Elliott, a spokesperson for the Arizona Department of Health Services, defended the state's decision not to include farmworkers in the first-tier of people eligible for the vaccine

Vaccine supplies were "extremely limited" from December through March, he said.

"The state’s decisions to prioritize healthcare workers, first responders, protective services workers, and older individuals, along with teachers, was in line with federal recommendations and best practices used by other states," Elliott said in a written statement.

"Transitioning to a hybrid approach with state sites vaccinating according to age and counties vaccinating frontline essential workers protected those most vulnerable to severe outcomes from COVID-19 at a time when hospital resources were stressed," Elliott said.

The state health department has since coordinated with Yuma County to run a mass-vaccination site at the Yuma Civic Center. The site offers vaccine to everyone 16 and over regardless of their permanent address, including migrant farmworkers.

Christ also held a telephone town hall for underserved areas of Yuma County in an effort to boost the number of people getting the vaccine, Elliott said

"Protecting farm workers has been a priority not just of the state but of the counties who serve as the local vaccine allocators in Arizona’s prime agricultural areas, including Yuma and Maricopa counties," Elliott said."The state and counties have received positive feedback for their efforts to help farm workers and agriculture companies."

Farm owners recount struggles to get their farmworkers vaccinated

Several farm owners in Arizona, however, said it's been a struggle to get their farmworkers vaccinated.

Jennifer Millican, an assistant manager at Stotz Dairy, a large farm in Buckeye, said her husband spent two weeks trying find an opening for a COVID-19 vaccine online. He finally got one at 4:10 a.m. in Phoenix 40 minutes away.

"And that's with him having access to a computer all day," Millican said. "So the farmworkers who are out in the field all day working eight to 12 hour days depending on which job they have, it's a big ask for them to say, Hey, now go online and spend a bunch of time trying to find an appointment."

Millican said she spent days Googling and making telephone calls until she found someone at the Maricopa County Public Health Department to help her set up a vaccine clinic on March 29. The event was run by the University of Arizona Health Sciences' Primary Prevention Mobile Health Unit. The COVID-19 vaccine initiative is called the Mobile Outreach Vaccination and Education for Underserved Populations, known as MOVE UP. The program is run by a team of bilingual staff and volunteers.

The university launched a second mobile unit April 23 to bring the vaccine to underserved communities in rural southern Arizona, including farmworkers.

Millican invited neighboring farms to the event. In all, 623 people received the shot that day. For the event, Millican set up tables in the breezeway of the milk barn where trucks usually pass.

Millican specifically requested the Johnson and Johnson version of the shot.

"The one-and-done aspect was key, that they weren't going to have to worry about going back again in two weeks," Millican said.

At first, only about 50% of the dairy's 158 workers signed up for the vaccine, Millican said.

She wanted to get closer to 85% of her workers vaccinated to reach herd immunity.

So as an incentive, she gave every worker who got a vaccine a $100 bonus. About 75% of her workers ended up getting the shot.

The bonuses cost the farm about $12,000. Millican said the extra cost was worth it.  A COVID-19 outbreak swept through the dairy farm during the Christmas holidays. To keep the 20,000-animal operation running, she had to pay workers who were not sick to work double shifts.

"We weren't going to force anybody to get vaccinated, but we were heavily incentivizing it," Millican said.

Back in March, Mark Schnepf started trying to get a mobile unit to come out to his farm, Schnepf Farms in Queen Creek, to vaccinate his farmworkers.

"I thought, how convenient it would be if we could get them to do it right on the farm," Schnepf said.

He only could round up about 30 farmworkers from his farm and neighboring farms to get the vaccine. Because the number was too low, Schnepf said he was instead directed by the county to tell his farmworkers to register for an upcoming May 11 vaccine event for essential workers at the Queen Creek Fire and Medical Department.

The Maricopa County Public Health Department has partnered with the University of Arizona Health Services to hold vaccine events at four other agriculture sites in Maricopa County, including at the JBS Beef Plant in Tolleson and at Rousseau Farming Company in Waddell. 

As of May 21,  2,990 farmworkers from 37 farms, had received shots at the events, which included farmworkers from neighboring farms, according to Maricopa County spokesperson Amy Bolton. The number includes farmworkers who have received two shots. 

Rousseau, a large vegetable farm, paid farmworkers who got the shot for their time and travel and gave them gift cards, said Kami Weddle, director of food sales.

"I think it's just important that we have a steady food supply and these are individuals that are harvesting our crops and working day in and day out to make sure that we continue to supply food to retailers and restaurants and people's homes," Weddle said. "So I think it's just important that we provide them a safe work environment and making sure that it's COVID-free is important."

'Thank God I was able to get the vaccine,' farmworker says

Although about 44.3% of Arizona's eligible population as of May 20 has received at least one dose of the vaccine, the percentages are much lower in rural areas of the state. In Aguila, only 25.8% of the eligible population had received at least the first dose, according to Maricopa County data.

The recent vaccine event in Aguila was open to the entire community of around 900 year-round residents. Many of the people who showed up were farmworkers from the nearby Martori Farms who came straight from work. They were easy to spot with their dusty boots and sweat-stained baseball caps.

Daniel Ramirez, a 29-year-old farmworker from the Mexican state of Tlaxcala, said his boss let him leave work for 30 minutes to get the shot. He works at the farm welding machinery and lives in barrack-style housing with other farmworkers.

He said he came down with COVID-19 in June along with several co-workers. They had to be isolated while they recovered and couldn't work for two weeks.

He said he felt fortunate to be able to get the vaccine without having to travel far from the farm.

"There was a lot of sickness last year," Ramirez said, as he filled out some paperwork. "Thank God I was able to get the vaccine. Now I don't have to worry."

Steve Martori, the chairperson of Eagle Produce LLC, which runs Martori Farms, said over the next month hundreds of seasonal workers from Mexico and Guatemala will descend on the farm in time for the spring planting season. The massive farm grows cantaloupes, watermelons and other produce. The farm contracts with workers from Mexico and Guatemala through the federal government's H2A temporary agricultural worker program.  

The University of Arizona's mobile vaccine unit was scheduled to return May 21 to Aguila to offer COVID-19 shots to farmworkers. This time the event will be held on the farm, Martori said.

Out of about 1,000 total farmworkers employed on the farm either seasonally or year round, only about 33 got sick with COVID-19 last year, not enough to slow production, he said. 

Martori said he still worries about a COVID-19 outbreak on the farm, especially for workers who work indoors in a cantaloupe-packing facility where it harder to socially distance than for workers out in the fields. 

The main reason he wants to offer farmworkers the opportunity to get the shot without having to go out hunting for it themselves is out of concern for their health, he said.

"Obviously, I don't want my production affected," Martori said. "But many of these people, they are all H2A guestworkers, come back year after year and they have a relationship with the company and with people within the company. So they are not just workers. They are part of the company."

Reach the reporter at daniel.gonzalez@arizonarepublic.com or at 602-444-8312. Follow him on Twitter @azdangonzalez.

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