How Inequity Gets Built Into America’s Vaccination System
People eligible for the coronavirus vaccine tell us they are running up against barriers that are designed into the very systems meant to serve those most at risk of dying of the disease. We plan to continue tracking these roadblocks.
 
It’s a fact that simply being eligible for a vaccine in America doesn’t mean that you can instantly get one. Yet the ability to get to the front of the line isn’t the same for everyone. ProPublica has found that, whether intentionally or not, some vaccine programs have been designed with inherent barriers that disadvantage many people who are most at risk of dying from the disease, exacerbating inequities in access to health care.
 
In many regions of the U.S., it’s much more difficult to schedule a vaccine appointment if you do not have access to the internet. In some areas, drive-through vaccinations are the only option, excluding those who do not have cars or someone who can give them a ride. In other places, people who do not speak English are having trouble getting information from government hotlines and websites. One state is even flat-out refusing to allow undocumented workers with high-risk jobs to get prioritized for vaccination.
 
The vaccine supply is too low to inoculate everyone who is eligible, and competition for appointments is fierce.
 
“My nightmare scenario is that we have this two-tiered health system where there are people who are wealthy, privileged or connected, and then there's everybody else,” Dr. Jonathan Jackson, director of the Community Access, Recruitment, and Engagement Research Center at Massachusetts General Hospital and Harvard Medical School, told ProPublica. “Once we hit that saturation point where the first tier has all gotten their vaccines, the narrative will shift to blame. It'll be ‘Why haven't you taken care of this yet?’”
 
For People With Disabilities, It Can Be a Struggle Just to Access Their Appointments 
 
From the moment her 69-year-old father, Jose Balboa, became eligible for the vaccine in January, Kristine Mathason spent part of each day on the phone and online trying to get him a shot. She found available appointments a few times, but couldn’t find a way to actually take her father to the vaccination sites. Balboa is paralyzed on his left side after a stroke and needs a wheelchair to get around. In Miami, where he lives, most vaccine sites are drive-up only.
 
Mathason doesn’t have a van that can accommodate Balboa’s wheelchair, and she isn’t able to lift her father out of it. To move him between his bed and the chair, his home health aides use a patient lift. This isn’t possible when trying to get him into a car, Mathason said, as the door gets in the way of either a lifting device or two people trying to support him at once. In the past when family members tried to move him, Balboa fell.
 
Mathason said she was “willing to jump through all the hoops” to get Balboa the vaccine. “He’s super high-risk: He’s diabetic, he had a stroke 17 years ago,” she said. “He has high blood pressure. My half brother who lives with him works at a restaurant, so that’s like a high-risk job. We do our best.” 
 
If You Can’t Access or Navigate the Internet, You Might Have Fewer Options 
 
Eneyda Morales, a 40-year-old mother of three in East Hampton, New York, was diagnosed with breast cancer two years ago and is still undergoing treatment. Four days a week, she works at a bagel shop near her home. “I’d like to get a vaccine because of the health issues I have and because I work in a place where I have to serve people,” Morales said in Spanish. But she’s not sure how she’s actually going to get a vaccine; while many Americans are hunting for information online, Morales doesn’t own a computer, nor does she know how to use one. She has a smartphone, but she primarily uses it for simple searches like looking up addresses. The only computer at her home is the one her 8-year-old daughter’s school provided for classwork. 
 
Unclear Communication Leaves People Anxious and Unable to Plan 
 
James, 82, lives in Chesterfield County, Virginia, outside of Richmond. (He asked to be identified only by his first name for privacy reasons.) Like many Americans, he turned first to his primary care physician for information about the vaccine. “I contacted my physician’s office to find out if they’d let me, as a patient, know when I’d get the vaccine, and they said, ‘Oh, no, no, we’re not going to do that.’” They instead directed him to the Virginia Department of Health. So James went on the state health department’s website. “I filled in all their little boxes,
 
and that was it — I never heard a word,” he said. “I had no idea whether I’m registered or not.” He also tried registering on his county health department’s website, and had the same experience. “You don’t know whether you’re talking to a computer or to a garbage can,” he said. “When you’re filling it in, where does the form go? I’m concerned that when I finally get to go to the vaccine site, someone’s going to say I’m not registered.” Continue Reading… 
 
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