Navigating the COVID-19 vaccination scheduling site in Allegheny County is like taking an online final exam when none of the multiple-choice options is the right answer; a privileged few are wrecking the grading curve; and the entrance to the exam site is obscured for the poor, homeless, Black and Brown.Pennsylvania has received more than 2.7 million doses of COVID-19 vaccines but has only delivered roughly 2 million — or 73.3%. This rate is 5.5% lower than the national average. Five percent may not sound like a lot. But in this case, it is more than just the difference between Pass and Fail.
An increase to the national average (78.8%) would mean that 146,000 more Pennsylvania residents would already have received their first dose. In Allegheny County, fewer than 52,000 residents have received the full vaccination schedule and another 153,000 have received the first of two recommended doses.Looking through the lens of equity, the picture becomes clearer and more dire. In a state where 11.8% of the population is Black, only 3.6% of the vaccine recipients have been Black.
The most complex reasons for lower vaccine administrations among the county’s Black and Brown communities stem from mistrust of the healthcare system born from modern and historical betrayal prior to the pandemic. More recent barriers could resolve through shared planning with community organizations to establish strategies best for connecting to targeted communities.
Another factor that cannot be ignored starts with how the vaccine is sourced and flows to communities. There is still a national shortage of COVID-19 vaccine. Currently, information about the amount of vaccine coming to Allegheny County passes from the national level to the state department of health to the county department of health and finally to those who organize the vaccination events, leaving less than a week to plan. This short planning period and the high stakes for missing the target make it more likely that online portals will be opened publicly and communities with lower barriers will fill coveted vaccination slots.
But the most easily fixed barrier accounting for lower access to vaccines among seniors and those with limited technology access largely found in Black and Brown communities is the complexity of the registration process.
One specific solution to the wholly solvable barrier is being promoted by the Allegheny County Council to the Pennsylvania Department of Health this week — the establishment of a statewide registration system to coordinate administration of COVID-19 vaccine doses within the Commonwealth.
Use of a centralized repository of earnest vaccine-seekers made up of basic contact information and a general report of personal risk level, based on age and the presence of other health issues, was tested and proven successful during the community-led COVID vaccine pop-up clinic in Homewood on Feb. 5-6.
In 24 hours, this organically developed process utilized an easy-to-access pre-registration system that produced a 1,000-person roster of people older than 65, many of whom had tried and failed to navigate the county’s formal system.
In addition to expanding access, volunteer callers found that patients’ understanding of the process was greatly improved in that they were called for scheduling based on their eligibility, rather than having to suss out the vaccine guidelines and arrange scheduling and transportation on their own.
This recommendation for a centralized and easily navigable registration process deserves our support as it is designed to increase access and equity in the time of crisis and save lives. At the same time, the longer-term goal is that this response to an episodic challenge will lead to long-term solutions that outlive the current tests of the system.
Jamil Bey is president and CEO of the UrbanKind Institute. Jerrel T. Gilliam is executive director of Light of Life Ministries. Walter Lewis is president and CEO of Homewood Children’s Village. If you want to send a message to the authors, email firstname.lastname@example.org.