A woman receives a vaccination card at a clinic in Langley Park.
Anyone over the age of 16 who lives or works in the District is now eligible for a coronavirus vaccination. But as public health and community leaders embark on the campaign to get the general population vaccinated, D.C. is still struggling to get shots to local seniors, who have been eligible for months.
The problem is especially acute in areas of the District with higher numbers of Black and Brown residents. In majority-Black Ward 8, for instance, just 40% of seniors have been fully vaccinated, compared to 60% of seniors in wealthier, whiter Ward 3. Overall, about 50% of D.C. seniors have been fully vaccinated.
Advocates say the disparity is a symptom of the longstanding lack of investment in those neighborhoods, including inadequate access to technology, information, and transportation.
"I think it's unfair to expect people to want to participate and get to the level of herd immunity when for decades...with this system that we set up [people] felt like they were shut out," says Salim Adofo, a Ward 8 advisory neighborhood commissioner. "Nobody cared to get them engaged or involved. And now we're in this space."
That dynamic, Adofo says, is exacerbated by what he thinks is an overreliance on social media to distribute information about the vaccine rollout — particularly when it comes to seniors, who may not own a smartphone or have a reliable internet connection.
"I think that the city would be best served if they could employ some more grassroots tactics and just knocking on doors, being out in the community and just talking to people to try to get them to get registered, as opposed to heavily relying on social media," he says.
D.C. has a number of initiatives designed to reach people where they are. The Senior Vaccine Buddies program has met more than 1,000 seniors in person to help them navigate the pre-registration process and schedule appointments online. The Faith in the Vaccine initiative, which partners with local houses of worship to get information out and host clinics, has given shots to 2,900 people, with plans for new clinics in future. The D.C. Housing Authority, along with DC Health and medical partners, has vaccinated more than 2,500 residents in DCHA-owned properties and DCHA customers in Wards 5, 7 and 8.
The District had plans to create a mobile vaccination unit, aimed at getting shots to seniors who are homebound. That's on hold now, however, after federal authorities called for a pause in administering the one-shot Johnson & Johnson vaccine.
"While there is still a discrepancy in demand for the vaccine among different communities, DC Health is working with Community-Based Organizations (CBOs) for more community engagement," a spokesperson for the department writes in an email. "Ensuring an equitable approach to vaccine administration in the District is incredibly important. The range of special initiatives the District has launched has been focused on identifying and vaccinating individuals who otherwise would not have received the vaccine via their healthcare provider or vaccinate.dc.gov."
For seniors who can't access these services, the main infrastructure for getting a vaccine appointment remains the District's online pre-registration portal, which requires a smartphone or computer to access. Once people input their information into the system, they are then invited to book appointments based on a randomized process, which allocates slices of the total pie to different groups — 20% to seniors, 30% to essential workers, 30% to people with qualifying medical conditions, 20% the general public. Half of each category goes to people in zip codes where vaccination rates are lagging. Everyone has 48 hours to book their appointment after they receive an invitation.
Currently, about 181,000 people are pre-registered in the District system and waiting to receive an invitation to book an appointment. D.C. officials say seniors who pre-register now will be prompted to schedule their vaccination for the following week.
"For all those 181,000, there are thousands who aren't registered at all and aren't in line for an appointment," Mayor Muriel Bowser said in a press conference on Tuesday. "I don't want us to lose sight that we still have a lot of work to do to get people registered."
Many people who are pre-registered end up not making appointments when they get the chance. In late March, the District released information suggesting that about 40% of seniors in priority zip codes didn't follow through in booking an appointment, though they received notifications by email or phone. By comparison, less than 25% of essential workers and people with qualifying health conditions failed to respond to invitations to book an appointment.
"You may have a loved one who's helping you, and you may not even have access to that individual, that loved one, at all times," says Nekkita Beans, the special projects coordinator at the Far Southeast Family Strengthening Collaborative, a nonprofit serving families in Southeast D.C.. "And so if you're with him, you're getting registered or put into the system. But it may not necessarily be the time for you to go back into to schedule the appointment. That creates an additional barrier."
The technological access problem was especially apparent in the early days of the vaccine rollout, when seniors were first eligible. At the time, the District didn't have a pre-registration system and was simply making a limited number of appointments available all at once on a glitch-ridden web portal. Some seniors say the chaos of that system turned some residents permanently off of trying to book appointments.
Because some seniors are frequently busy taking care of their multigenerational families, Beans says it's crucial that the system work in the precious few moments when the stars align and they manage to log on.
"Oftentimes our seniors don't have the luxury to prioritize their health care when they are fighting for the lives of their families," Beans says. "So when they get to that point where you have them excited, you're ready to get them signed up ...and then they get on to the system and it doesn't work. Just to me, it says to them, 'This system isn't made for you.'"
When Beans, Adofo and other community partners teamed up to host a vaccination event in Ward 8 at the beginning of April, she says they designed the registration system specifically for the families the collaborative serves, taking people's information via a simple, mobile-friendly landing page and a phone number to call.
"What is going to be the easiest for our families, how can we meet our families where they are instead of establishing a process and hoping they will fit in, hoping they will find their place, hoping they will be able to navigate their own way?" was the guiding question driving the project, Beans says.
It worked: they ultimately gave shots to 889 people in a single day.
Beans says she thinks D.C. is on the right track with the Faith in Vaccines program and other on-the-ground outreach efforts, but she sees more potential for the District to collaborate with community partners — particularly since the racial gaps in vaccine distribution persist, months into the rollout.
"We want to see the city continue to leverage us and our relationship and our direct connections to the residents," she says.
"It's going to take an all-hands-on-deck type of approach to get the word out," he says.
This story is from DCist.com, the local news website of WAMU.