For the approximately 476,000 undocumented immigrants living in NYC, multiple barriers are creating gaps in vaccination rates among undocumented immigrants. The lack of accommodation for undocumented immigrants in the U.S. health system furthers the narrative that undocumented immigrants are ineligible to receive a vaccination for free and will risk deportation. Many fear that if they are vaccinated the healthcare system will notify immigration authorities and trigger the public charge rule, meaning they have become or are likely to become dependent on the federal government for subsistence.
Based on data and available information, getting vaccinated does not trigger a public charge and, in fact, may be necessary to apply for documentation in the United States.
“Public charge in simple words is when an immigrant becomes, or is likely to become, primarily dependent on the federal government for subsistence. The benefits that usually trigger that determination is the public cash assistance, Supplemental Security Income (SSI), or long term institutional care,” explained Sonia Mansoor, senior manager of public benefits at Sanctuary for Families (SFF).
Marc Valinoti, coordinating immigration attorney of the Northern Manhattan Improvement Corporation (NMIC) explained that “if you are bringing someone into the country like a relative or spouse and legalizing them here, you would have to show that as the person who is here with status, you have the income and resources that at least for a several year period, the person you are bringing in would not become reliant on government resources. That they would not become a public charge.”
However, public charge does not apply to all immigrants. Congress has created certain exemptions to the public charge ground of inadmissibility including refugees, asylees, some nonimmigrant visa applicants including victims of domestic violence and/or human trafficking, and self-petitioners under the Violence Against Women Act (gender-based violence survivors).
“Public charge is a concept that is very old,” explained Valinoti. According to the USCIS website, public charge has been a part of U.S. immigration law for more than 100 years. However, a lot of the fear about triggering public charge came under the Trump administration, according to Mansoor. “This is why politics are important when it comes to health care, because every time there is a Draconian law like the 2019 Public Charge Rule, it sends chilling effects within the immigrant community and it takes a lot of time and effort to undo those chilling effects.” Dr. Goleen Samari, assistant professor of public health at Columbia University, explained that the drastic shift between the 2019 rule and the “current rule has caused lots of damage in trust for undocumented individuals, as well as understanding what version of the rule is currently instituted.”
Under the 2019 Public Charge Rule that was instituted under Trump, in addition to cash-based benefits such as SSI and institutionalized care, Medicaid, housing assistance, and food stamps were added as public charges. The intensity of the 2019 rule still radiates fear among immigrant communities, according to Mansoor.
It is important to note that the 2019 public charge rule is no longer in effect.
“There are very different soundbites in this administration. They are trying to rebuild trust with the immigrant communities.” Mansoor explained the differences in the nature of public charge under the Trump administration versus the Biden administration. Under the current public charge rule, only public cash assistance and long-term institutional care are considered a public charge.
The USCIS released information about public charge and COVID-19, clearly stating that receiving a COVID-19 vaccination does not impact an individual’s immigration status. The agency actually encourages vaccination, regardless of immigration status. “You can continue to receive the care you and your family need to protect your health and limit the spread of COVID-19. We do not consider vaccinations when making public charge inadmissibility determinations. In fact, we encourage everyone, regardless of immigration status, to receive the COVID-19 vaccine.”
Michelle Molina, deputy director at El Centro Del Inmigrante, spoke to the AmNews and provided insight on how the organization’s clients, who are undocumented, perceive the public charge issue. Molina explained that her clients’ willingness to get the COVID-19 vaccine was impacted by public charge because it was still a concern. “Clients were impacted to the point that they refused to access certain services because of the fear,” she said.
Molina further explained that because El Centro initiatives aided in creating a sense of trust through word of mouth, the effect that the organization and its work had within the undocumented community was felt through the number of undocumented people that went to the vaccination clinic that El Centro hosted. Since vaccines became available in late 2020, the organization has vaccinated over 5,000 people at their on site clinic.
To explore the threats of deportation for seeking health services the AmNews spoke with Pooja Asnani, director of immigration project for Sanctuary for Families, a non profit service provider, who explained a principle of law, known as reliance, and its impact on public charge. “Reliance dictates that if you were given information by a reliable source, and you relied on that, you cannot be then penalized at a later point.”
Given existing barriers and misinformation, it is understandable that vaccine hesitancy exists, but the COVID-19 vaccine is essential to staying healthy. The COVID-19 vaccine protects your health by creating an antibody response without you having to potentially experience the severe illness or post-COVID conditions.
Valinoti explained that people in the service industry, an industry disproportionately made up by undocumented immigrants, were being laid off when businesses were forced to close during the pandemic. As soon as businesses started to reopen, vaccines were required to return to work, but because of existing fears and hesitancy, many undocumented individuals feared getting the vaccine. The inability to return to work made many undocumented immigrants food insecure and financially unstable.
In addition to the health benefits, the COVID-19 vaccine is required to apply for a green card or permanent residency. “The last step of the process is always to have a doctor do a physical exam which includes vaccination history, which includes the COVID-19 vaccine. This is then submitted as a sealed document to USCIS,” Valinoti explained.
To promote trust-building and combating fear, the NYC Health Department has multiple resources in place to facilitate vaccinations among undocumented immigrants.
Dr. Olusimbo Ige, assistant commissioner in the Center for Health Equity and Community Wellness at the New York City Department of Health, explained that none of the NYC sites are allowed to ask for immigration status. Also, to further secure privacy and information, medical providers are prohibited from sharing any personal identifying-information about an individual who gets vaccinated. While aggregate data on the number of vaccinations is shared, personal information about people receiving the vaccine is not.
The New York City Department of Health provides accessible transportation to and from vaccination sites for people with disabilities and those who are 65+ years of age. There is also an at-home vaccination option, which can be arranged by calling 877-829-4692. Lastly, to answer any questions and concerns about the vaccine, the DOH has a hotline (212-268-4319) available in several languages.
COVID-19 testing and vaccination resources can also be accessed on the AmNews COVID-19 page: www.amsterdamnews.com/covid/
An insightful article that highlights the impact of change in Public Policy on
Immigrants. The interviews of practitioners especially Sonia Mansoor informs the reader of ground realities.