<\/a><\/p>\nRight now, the priority for many states is scale. Some are setting up mass vaccination sites at public venues like stadiums to get as many shots into arms as possible, as fast as possible. However, some health experts argue that in addition to going big, communities should also go small, working through local clinics and community groups in order to reach the most vulnerable. It may come at the expense of speed, but it would help ensure equity in who\u2019s getting vaccinated for Covid-19. <\/p>\n
Vaccinating the most vulnerable people requires active outreach<\/p>\n
No community or demographic has been spared from the Covid-19 pandemic. More than half a million Americans have died from the disease, and many more have gotten sick. But some groups are getting hit harder than others, and it\u2019s not just the elderly.<\/p>\n
\u201cThroughout the pandemic, people of color have consistently been disproportionately sickened and killed by the virus,\u201d wrote Youyou Zhou and Vox\u2019s Julia Belluz in a recent piece. \u201cThey also died young: Of Covid-19 deaths in people under the age of 45, more than 40 percent were Hispanic and about a quarter were Black.\u201d <\/p>\n
These same groups are also less likely to interact with the existing health care system and are more likely to face impediments when seeking the vaccine. Technology is one barrier that\u2019s emerged in several states. For example, the online booking system for vaccine appointments in Arizona seems to be favoring some groups over others. <\/p>\n
\u201cWhen appointments become available, it\u2019s like a gold rush,\u201d said Will Humble, executive director of the Arizona Public Health Association and a former state health official. \u201cIf you work at a grocery store or don\u2019t have wifi, you\u2019re at a big, big disadvantage.\u201d<\/p>\n
Arizona has set up mass vaccination sites around major metropolitan areas. That\u2019s helping the state boost its numbers \u2014 about 15 percent of its population has now been vaccinated \u2014 but many of its most vulnerable people haven\u2019t been able to sign up for the limited appointment slots during the few short hours when they\u2019re open. Some also aren\u2019t able to drive to these sites from their homes, according to Humble. <\/p>\n
\u201cThe effect of that [mass vaccination strategy] was yes, it did speed up the administration of vaccine, but it also has disproportionately served high-income people,\u201d Humble said. \u201cWhat vaccinators tell me is they are vaccinating Teslas and Tahoes all day.\u201d <\/p>\n
According to a Kaiser Family Foundation assessment on February 18, about 12 percent of Arizona\u2019s white population has been vaccinated so far against Covid-19, compared with 4 percent of Black people, 3 percent of Hispanic people, and 9 percent of Asian people.<\/p>\n
Another issue for Arizona, like in many states, is that remote regions may not have the resources to administer both of the Covid-19 vaccines that are currently available in the US. While the Moderna vaccine has less stringent freezer demands, the Pfizer\/BioNTech Covid-19 vaccine requires ultra-cold storage, so it\u2019s being allocated mainly to larger counties that have the facilities to store it.<\/p>\n
Humble said that one way to improve the system would be to have a one-time sign-up and then a weighted lottery to allocate appointments, so people with fast fingers, fast internet connections, and free time wouldn\u2019t have such an overwhelming advantage. <\/p>\n
But getting to some of the most vulnerable also requires active outreach. \u201cWe\u2019re doing a real grassroots approach to this, which requires us going to the communities … literally knocking on doors,\u201d said Tomas Ramos, the founder of the Bronx Rising Initiative, a group helping vaccinate Bronx residents against Covid-19. \u201cWhat I get when I knock on the door and speak to an elder, they just don\u2019t even know when to start. That\u2019s where we come in.\u201d<\/p>\n
Bronx Rising Initiative is working on raising funds for local clinics to increase capacities for Covid-19 vaccination, and also for setting up remote vaccination sites in public housing. In addition, the group is seeking out seniors and other vulnerable people to sign up for vaccine appointments, following up with reminders and helping them arrange transportation if needed. <\/p>\n
Many of the initiative\u2019s volunteers are from the Bronx, too. And that helps build trust, fight vaccine misinformation, and coax reluctant Bronxites to get immunized. <\/p>\n
\u201cWe are from the community, so when [volunteers] knock on the door, [residents] see someone that lives in the same community talking to them about it,\u201d Ramos said. <\/p>\n
Local health clinics can close gaps in vaccinations, but they need doses first<\/p>\n
Many communities around the country have had months to set up their programs to administer Covid-19 vaccines. But supplies remain limited, and there is a frustrating lack of information about when they\u2019ll be replenished.<\/p>\n
\u201cWe have the whole infrastructure to give it,\u201d said Julie Vaishampayan, the public health officer for Stanislaus County in California. \u201cWe\u2019re getting it out into pretty good arms, but we\u2019re not getting it out to every eligible arm and we\u2019re not quite sure who we\u2019re missing.\u201d<\/p>\n
Another complication is that local health officials have to jump through hoops to order vaccines from the county, state, or federal government. And it\u2019s not always transparent where these vaccines are going, so health workers on the front lines don\u2019t have much time to prepare. When vaccines do arrive, local health officials have to identify eligible recipients, round them up for appointments, administer the shots before they expire, and keep track of patients to make sure they get their second doses. There can be overlap between different areas of health coverage, so even if someone is a perfect candidate for a vaccine, it can be hard to tell which group or agency is in change giving them a shot. <\/p>\n
\u201cI can\u2019t see the vaccine that\u2019s coming from the federal government or the state government,\u201d Vaishampayan said. \u201cI don\u2019t know who it\u2019s going to. I don\u2019t know how many doses they\u2019ve received. I don\u2019t know how many doses they\u2019ve given. It makes it really difficult to set up a network or providers who are going to reach your population.\u201d<\/p>\n
A central information hub that tells local health officials how vaccines will be allocated up to a week in advance would go a long way toward optimizing distribution, according to Vaishampayan. Currently, many health departments have to deal with much shorter lead times for receiving vaccines. <\/p>\n
One potential bit of good news is that the Covid-19 vaccine developed by Johnson & Johnson may get emergency approval from the Food and Drug Administration this weekend. Not only would a third vaccine help bolster the supplies, the Johnson & Johnson vaccine requires only one dose instead of two and can be stored at ordinary refrigerator temperatures.<\/p>\n
That vaccine would be particularly suited to smaller family practices and community clinics, which are less likely to have ultra-cold freezers. These types of facilities may have a lower throughput of vaccinations (since they are equipped to handle fewer patients and may not have the facilities to stockpile vaccines), but they may be able to better identify the people in greatest need of a Covid-19 vaccine.<\/p>\n
Having a one-dose Covid-19 vaccine that can be stored in an ordinary medical refrigerator would allow these clinics to join in and expand the scope of the vaccination campaign.<\/p>\n
\u201cWhen we get to that vaccine, all of sudden there is a real opportunity for the average family doc or primary care person,\u201d said Savoy. \u201cIf we ever had a vaccine to actually distribute and had one we could have at the practice and store it, we would have a whole network of people ready to go.\u201d<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"
The good news is that the rate of Covid-19 vaccinations in the United States is increasing, while the rates of new infections, hospitalizations, and deaths are slowing. As of this week, more than 66 million doses have been administered to at least 42 million Americans, about 13 percent of the population. But the disease is…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-9843","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/posts\/9843","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9843"}],"version-history":[{"count":0,"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/posts\/9843\/revisions"}],"wp:attachment":[{"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9843"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9843"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9843"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}