North Carolina is home to an estimated 325,000 undocumented immigrants. Although the state is on track for all adults to be eligible for the COVID-19 vaccine by May 1, undocumented residents face barriers—like the fear of being asked for government-issued identification.

A government-issued ID card, like a driver’s license or photo ID, is not required by the state of North Carolina to be vaccinated. According to the North Carolina Department of Health and Human Services (NCDHHS), the agency has “encouraged vaccine providers to not ask for photo ID, as this presents a barrier for many populations within [the] state, including older adults, particularly those from racial and ethnic minority groups, immigrants, and homeless individuals.”

But some North Carolinians report that NCDHHS’s recommendations are not being adhered to at vaccination sites across the state.

A Durham resident says her Peruvian father was asked to provide an ID to be vaccinated in the Ballantyne neighborhood of Charlotte— the most populous city in the state, home to nearly one-third of North Carolina’s undocumented immigrants. Fortunately, he was able to use his passport. Similarly, Rev. Daniel Robayo, who serves as Missioner for Latino/Hispanic Ministries of the Diocese of North Carolina, reported that he received word from a farmworker organization in eastern North Carolina’s Harnett County that an ID was requested at vaccine sites. Ashley Deans Bauer, the community relations coordinator for the Harnett County Manager’s Office, said that the Harnett County Health Department does not require individuals to show a government-issued ID or a social security card in order to be vaccinated.

It can be detrimental to undocumented people when directives from county health officials are not adhered to on the ground. COVID-19 has hit undocumented immigrants particularly hard both nationwide and in North Carolina. These community members are overwhelmingly front-line workers disproportionately represented in industries tied to large COVID-19 outbreaks including: agriculture, meat and poultry processing, and manufacturing.

Information gaps, a lack of health insurance, language barriers, and identification have proven to be a “lethal combination.” Undocumented immigrants at higher risk of COVID-19 were afraid to seek testing or care as the pandemic unfolded due to fear of deportation. Requesting government-issued IDs at vaccine sites may also dissuade these community members from getting vaccinated. Furthermore, only 16 states and the District of Columbia allow undocumented immigrants to obtain driver’s licenses, and North Carolina is not one of them.

“It’s unnecessary to ask for identification,” Robayo said. “For the majority of people, it’s not something they think of as being a big deal. It probably was driven by the nicest of intentions as in, ‘Let’s make sure we can contact people if there’s a problem.’ But how we set these things up creates barriers that actually single out a significant number of people—the most at-risk and the most vulnerable.”  

Prism reached out to the health directors of each of the state’s 100 counties, and all of them confirmed that government-issued identification and/or a social security card are not required to be vaccinated. But a dozen counties outlined caveats that could lead to undocumented immigrants being asked to provide government-issued identification. Here is what those counties said:

• Beaufort County Health Department asks for government-issued IDs or a social security number, but it’s not required, according to director Jim Madson.
• Buncombe County Health & Human Services reported identification is “helpful” to provide during check-in and registration, but it’s not required, per director Stacie Turpin Saunders.
• Cabarrus County Health Alliance clarified that vaccine registration paperwork does include a space for a social security number, but it’s not required for vaccine administration, according to chief community health officer Marcella Beam.
• Cherokee County Health Department asks for a social security number for billing and to ensure duplicate records aren’t created, but not having a social security number would not exclude anyone from getting vaccinated, according to director David Badger.
• Haywood County Health and Human Services Agency may ask for identification at its mass vaccination site for “quicker paperwork,” but it’s not required, per interim public health director Garron Bradish.
• Lincoln County is utilizing an online appointment system and “valid identification or print-out appointment confirmation” can be used for vaccination, according to director Davin Madden.
• Martin, Tyrrell, and Washington counties ask for identification for “administrative billing purposes,” but the vaccine is still administered to those who don’t have identification or insurance, according to director Wes Gray.
• Onslow County Health Department asks COVID-19 vaccine recipients for a copy of their identification and insurance card, but “no one is denied the opportunity to receive the COVID-19 vaccine if they do not have an ID, insurance card, or social security number,” per director Kristen Richmond-Hoover.
• Robeson County Health Department bills insurance for the vaccine administration fee, so the county asks for an insurance card and proof of identity that matches the insurance card. However, if a person is uninsured, “no identification is required,” according to director William Smith.
• Vance County hospitals, doctor’s offices, and federally qualified health centers may ask for identification and insurance to the vaccination administration fee, but this only applies to those with insurance or Medicaid, according to director Lisa Macon Harrison.

NCDHHS clarified that although some vaccine providers may ask for a way to confirm your identity, they should not withhold vaccinations if residents cannot present ID. If this does happen, or community members want to report sites that are requesting identification, they are urged to call both the county health department and NCDHHS.

“The COVID-19 vaccine will be available to everyone for free whether or not they have health insurance and regardless of their immigration status,” a spokesperson for NCDHHS said in a statement. “Information is kept confidential and won’t be shared with [Immigration and Customs Enforcement] for immigration enforcement.”

The Department of Homeland Security released a statement saying federal immigration agencies will not conduct enforcement operations at or near vaccine distribution sites or clinics. NCDHHS noted that receiving the vaccine does not have a negative impact on a person’s ability to eventually adjust their immigration status.

Black and Latinx communities have been contracting and dying from COVID-19 at higher rates than white people, but white people are receiving the highest share of vaccinations, sometimes going as far as claiming vaccinations at sites intended for low-income communities of color. When it comes to vaccination rates in North Carolina, Latinxs lag far behind other racial and ethnic groups. Just 2.7% of those who have been vaccinated in the state are Latino, according to the latest numbers from NCDHHS.

Ilana Dubester, the founder and executive director of El Vínculo Hispano, said she understands that requesting identification is a complicated issue because it can be a way to ensure that vaccines are going to people in certain communities. It’s not that it’s not OK, but rather that it’s not OK to turn someone away who can’t provide an ID, she said. El Vínculo Hispano is one of the first Latinx nonprofit organizations in the rural central Piedmont Region encompassing counties that were disproportionately affected by COVID-19 as outbreaks ravaged the region’s poultry plants. Dubester, an immigrant from Brazil, was recently vaccinated through the UNC Health system and was asked for identification.

“I asked what would happen if I didn’t have an ID and I was told it wouldn’t have been a problem,” Dubester said. “But that tells me they’re probably not vaccinating enough Latinos. What I worry about is that there isn’t supposed to be an ID requirement at all, and while some [vaccination] sites say a work ID can be used, a person working under a different name won’t be able to provide that.”

Some counties appear to be trying to meet the needs of vulnerable immigrant communities. AppHealthCare, which oversees Alleghany, Ashe, and Watauga counties, said they are working “very hard” to lower barriers. This includes offering vaccinations at different times of day and doing outreach through a farmworker health program, according to health director Jennifer Greene. Franklin County Health Department Director Scott LaVigne said that his county asks that people getting vaccinated provide something legible that shows their first and last name, their address, and date of birth. While many people opt to use their driver’s license, Franklin County accepts anything that is legible and shows this information—including handwritten information on a piece of paper.

Despite the complications, conflicting information, and obstacles, Dubester said she wants undocumented immigrants to know that everybody is entitled to a vaccine for free—regardless of their immigration status.

“If you have any kind of identification—a matrícula, passport, whatever—consider taking it with you if you are worried or want to make things simpler. But please don’t worry,” Dubester said. “You cannot be turned away for not having documentation. If that does happen, call us or any other Latino organization and ask for help. We will help you get vaccinated and we will report what happened on your behalf.”

Prism contacted every county health department in the state of North Carolina to ask whether they required government-issued identification. You can check out each county’s responses here.