intro
La Unión del Pueblo Entero (LUPE) is a grassroots organization dedicated to empower low-income Rio Grande Valley residents and provide services to colonias along the Texas-Mexico border. Founded by Latino civil rights leaders César Chávez and Dolores Huerta, LUPE builds stronger, healthier communities where colonia residents use the power of civic engagement for social change.
LUPE’s strength derives from our 8,000+ members throughout the Rio Grande Valley. A vast majority of our members are low-income immigrants who live in the colonias, or unincorporated neighborhoods that lack basic public infrastructure. When public institutions neglect or harm their relationship with immigrant communities, we step in to hold them accountable. This is a common theme across the many issues we work on. The COVID-19 pandemic response and vaccine distribution are no exceptions.
At the start of the pandemic, for example, the U.S. government failed to include all farm workers and immigrants from public relief funds related to COVID-19. In response, LUPE created the Dando La Mano Fund. Through that initiative, we distributed more than $100,000 directly to low-income residents and called for all people living in the U.S. to be included in future relief packages.
Evon Bueno, LUPE staff member, preparing aid to pass out to members | LUPE
Now, since the vaccine distribution began in Texas, we have tracked vaccine access for undocumented immigrants in the Rio Grande Valley. We were alarmed by reports from our members who are undocumented immigrants saying that vaccine providers rejected them because they did not have a U.S.-issued ID. Through testimonials from our members and investigations by our staff, we tracked whether at least 19 vaccine providers across Cameron County, Hidalgo County, and Starr County were requiring a U.S.-issued ID.
We found alarming inconsistencies and insufficient critical knowledge by vaccine providers on whether someone without a U.S.-issued ID was eligible for the vaccine. Though there is no blanket pattern across the three South Texas counties on denying people the vaccine, the inconsistency between each vaccine provider creates inequitable access and unnecessary stress and fear for a population that is among the hardest hit by the COVID-19 pandemic.
This report will highlight the testimonials from our members, some of our key findings and analysis from the investigation, and recommendations for moving forward.
Photo by LUPE
We hope this report serves to guide medical providers, elected officials, advocates, and all people of good conscience on how to remedy the problem and increase public awareness on why this is happening and the detrimental impact it has on people across the country. The Rio Grande Valley is not alone, as proven by media reports of vaccine providers discriminating against undocumented immigrants in North Carolina, Florida, Minnesota, California, and Baltimore. Moreover, inequitable access to medical care is not new to undocumented immigrants; COVID-19 has only exacerbated and added one more spotlight to the critical inequalities millions of people face in the U.S.
Collective immunity benefits us all. We can't reach that level of protection without racial equity in the vaccine rollout. Providers who ask for a social security number and government-issued ID, without providing clear steps for people without them to receive the vaccine, are holding us back from reaching the herd immunity that protects us all.
All medical providers have a moral responsibility and a public health imperative to build trust with immigrant communities. When someone is denied life-saving medical care due to their immigration status, that puts their lives in state-sanctioned danger and puts us all at risk.
UTRGV's Mistake
Jesús Diaz woke up on Feb. 20, 2021, expecting that morning would bring the moment he and his family had anticipated for months: Jesús was going to get vaccinated.
Jesús, a LUPE member, is 61 years old with a chronic illness that qualified him to receive the vaccine. He lives in the Rio Grande Valley, a historically underserved region by government aid and targeted by right-wing militaristic policies due to its location along the Rio Grande in South Texas. Among the detrimental effects, those two realities cause high poverty levels and poor access to health care. That leaves many of its residents likely working jobs that put them at high risk of contracting COVD-19 with little to no resources to get adequate medical care should they need it.
That is the context in which Jesús and his family have lived around for more than 20 years, and that is why he dropped everything he had planned that day to wait in line at the University of Texas Rio Grande Valley (UTRGV).
However, after a four-hour wait at the Edinburg campus, Jesús’ hope was brought to a jarring halt: because he is undocumented, a staff member told him he couldn’t get the vaccine.
“Vaccines here are exclusive for American citizens and legal residents of this country. We can’t help you. I’m so sorry, but these are the rules,” Jesús recalled the staff member saying, as reported by The Washington Post. Humiliated and discouraged, Jesús left the vaccination clinic and called his family.
Minutes after, Jesús’ son, Abraham, took to Twitter to expose what happened to his father. “After being in line [for] 4+ hours, @utrgv denied my father the covid vaccine because he's undocumented,” Abraham tweeted. “He's 60+ with underlying conditions. They said their website mentions it, but it's a lie.”
Abraham, an immigration activist who happens to be a LUPE staff member, knew what UTRGV did was wrong. He quickly mobilized to expose what the public institution had done in hopes it would be corrected for his father and all other undocumented immigrants. Only a few weeks before the incident, the federal government made clear “all individuals, regardless of immigration status,” were to receive the vaccine once they were eligible.
After being in line fit 4+ hours, @utrgv denied my father the covid vaccine because he's undocumented. He's 60+ with underlying conditions. They said their website mentions it but it's a lie.@MALDEF @ACLU
— Abe Díaz (@_AbeDiaz_) February 20, 2021
By Monday, Feb. 22, LUPE launched a petition calling on the university to correct its mistake and implement measures to prevent it from happening again. The demands listed were:
-
- Release the name of the official who decided to implement this policy, under what circumstances they implemented it, and how many people were denied;
- Pledge not to deny any eligible person based on immigration status;
- Quickly launch an education campaign in Spanish with the message that the vaccine is for everyone, regardless of immigration status.
With the obvious public health urgency, we gave UTRGV a deadline of Feb. 24 at 4 PM CDT to respond to our demands. Though UTRGV’s immediate response shied away from acknowledging they rejected people based on immigration status, the university eventually accepted full responsibility and precisely apologized for their mistake. In letters sent to LUPE and MALDEF, representatives of UTRGV detailed they would implement all our demands from the petition signed by more than 1,300 people.
A public notice from #UTRGV: pic.twitter.com/hReswhZjkQ
— UTRGV (@utrgv) February 24, 2021
UTRGV took its position seriously in the community as a leader in public health. That leadership depends on maintaining a strong relationship with immigrants. With these actions, UTRGV took the lead among vaccine providers in the RGV in declaring that no eligible individual will be denied a vaccine based on immigration status. This is the standard that we expect from all vaccine providers.
What we found
Even though UTRGV quickly took accountability for its mistake, it is only one of the dozens of vaccine providers across the RGV. After learning through their letter how the error happened, we now had to face the prospect that other vaccine providers were likely discriminating against undocumented immigrants.
We could not wait for other stories like Jesús’ for us to know which vaccine providers were making the same mistake. Additionally, we know of other barriers, including lack of health insurance or access to the internet, making it challenging for low-income individuals to get vaccinated.
What we decided to do next was for LUPE staff to call at random vaccine providers across the Rio Grande Valley to ask them the following questions:
-
- What type of ID do you require?
- Are you asking for a social security number?
- How are you making sure that those without a U.S. ID do receive the vaccine?
- (For those who require online registering) If someone doesn’t know how to use the computer, how can they register?
LUPE staff in San Juan, TX, unloading resources to pass out to members | LUPE
We chose to call providers because we assume that is what a vast majority of people will do to inquire about ID requirements, so we wanted to receive the same information any other person would get if they called themselves. Ultimately, the information they receive on that call will influence their decision to get vaccinated.
We obtained information on at least 19 vaccine providers across Cameron County, Hidalgo County, and Starr County. We found alarming inconsistencies and insufficient critical knowledge by vaccine providers on whether someone without a U.S.-issued ID was eligible for the vaccine. Some providers were confident and encouraging and said no one eligible would be turned away; others were less than encouraging, said they did not know, and recommended attempting another provider. Some said you needed a social security number; others said they never asked for it.
There was no cohesive trend across the three South Texas counties on denying people the vaccine based on immigration status. Still, the complicated inconsistencies between each vaccine provider create inequitable access and unnecessary stress and fear for a population that is among the hardest hit by the COVID-19 pandemic.
Table 1: Findings of our calls to 20 vaccines providers in the Rio Grande Valley
| City/County | Provider | Highlights of their responses |
|---|---|---|
| Weslaco | HEB | Any ID with a photo is acceptable |
| Weslaco & Donna | CVS | If you don’t have health insurance, you will be asked for a social security number You can register online or by phone |
| Edinburg | Walmart | You can only register online and offer no support or alternative if you don’t have access to the internet |
| Edinburg | Walgreens | Require social security number |
| Edinburg | Ochoa’s Pharmacy | Any ID with a photo is acceptable |
| Edinburg | CVS | Require Texas ID |
| Edinburg | HEB | Any ID with a photo is acceptable Require proof from a doctor of the underlying condition You can only register online |
| City of Hidalgo | Mass vaccination clinic | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| McAllen | Lee’s Pharmacy | Only vaccinating those with referrals from doctors |
| Pharr | Walmart | Refused to provide any information via phone |
| Pharr | HEB | Store redirected to 1-800 hotline for all COVID-19 questions; 1-800 hotline said they had no information until appointments were available |
| Mission | Richard’s Pharmacy | Any ID with a photo is acceptable |
| Palmhurst | HEB | Any ID with a photo is acceptable |
| Mission | CVS | Require Texas ID Are asking for a social security number |
| Starr County | Walmart | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | HEB | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | Popular Pharmacy | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | Fred’s Pharmacy | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | Lino’s Pharmacy | Any ID with a photo is acceptable Said if a patient doesn't have social or ID, they can use a phone number to register |
| Starr County | Saenz Medical Pharmacy | Any ID with a photo is acceptable to verify age |
When looking at Table 1, one should consider that while most providers seemingly are properly providing the vaccine to everyone eligible, there are still plenty who are making the same mistake as UTRGV. When even one person is turned away due to their immigration status, that individual and their loved ones lose trust in critical institutions that are supposed to keep all of us safe. Before UTRGV corrected course, they had rejected “approximately 14 individuals.”
This conflicting, confusing information can be in effect a denial. Take the story of a woman who registered to receive the vaccine at CVS in Mission, Texas. (To protect her privacy, her identity is confidential to LUPE.) The woman registered online with CVS and left the field for social security number and state-issued driver’s license blank. The system assigned her appointment to a CVS pharmacy in Mission, Texas. She called the pharmacy to verify the requirements for her appointment.
“And they told me that a social security number was mandatory,” she told LUPE. “I told them I did not have one but that I had a visa. And they responded that they could not vaccinate me. After that, I called the 1-800 number and I told them the same thing, and they told me that no, I had to have a valid state ID.”
CVS effectively denied the woman twice. But she did not give up. She called LUPE for help. We asked her to attend her designated appointment and allow us to come along to document it.
At her appointment, the pharmacy staff accepted her visa, did not ask for a social security number, and treated her with courtesy when they gave her the vaccine.
Art by Josue Ramirez
Another example is the story of Gabriel. Gabriel, who is undocumented, made an appointment at an HEB in Alamo, Texas. There he was told he needed to have health insurance to receive the first dose. He was not offered any alternatives.
“There were several people there and I had waited in line for a while,” Gabriel told LUPE. “So when [I was rejected], all the people in line witnessed it. I felt bad. I felt embarrassed. It felt like discrimination, and that’s why I’m giving my testimony.”
Gabriel did not return to HEB, but he received the vaccine through a vaccination clinic in Pharr, Texas, with the help of LUPE.
With confusion, misinformation, and mistrust in public institutions at play for Latinx and immigrant members of the Rio Grande Valley community, not all people will be so persistent or reach out to community organizations for help. Neither should they have to be. Providers have an obligation to eliminate barriers to life-preserving care. Further, they are not required to supply a social security number or proof of government-issued ID to the federal government for reimbursement of vaccine administration costs. They can ask for a social security number and government-issued ID but cannot deny someone for lack thereof.
Without a consistent guarantee no vaccine provider will turn people away for being undocumented, the fear of discrimination will certainly discourage immigrants from trying to get vaccinated. With reports of low vaccination rates among Black and brown people living in the U.S., discriminating based on immigration status may force people to not get vaccinated.
Collective immunity benefits us all. We can't reach that level of protection without racial equity in the vaccine rollout. Providers who ask for a social security number and government-issued ID— without providing clear steps for people without them to receive the vaccine— are holding us back from reaching the collective immunity that protects us all. The hard-hit Rio Grande Valley is mostly Latinx and people of color. Barriers to vulnerable RGV residents receiving the vaccine threaten the health and safety of all of us.
It’s important to reemphasize that many undocumented immigrants live in regions and work in spaces that are high-risk for contracting COVID-19. Those living in Texas face the added threat of a neglectful state government that has done little to enforce measures to slow the spread of the unprecedented deadly virus.
More testimony from UTRGV
Norma Garza and her mother, both of Edinburg, attended UTRGV's vaccination clinic on Feb. 8, 2021. The clinic worker who received Norma and her mother asked if her mother had a social security number and whether she was a citizen. The worker explained that they needed to ask because the clinic was federally funded. Norma responded that she was not, explaining that a clinic representative the day before over the phone said it was okay she did not have a social security number.
At that point, a manager stepped in, asking, "So she does not have a social? And she is not a citizen?" Norma again explained what her mother was told over the phone. The manager replied, "He made a mistake. He is my employee, and it was wrong. We cannot give her the vaccine."
Norma did not give up. She knew that the Biden Administration had only days prior announced that undocumented immigrants were eligible to receive the vaccine. She explained that her mother was a Texas resident and that she lived with her in Edinburg. She offered the manager a document from her mother's doctor to that effect.
That prompted the manager to step away for help. After returning, she took another look at her mother's doctor's document and relented. The clinic worker allowed Norma's mom to get the vaccine and scheduled her for the second dose.
LUPE members picking up resources at the San Juan office | LUPE
Other targeted people
While this report centers on how ID requirements harm undocumented immigrants, the effects of requiring IDs extend far beyond one population. Strict ID requirements can create barriers for houseless people, returning citizens or formerly incarcerated individuals, farmworkers, trans individuals, and/or other groups who have historically been barred from easily obtaining an ID from the U.S. government. We urge all medical providers to take seriously how their ID policies can harm vulnerable populations.
Any policy that requires someone to present a state-issued photo ID is going to create a potential obstacle for trans people. Many trans people avoid anything that requires them to use an ID for fear of encountering harassment or discrimination if the name on the ID does not match their identity and presentation. Misinformed or transphobic pharmacies or clinic workers may unjustly turn away or discriminate against a trans person who has not legally changed their name or gender marker. Some people may avoid getting the vaccine entirely for fear of negative experiences they have had in the past.
People less likely to have access to documents necessary to secure a driver’s license or state ID include people returning home from incarceration, survivors of domestic violence, people experiencing housing insecurity, and survivors of natural disasters. Formerly incarcerated people may not always have IDs issued by TDCJ and often do not have bills or correspondence in their name. After natural disasters, identity and residency documents needed for driver’s licenses are often lost or destroyed. In intimate partner violence, an abusive spouse or partner may hoard or destroy identity and residency documents. A survivor fleeing abuse may not escape with their ID or the documents needed to replace their ID.
Without the inclusion of undocumented people, trans people, people who were formerly incarcerated, people who are unhoused, and survivors of abuse or natural disaster, we cannot reach collective immunity that protects us all.
Recommendations
FOR RGV VACCINE PROVIDERS:
- Ensure all staff is trained to not turn anyone away based on not having a US government-issued ID and social security number
- Ensure that all marketing materials promoting the vaccine are in English and Spanish make it clear that a US government-issued ID and social security number are not required
- Consider accepting our LUPE membership ID as proof of identification
FOR RGV COUNTY OFFICIALS AND HEALTH DEPARTMENTS:
- Send official notices to all vaccine providers to make sure they are not rejecting people based on not having a US government-issued ID and social security number
- Launch an educational campaign in English and Spanish for the public to know their rights
- Provide an online form and phone number for people to report if a vaccine provider is rejecting people based on not having a US government-issued ID and social security number
FOR TEXAS STATE OFFICIALS, HEALTH DEPARTMENT, AND CONGRESS MEMBERS:
- Expose and investigate providers who refuse to comply
- Release public statements making it clear that a US government-issued ID and social security number are not requirements to receive the COVID-19 vaccine
- The state should increase support for vaccine providers, counties, and cities to do community outreach so that the public is aware of their rights
FOR PRESIDENT BIDEN’S ADMINISTRATION AND THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC):
- Launch an immediate multilingual educational campaign specifically about ID and social security barriers for the public to know their rights and to educate all vaccine providers
- If a vaccine provider refuses to comply, all federal aid should be pulled until they comply
- Provide an online form and phone number for people to report if a vaccine provider is rejecting people based on not having a US government-issued ID and social security number
intro
La Unión del Pueblo Entero (LUPE) is a grassroots organization dedicated to empower low-income Rio Grande Valley residents and provide services to colonias along the Texas-Mexico border. Founded by Latino civil rights leaders César Chávez and Dolores Huerta, LUPE builds stronger, healthier communities where colonia residents use the power of civic engagement for social change.
LUPE’s strength derives from our 8,000+ members throughout the Rio Grande Valley. A vast majority of our members are low-income immigrants who live in the colonias, or unincorporated neighborhoods that lack basic public infrastructure. When public institutions neglect or harm their relationship with immigrant communities, we step in to hold them accountable. This is a common theme across the many issues we work on. The COVID-19 pandemic response and vaccine distribution are no exceptions.
At the start of the pandemic, for example, the U.S. government failed to include all farm workers and immigrants from public relief funds related to COVID-19. In response, LUPE created the Dando La Mano Fund. Through that initiative, we distributed more than $100,000 directly to low-income residents and called for all people living in the U.S. to be included in future relief packages.
Evon Bueno, LUPE staff member, preparing aid to pass out to members | LUPE
Now, since the vaccine distribution began in Texas, we have tracked vaccine access for undocumented immigrants in the Rio Grande Valley. We were alarmed by reports from our members who are undocumented immigrants saying that vaccine providers rejected them because they did not have a U.S.-issued ID. Through testimonials from our members and investigations by our staff, we tracked whether at least 20 vaccine providers across Cameron County, Hidalgo County, and Starr County were requiring a U.S.-issued ID.
We found alarming inconsistencies and insufficient critical knowledge by vaccine providers on whether someone without a U.S.-issued ID was eligible for the vaccine. Though there is no blanket pattern across the three South Texas counties on denying people the vaccine, the inconsistency between each vaccine provider creates inequitable access and unnecessary stress and fear for a population that is among the hardest hit by the COVID-19 pandemic.
This report will highlight the testimonials from our members, some of our key findings and analysis from the investigation, and recommendations for moving forward.
Photo by LUPE
We hope this report serves to guide medical providers, elected officials, advocates, and all people of good conscience on how to remedy the problem and increase public awareness on why this is happening and the detrimental impact it has on people across the country. The Rio Grande Valley is not alone, as proven by media reports of vaccine providers discriminating against undocumented immigrants in North Carolina, Florida, Minnesota, California, and Baltimore. Moreover, inequitable access to medical care is not new to undocumented immigrants; COVID-19 has only exacerbated and added one more spotlight to the critical inequalities millions of people face in the U.S.
Collective immunity benefits us all. We can't reach that level of protection without racial equity in the vaccine rollout. Providers who ask for a social security number and government-issued ID, without providing clear steps for people without them to receive the vaccine, are holding us back from reaching the herd immunity that protects us all.
All medical providers have a moral responsibility and a public health imperative to build trust with immigrant communities. When someone is denied life-saving medical care due to their immigration status, that puts their lives in state-sanctioned danger and puts us all at risk.
UTRGV's Mistake
Jesús Diaz woke up on Feb. 20, 2021, expecting that morning would bring the moment he and his family had anticipated for months: Jesús was going to get vaccinated.
Jesús, a LUPE member, is 61 years old with a chronic illness that qualified him to receive the vaccine. He lives in the Rio Grande Valley, a historically underserved region by government aid and targeted by right-wing militaristic policies due to its location along the Rio Grande in South Texas. Among the detrimental effects, those two realities cause high poverty levels and poor access to health care. That leaves many of its residents likely working jobs that put them at high risk of contracting COVD-19 with little to no resources to get adequate medical care should they need it.
That is the context in which Jesús and his family have lived around for more than 20 years, and that is why he dropped everything he had planned that day to wait in line at the University of Texas Rio Grande Valley (UTRGV).
However, after a four-hour wait at the Edinburg campus, Jesús’ hope was brought to a jarring halt: because he is undocumented, a staff member told him he couldn’t get the vaccine.
“Vaccines here are exclusive for American citizens and legal residents of this country. We can’t help you. I’m so sorry, but these are the rules,” Jesús recalled the staff member saying, as reported by The Washington Post. Humiliated and discouraged, Jesús left the vaccination clinic and called his family.
Minutes after, Jesús’ son, Abraham, took to Twitter to expose what happened to his father. “After being in line [for] 4+ hours, @utrgv denied my father the covid vaccine because he's undocumented,” Abraham tweeted. “He's 60+ with underlying conditions. They said their website mentions it, but it's a lie.”
Abraham, an immigration activist who happens to be a LUPE staff member, knew what UTRGV did was wrong. He quickly mobilized to expose what the public institution had done in hopes it would be corrected for his father and all other undocumented immigrants. Only a few weeks before the incident, the federal government made clear “all individuals, regardless of immigration status,” were to receive the vaccine once they were eligible.
After being in line fit 4+ hours, @utrgv denied my father the covid vaccine because he's undocumented. He's 60+ with underlying conditions. They said their website mentions it but it's a lie.@MALDEF @ACLU
— Abe Díaz (@_AbeDiaz_) February 20, 2021
By Monday, Feb. 22, LUPE launched a petition calling on the university to correct its mistake and implement measures to prevent it from happening again. The demands listed were:
-
- Release the name of the official who decided to implement this policy, under what circumstances they implemented it, and how many people were denied;
- Pledge not to deny any eligible person based on immigration status;
- Quickly launch an education campaign in Spanish with the message that the vaccine is for everyone, regardless of immigration status.
With the obvious public health urgency, we gave UTRGV a deadline of Feb. 24 at 4 PM CDT to respond to our demands. Though UTRGV’s immediate response shied away from acknowledging they rejected people based on immigration status, the university eventually accepted full responsibility and precisely apologized for their mistake. In letters sent to LUPE and MALDEF, representatives of UTRGV detailed they would implement all our demands from the petition signed by more than 1,300 people.
A public notice from #UTRGV: pic.twitter.com/hReswhZjkQ
— UTRGV (@utrgv) February 24, 2021
UTRGV took its position seriously in the community as a leader in public health. That leadership depends on maintaining a strong relationship with immigrants. With these actions, UTRGV took the lead among vaccine providers in the RGV in declaring that no eligible individual will be denied a vaccine based on immigration status. This is the standard that we expect from all vaccine providers.
What we found
Even though UTRGV quickly took accountability for its mistake, it is only one of the dozens of vaccine providers across the RGV. After learning through their letter how the error happened, we now had to face the prospect that other vaccine providers were likely discriminating against undocumented immigrants.
We could not wait for other stories like Jesús’ for us to know which vaccine providers were making the same mistake. Additionally, we know of other barriers, including lack of health insurance or access to the internet, making it challenging for low-income individuals to get vaccinated.
What we decided to do next was for LUPE staff to call at random vaccine providers across the Rio Grande Valley to ask them the following questions:
-
- What type of ID do you require?
- Are you asking for a social security number?
- How are you making sure that those without a U.S. ID do receive the vaccine?
- (For those who require online registering) If someone doesn’t know how to use the computer, how can they register?
LUPE staff in San Juan, TX, unloading resources to pass out to members | LUPE
We chose to call providers because we assume that is what a vast majority of people will do to inquire about ID requirements, so we wanted to receive the same information any other person would get if they called themselves. Ultimately, the information they receive on that call will influence their decision to get vaccinated.
We obtained information on at least 20 vaccine providers across Cameron County, Hidalgo County, and Starr County. We found alarming inconsistencies and insufficient critical knowledge by vaccine providers on whether someone without a U.S.-issued ID was eligible for the vaccine. Some providers were confident and encouraging and said no one eligible would be turned away; others were less than encouraging, said they did not know, and recommended attempting another provider. Some said you needed a social security number; others said they never asked for it.
There was no cohesive trend across the three South Texas counties on denying people the vaccine based on immigration status. Still, the complicated inconsistencies between each vaccine provider create inequitable access and unnecessary stress and fear for a population that is among the hardest hit by the COVID-19 pandemic.
Table 1: Findings of our calls to 20 vaccines providers in the Rio Grande Valley
| City/County | Provider | Highlights of their responses |
|---|---|---|
| Weslaco | HEB | Any ID with a photo is acceptable |
| Weslaco & Donna | CVS | If you don’t have health insurance, you will be asked for a social security number You can register online or by phone |
| Edinburg | Walmart | You can only register online and offer no support or alternative if you don’t have access to the internet |
| Edinburg | Walgreens | Require social security number |
| Edinburg | Ochoa’s Pharmacy | Any ID with a photo is acceptable |
| Edinburg | CVS | Require Texas ID |
| Edinburg | HEB | Any ID with a photo is acceptable Require proof from a doctor of the underlying condition You can only register online |
| City of Hidalgo | Mass vaccination clinic | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| McAllen | Lee’s Pharmacy | Only vaccinating those with referrals from doctors |
| Pharr | Walmart | Refused to provide any information via phone |
| Pharr | HEB | Store redirected to 1-800 hotline for all COVID-19 questions; 1-800 hotline said they had no information until appointments were available |
| Mission | Richard’s Pharmacy | Any ID with a photo is acceptable |
| Palmhurst | HEB | Any ID with a photo is acceptable |
| Mission | CVS | Require Texas ID Are asking for a social security number |
| Starr County | Walmart | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | HEB | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | Popular Pharmacy | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | Fred’s Pharmacy | Any ID with a photo is acceptable Said all their staff is trained to ensure no one is turned away |
| Starr County | Lino’s Pharmacy | Any ID with a photo is acceptable Said if a patient doesn't have social or ID, they can use a phone number to register |
| Starr County | Saenz Medical Pharmacy | Any ID with a photo is acceptable to verify age |
When looking at Table 1, one should consider that while most providers seemingly are properly providing the vaccine to everyone eligible, there are still plenty who are making the same mistake as UTRGV. When even one person is turned away due to their immigration status, that individual and their loved ones lose trust in critical institutions that are supposed to keep all of us safe. Before UTRGV corrected course, they had rejected “approximately 14 individuals.”
This conflicting, confusing information can be in effect a denial. Take the story of a woman who registered to receive the vaccine at CVS in Mission, Texas. (To protect her privacy, her identity is confidential to LUPE.) The woman registered online with CVS and left the field for social security number and state-issued driver’s license blank. The system assigned her appointment to a CVS pharmacy in Mission, Texas. She called the pharmacy to verify the requirements for her appointment.
“And they told me that a social security number was mandatory,” she told LUPE. “I told them I did not have one but that I had a visa. And they responded that they could not vaccinate me. After that, I called the 1-800 number and I told them the same thing, and they told me that no, I had to have a valid state ID.”
CVS effectively denied the woman twice. But she did not give up. She called LUPE for help. We asked her to attend her designated appointment and allow us to come along to document it.
At her appointment, the pharmacy staff accepted her visa, did not ask for a social security number, and treated her with courtesy when they gave her the vaccine.
Art by Josue Ramirez
Another example is the story of Gabriel. Gabriel, who is undocumented, made an appointment at an HEB in Alamo, Texas. There he was told he needed to have health insurance to receive the first dose. He was not offered any alternatives.
“There were several people there and I had waited in line for a while,” Gabriel told LUPE. “So when [I was rejected], all the people in line witnessed it. I felt bad. I felt embarrassed. It felt like discrimination, and that’s why I’m giving my testimony.”
Gabriel did not return to HEB, but he received the vaccine through a vaccination clinic in Pharr, Texas, with the help of LUPE.
With confusion, misinformation, and mistrust in public institutions at play for Latinx and immigrant members of the Rio Grande Valley community, not all people will be so persistent or reach out to community organizations for help. Neither should they have to be. Providers have an obligation to eliminate barriers to life-preserving care. Further, they are not required to supply a social security number or proof of government-issued ID to the federal government for reimbursement of vaccine administration costs. They can ask for a social security number and government-issued ID but cannot deny someone for lack thereof.
Without a consistent guarantee no vaccine provider will turn people away for being undocumented, the fear of discrimination will certainly discourage immigrants from trying to get vaccinated. With reports of low vaccination rates among Black and brown people living in the U.S., discriminating based on immigration status may force people to not get vaccinated.
Collective immunity benefits us all. We can't reach that level of protection without racial equity in the vaccine rollout. Providers who ask for a social security number and government-issued ID— without providing clear steps for people without them to receive the vaccine— are holding us back from reaching the collective immunity that protects us all. The hard-hit Rio Grande Valley is mostly Latinx and people of color. Barriers to vulnerable RGV residents receiving the vaccine threaten the health and safety of all of us.
It’s important to reemphasize that many undocumented immigrants live in regions and work in spaces that are high-risk for contracting COVID-19. Those living in Texas face the added threat of a neglectful state government that has done little to enforce measures to slow the spread of the unprecedented deadly virus.
More testimony from UTRGV
Norma Garza and her mother, both of Edinburg, attended UTRGV's vaccination clinic on Feb. 8, 2021. The clinic worker who received Norma and her mother asked if her mother had a social security number and whether she was a citizen. The worker explained that they needed to ask because the clinic was federally funded. Norma responded that she was not, explaining that a clinic representative the day before over the phone said it was okay she did not have a social security number.
At that point, a manager stepped in, asking, "So she does not have a social? And she is not a citizen?" Norma again explained what her mother was told over the phone. The manager replied, "He made a mistake. He is my employee, and it was wrong. We cannot give her the vaccine."
Norma did not give up. She knew that the Biden Administration had only days prior announced that undocumented immigrants were eligible to receive the vaccine. She explained that her mother was a Texas resident and that she lived with her in Edinburg. She offered the manager a document from her mother's doctor to that effect.
That prompted the manager to step away for help. After returning, she took another look at her mother's doctor's document and relented. The clinic worker allowed Norma's mom to get the vaccine and scheduled her for the second dose.
LUPE members picking up resources at the San Juan office | LUPE
Other targeted people
While this report centers on how ID requirements harm undocumented immigrants, the effects of requiring IDs extend far beyond one population. Strict ID requirements can create barriers for houseless people, returning citizens or formerly incarcerated individuals, farmworkers, trans individuals, and/or other groups who have historically been barred from easily obtaining an ID from the U.S. government. We urge all medical providers to take seriously how their ID policies can harm vulnerable populations.
Any policy that requires someone to present a state-issued photo ID is going to create a potential obstacle for trans people. Many trans people avoid anything that requires them to use an ID for fear of encountering harassment or discrimination if the name on the ID does not match their identity and presentation. Misinformed or transphobic pharmacies or clinic workers may unjustly turn away or discriminate against a trans person who has not legally changed their name or gender marker. Some people may avoid getting the vaccine entirely for fear of negative experiences they have had in the past.
People less likely to have access to documents necessary to secure a driver’s license or state ID include people returning home from incarceration, survivors of domestic violence, people experiencing housing insecurity, and survivors of natural disasters. Formerly incarcerated people may not always have IDs issued by TDCJ and often do not have bills or correspondence in their name. After natural disasters, identity and residency documents needed for driver’s licenses are often lost or destroyed. In intimate partner violence, an abusive spouse or partner may hoard or destroy identity and residency documents. A survivor fleeing abuse may not escape with their ID or the documents needed to replace their ID.
Without the inclusion of undocumented people, trans people, people who were formerly incarcerated, people who are unhoused, and survivors of abuse or natural disaster, we cannot reach collective immunity that protects us all.
Recommendations
FOR RGV VACCINE PROVIDERS:
- Ensure all staff is trained to not turn anyone away based on not having a US government-issued ID and social security number
- Ensure that all marketing materials promoting the vaccine are in English and Spanish make it clear that a US government-issued ID and social security number are not required
- Consider accepting our LUPE membership ID as proof of identification
FOR RGV COUNTY OFFICIALS AND HEALTH DEPARTMENTS:
- Send official notices to all vaccine providers to make sure they are not rejecting people based on not having a US government-issued ID and social security number
- Launch an educational campaign in English and Spanish for the public to know their rights
- Provide an online form and phone number for people to report if a vaccine provider is rejecting people based on not having a US government-issued ID and social security number
FOR TEXAS STATE OFFICIALS, HEALTH DEPARTMENT, AND CONGRESS MEMBERS:
- Expose and investigate providers who refuse to comply
- Release public statements making it clear that a US government-issued ID and social security number are not requirements to receive the COVID-19 vaccine
- The state should increase support for vaccine providers, counties, and cities to do community outreach so that the public is aware of their rights
FOR PRESIDENT BIDEN’S ADMINISTRATION AND THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC):
- Launch an immediate multilingual educational campaign specifically about ID and social security barriers for the public to know their rights and to educate all vaccine providers
- If a vaccine provider refuses to comply, all federal aid should be pulled until they comply
- Provide an online form and phone number for people to report if a vaccine provider is rejecting people based on not having a US government-issued ID and social security number
Credits: Testimonies by Abraham Díaz, Jesús Díaz, Gabriel, and Norma Garza; written by Dani Marrero Hi and John-Michael Torres; edited by Juanita Valdez-Cox, Daniel Diaz, Tania Chavez, Vanessa Alvarado; investigation by Esther Herrera, Marcela Alejandre, Sareth Garcia, Elizabeth Marquez, Kayla Montano, Neri Curiel, John-Michael Torres, Juanita Valdez-Cox, Tania Chavez, Norma Garza; art by Josue Ramirez; translation to Spanish by Frida López; special thanks to Gabriel Sanchez and Jorge Renaud