COVID-19 vaccine bypasses some older people

Jean Andrade, an 88-year-old woman who lives alone, has been waiting for her COVID-19 vaccine since she became eligible for state guidelines almost a month ago. She assumed her social worker would contact her to get one, especially after spending nearly two days trapped in a power recliner during a recent power outage.

It wasn’t until she saw a TV report about the competition for the limited supply of shots in Portland, Oregon, that she realized no one was scheduling her fix. A grocery delivery service for the elderly confined to the home eventually provided a leaflet with information about the vaccines, and Andrade asked an aide who spends four hours a week to try to make an appointment for him. .

“I thought it would be a priority when you were 88 and someone informed me,” said Andrade, who has lived in the same house for 40 years and has no family member who can help. . “You ask anybody else that’s 88, 89, and nobody has anyone to help them, ask them what to do. Well I still have my brain, thank goodness. But I am very angry.

Older adults have top priority in getting COVID-19 vaccinations around the world right now, and hundreds of thousands of them are spending hours online, seeking help from their children and traveling for hours. in remote pharmacies in a desperate attempt to obtain a COVID-19 vaccine. But countless numbers like Andrade are left behind, invisible, because they are too overwhelmed, too fragile or too poor to fend for themselves.

The urgency of reaching this vulnerable population before the nation’s attention turns elsewhere is increasing as more Americans in other age groups and priority groups become eligible for vaccines. With time passing and with many states extending vaccines to people as young as 55, nonprofits, churches and advocacy groups are scrambling to find isolated alumni and get them vaccinated before they have to compete. with an even larger pelvis – and are potentially overlooked as a vaccination. the campaigns advance.

An extreme imbalance between vaccine supply and demand in nearly every part of the United States makes getting a vaccine a gamble. In Oregon, Andrade rivals up to 750,000 residents aged 65 and over, and demand is so high that weekly dose allocation appointments in Portland are shut down in less than an hour. On Monday, the city’s flooded vaccine information hotline was closed at 9 a.m. and online booking sites collapsed.

In the midst of such a frenzy, the vaccine rollout at home and abroad has strongly favored healthier older people with resources “who can jump in their cars anytime and drive two hours,” while more vulnerable older people are neglected, said James Stowe, director of services for aging and adults for an association of city and county governments in the bistate region of Kansas City.

“Why weren’t they the goal of our efforts, the very heart of what we wanted to do? Why didn’t he include this group from the start?” he said of the most vulnerable seniors.

Some of the older people who have yet to receive vaccines are so out of touch that they don’t even know they are eligible. Others find they are eligible, but without internet service and often email accounts they don’t know how to make an appointment and can’t get one anyway – so they haven’t tried. .

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Still others have debilitating health issues that make leaving home an overwhelming task, or they are so terrified of exposure to COVID-19 that they would rather not get the vaccine than risk venturing out. in public to get vaccinated.

In Kansas City, Missouri, 75-year-old Pat Brown knows she needs the vaccine because her asthma and diabetes put her at a higher risk of serious complications from COVID-19. But Brown didn’t try to make an appointment and didn’t even know if they were still offered in his area; she says she’s too overwhelmed.

“I don’t have a car, and it’s hard for me to get around. I just don’t like going to clinics and have to wait because you have to wait so long,” Brown said, adding that she was in constant pain from spinal arthritis. “I couldn’t do it. My back would give out… and I don’t have the money to take a cab.”

The pandemic has also shut down senior citizens’ centers, libraries and churches – all places where older Americans could stay visible in their communities and get information about the vaccine. And some public health departments initially relied on mass emails and texts to alert residents they were eligible, missing huge portions of the elderly population.

“Do you think everyone has access to the Internet? Do you really think everyone has an email?” Denise LaBuda, spokesperson for the Central Oregon Council on Aging, said. “We just don’t know where they all are. They have to put up their hands – and how do they do it?”

To address disparities in access, the Biden administration said on Wednesday it would partner with health insurance companies to help vulnerable seniors get vaccinated against COVID-19. The goal is to soon vaccinate 2 million of the most at-risk elderly people, said White House special advisor on coronavirus Andy Slavitt.

Slavitt says insurers will use their networks to contact Medicare beneficiaries with information about COVID-19 vaccines, answer questions, find and schedule first and second dose appointments, and coordinate transportation. The focus will be on reaching people in medically underserved areas.

Nonprofits, churches, and senior advocates have already spent weeks figuring out how to reach underprivileged Americans over 65 through patchwork and grassroots efforts that vary widely by location.

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Some are teaming up with charities like Meals on Wheels to spread vaccine information or grocery delivery programs like the one that alerted Andrade. Others use library card lists, senior center membership lists, and voter registration databases to find disconnected seniors.

Reaching out through organizations and faith groups that marginalized older Americans already trust is critical, said Margaret Scharle, who has developed a vaccine awareness toolkit for her Roman Catholic parish in the Oregon. The “low-tech” approach, which other charities have begun to use, relies on door calls, paper brochures and scripted phone calls to communicate with residents over 65.

“Once you’ve been blocked so many times trying to make an appointment, you risk giving up. So we are working as hard as possible to penetrate the most marginalized communities, to activate the networks that already exist,” he said. said Scharle, who, after the first contact, offers assistance with making appointments and transport.

In Georgetown, South Carolina, a rural community where many of the 10,000 residents are descendants of slaves, the local NAACP is using its lists from a free-voting campaign in November to bring in older citizens to get vaccinated. Section president Marvin Neal said they were trying to reach 2,700 people to let them know they were eligible for a photo and offer help with scheduling a date.

Many of these people do not have internet service or transportation, or suffer from medical conditions like dementia, he said.

“Some aren’t even aware that the vaccine is even in their community, that’s the challenge,” Neal said. “It’s like they’re just throwing their hands up and hoping someone would step in.” Because everyone I’ve spoken to wants the vaccine. I haven’t had one yet that didn’t say, “Sign me up.” ‘”

Outreach workers also identify loopholes in the system that prevent the most vulnerable older people from accessing vaccines. For example, a telephone call service in a rural part of Oregon does not take passengers beyond their city limits, which means they cannot get to the mass vaccination site in Oregon. their county. In the same region, only the largest city has a public bus system.

These obstacles highlight what outreach workers see as a huge demand for mobile vaccination clinics. Some local governments and nonprofits are partnering with paramedics and volunteer groups specializing in disaster response to immunize hard-to-reach older people.

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In South Carolina, pharmacist Raymond Paschal bought a $ 3,000 van and refrigerator to open a mobile clinic for underserved areas, but his independent Georgetown pharmacy cannot get any vaccines.

“There are a lot of people falling through the cracks,” Paschal said. “These old people who still haven’t received their vaccine, they’re going to have this whole younger generation to compete with. So we have to go to these old people first.”