By Patricia Vinchesi, ICMA NE regional director and Tad McGalliard, director, research and development

The long-awaited receipt of the COVID-19 vaccine is finally here and the distribution and administration of the roll-out, like many aspects of the pandemic response, has varied widely from state to state. Similarly, state governments, health care providers, counties, and communities, have instituted different policies and protocols to inform their residents of how to obtain the vaccine under various phases. These procedures can range from advance registration to luck-of-the-draw while shopping for groceries, depending on the requirements -in place.

While obtaining the vaccine may be situational, for some, certain universal obstacles remain. As was the case during the initial outset of the pandemic when businesses and schools had their operations significantly reduced or shuttered completely, issues of access and equity have emerged. This continues to be especially apparent around broadband. As was witnessed with the immediate onset of remote work and distance learning, rural communities and lower income groups remain critically disadvantaged by not having digital access either through available infrastructure for internet connections in the former, or financial limitations in the latter. While it is still unknown to what extent these two situations might pose relative to equal access to the vaccine, it is already apparent that at least a portion of one segment of the population is facing some obstacles–seniors.

What was eagerly anticipated is now causing added anxiety and stress. That is because to date, most procedures for obtaining the vaccine require some form of online registration. And for many seniors, ownership of, or access to, a personal computer is not prevalent. Similarly, vaccine notifications are often sent via text messages on cell phones, another communication device that many seniors typically do not use as their first source of information. According to a Pew Research Center study from 2019, 73% of American seniors over the age of 65 were “internet users.” The study also revealed that only 53% of people in the same age bracket were smartphone owners. But this latest data on 65 and up age bracket aggregates different behaviors at the lower and upper ends. Earlier research by Pew found, for example, that younger seniors were twice as likely than those 80 and above to go online or have broadband access, and four times as likely than their older counterparts to own a smartphone.

Providing Assistance with Vaccine Sign Up

To fill this gap, adult children, caregivers, family friends, and others are making arrangements for their parents and other loved ones to register and obtain the vaccine. For many, this process has been fraught with difficulties and frustrations. Many hoping to sign up for vaccines report trying for hours to schedule an appointment, eventually giving up. Even those with some technological acumen report having some difficulty with navigating various sites as well as trying to find locations, sometimes far distances from their homes. Unfortunately, many may be abandoning tries and waiting several days for second attempts.

Local Governments Are Reaching Out

For those without someone to shepherd them through the process, local governments have once again developed innovative ways to reach out to the community to take care of their residents. Most communities have excellent data on how many seniors they have and where they live. Employees know what locations are most accessible and familiar to residents for providing services and convenient for scheduling.

Hanover, New Hampshire (Julia Griffin, town manager, population 8,508), in accordance with state guidance, is developing a program along with the members of its UV Public Health Region covering 12 communities. Their directive is to identify seniors who are either living in congregate settings (i.e., retirement communities, HUD-subsidized housing facilities) or are living alone and may not be capable of registering for the vaccine or scheduling an appointment online. Staff have already identified one key contact person in each of the town’s senior residences–those apartment and condo complexes that serve seniors but are not congregate or assisted living facilities and were not, therefore, vaccinated as part of the first phase of the state’s vaccine roll out. The town’s goal was to have an individual(s) who would act as a conduit to communicate with, who could help fellow residents get registered, and who would work with town officials as it set up a mobile vaccination unit of firefighter/paramedics and other medical volunteers from the Medical Reserve Corps to bring vaccine shots to the residents. The Public Health Region teams are composed of local fire chiefs, the regional public health coordinator and staff, the medical center, and community nurses.

As a second piece, the town’s community nurse and public health officer are working with any senior who reaches out for help if they live alone or with a spouse and have trouble navigating the online system. The town will be issuing messages to residents via its E-News media alert. But is also recognizes that since many seniors have technology challenges or don’t even receive the alert, they are also reaching out to key contacts in the community that work directly with senior residents on a regular basis. Local physicians and clergy have been engaged to increase outreach and the senior center coordinator is focused on this outreach element. The biggest challenge now and for the foreseeable future, however, will be the limited number of doses allocated to meet the need.

Other communities are likewise seeing the challenge and taking steps:

• The Knox County (Tennessee) Health Department has now changed its registration process for those 75 and older, ensuring that a portion of their reservation slots are saved for people who are only able to make reservations via telephone.
• Greenburgh, New York, is organizing a volunteer network to assist seniors with the online registration process in New York state. Other communities are likewise seeing the challenge and taking steps. According to Town Supervisor Paul Feiner, the program has 175 volunteers and will be reaching out to more than 3,000 seniors in the community.
• Revere, Massachusetts, has launched a “reach every senior” program targeting the town’s 8,000 residents over the age of 65 to help with vaccination registration and more. More than 30 volunteers have been enlisted to support the program. The city also plans to use mobile vans and volunteers stationed in high traffic areas to get seniors the information they need about registration.

Volunteer Coordinators Are Stepping Up

Elsewhere, entities outside the local government have taken a leading role in volunteer coordination:

• A student group at George Washington University has rapidly mobilized student volunteers and matched them with seniors who need help getting registered for vaccines.
• In some communities, senior centers are coordinating efforts to facilitate registration or directly assist those that may not have friends or family. In Norwich, Connecticut, volunteers with the municipal human services department and Norwich public schools have started making phone appointments with seniors to help them sign up for the vaccine. They set up an email account for seniors seeking help, sign them up on the state’s website, and monitor the account for any emails on appointment times. The senior center manager maintains an Excel spreadsheet to keep track of everything.
• The Volunteer Vaccine Registration Assistance Team, a newly developed volunteer network in New York, has enlisted tech-savvy volunteers to help seniors get their shots scheduled through New York state’s systems. A similar network was started in Florida with a Facebook page by two health professionals and has grown in number of volunteers supporting the effort.

If the digital divide for seniors is an issue in the city or county, managers could consider leveraging the ecosystem of social service and community organizations in their jurisdiction and region including senior and community centers; ecumenical organizations; student groups at local colleges and universities or even high school volunteer groups; and area agencies on aging and AARP chapters. Just as these and many other organizations have pivoted to meet community needs throughout the pandemic, vaccine registration for technology challenged stakeholders is another area for managers to augment their own programing by leveraging internal staffing, volunteers, and partnering organizations.

The amount of staff attention and organizational meticulousness for just this one aspect of the community population is daunting. Yet it will also help set the stage as other phases of the vaccine become available in the late winter and spring.