COVID-19 vaccines are not reaching those in need. Blame the broadband gap

Between school and other appointments, cousins ​​Jaqueline Teague, 16, and Amelie Beck, 14, spend their time trying to enroll senior students in Kentucky for the Vaccine for covid-19. It all started after an ordeal trying to enroll her grandparents – and then her grandparents’ friends also needed help.

So high school students in Louisville, Kentucky, created an email address and phone number and then a Facebook page, figuring that this problem was more common. They are calling it VaxConnect Ky.

“People are calling us and they only have landlines and they have no internet, no computer, no e-mail,” says Beck. “This is more common than I realized.”

At the time of writing this book, Beck and Teague have reached about 700 people as well scheduled or vaccinated and there were 900 more emails and 700 calls waiting for them. They recruited their brothers to help and contacted the governor and local senators with recommendations on how to improve access.

“It is the most important thing now to just distribute the vaccines as quickly as possible,” says Teague.

The digital divide is a huge problem for the United States, with the pandemic and the resulting blockade a stark reminder that having adequate broadband is no longer a luxury. But the process of signing a vaccine nomination, which requires browsing through labyrinthine registration sites and applications, adds a new wrinkle to a problem that affects the elderly and many black communities in the United States, where access to the internet is difficult to obtain. Result: people who need the vaccine most are having a special difficulty signing up.

About 27% of American adults over 65 do not use the internet, according to the Pew Research Center. Pew also reported that a third of black adults in the United States do not have broadband at home. ABC News reported that the situation is even worse for black elderly people. Meanwhile, the Centers for Disease Control and Prevention said that people 65 and older, as well as members of racial and ethnic minority groups, are dying at disproportionate rates of COVID-19.

Difficulties in applying for the vaccine are just the most recent way in which the digital divide is affecting the United States. Microsoft estimates that more than 160 million people are not able to use the Internet at broadband speeds. When much of modern life requires an internet signal to do everything from completing schoolwork to applying for jobs and ordering groceries, especially during the pandemic, the inability to get a vaccine online can affect people’s survival. people.

“These technology tools that are so wonderful and promising are not working for the people who really need them,” said Kelly Hirko, assistant professor of epidemiology and biostatistics at Michigan State University.

But when the US crossed the half-million COVID-19 death mark in February, people are struggling to register those who cannot register.

The bias of technology tools

Although Teague and Beck have struggled to borrow their technological skills, similar scenes are taking place across the country, as friends, family and strangers try to find compromises for those who are having trouble doing this alone.

After Jennifer Fugel, 38, of Olivebridge, New York, registered her father – who doesn’t have an email address – her friends started calling her for help.

He’s “promoting me to his friends, like ‘my daughter set me up!’ and they’re calling me like, ‘How did you do that?’ Now I’m checking CVS, Walgreens and Rite Aid daily, several times, to get appointments from his friends, make an appointment for his girlfriend and my aunt, ”says Fugel.

She is part of a Facebook group where people post tips on the availability of the vaccine and is using her ability to expedite appointment scheduling to help her father’s friends find appointments.

In Pennsylvania, there is a Facebook group that offers a Google Form to connect those who need help with those who can provide it.

Several people I spoke with compared the situation to trying to get tickets to concerts or passes to Comic-Con, which adds an additional layer of challenge: speed.

“Many of my older patients are not comfortable using the Internet,” says Muriel Jean-Jacques, associate vice president for diversity, equity and inclusion in the Northwestern Medicine department of medicine. “They can have internet, they can have cell phones with wireless access, they can have text, but they don’t use it fast, they don’t feel comfortable.”

What this highlights is the false assumption that using the Internet is inherently easy and natural for everyone. When facing tech-savvy people who are quicker to find out about the vaccine’s availability and then get appointments, some seniors will simply run out of luck.

“It is very clear that the race is not fair,” says Jean-Jacques.

Reaching communities of color

The elderly are not the only ones left behind in an attempt to vaccinate the country, partly due to inequalities resulting from technology.

Research has shown that communities of color tend to have less access to broadband. The Brookings Institute, for example, found that black and Hispanic families have lower rates of broadband adoption compared to white and Asian families. North Carolina State University showed that about 75% of people in urban areas without broadband were people of color, and too much focus on bringing broadband to rural areas may be leaving blacks out.

Meanwhile, the Kaiser Family Foundation found that adults in communities of color were less likely than white adults to say they had information about where and when to be vaccinated.

“There is a dearth of alternative forms of information being provided to people,” said AJ Adkins-Jackson, a researcher at Massachusetts General Hospital and Harvard Medical School.

Even when a local government makes an effort to bring vaccines to communities of color, it doesn’t always work. The Los Angeles Times reported that in California, special access codes created specifically for the hard-hit black and Hispanic communities to sign up for vaccines and distributed through community organizations ended up in “richer social and professional networks.”

The New York Times reported that places like medical clinics in communities of color have seen a significant increase in white people outside the neighborhood in getting online appointments. The report noted that many in poor neighborhoods are blocked by sites that are difficult to navigate, transportation problems and telephone lines that may require hours of waiting – something that may be impossible to tackle in the middle of a workday.

“Because everyone feels the pain [of the pandemic], everyone feels that they should be first in line for the vaccine, but there has to be a way to balance the receipt of something as essential as a vaccine for protection, with the greatest need for vaccination, ”said Jean-Jacques says.

When technology knowledge is not enough

In the 1960s, Mary C. Childs was an electrical problem solver working on computers when they were the size of entire rooms. She even worked on the Apollo 11 landing gear. Now 83, she was one of many who tried to sign up for a vaccine without much luck in January.

Through Childs’ combined efforts, his son Pierre Cadieux, who has worked in computing since the 1990s, plus Cadieux’s wife, spent about two weeks scouring problematic websites, filling out endless fields and struggling with confusing user interfaces before that Cadieux received a tip from a friend via Slack that some availability of appointments had opened in the area.

“Technical knowledge was not necessarily a great savior in this case, but without it, I would never have been able to start,” says Cadieux.

Childs says he has friends who are also elderly people who are waiting to receive the vaccine. They don’t know how to search for information online.

“They don’t like computers,” she says. There are “elderly people who [won’t] deepen your technical knowledge. Some of them refuse to get a cell phone. Those are the ones that are hard to reach. ”

Thụy Nguyễn, 71, has a master’s degree in computer engineering. Registering with his 77-year-old brother and 82-year-old sister, who do not use computers much and speak mainly Vietnamese, was an exercise in frustration. The Orange, California resident encountered crashes on the website, differences in information between the application and the website, and a confusing user interface.

Without it, he says “my sister and brother wouldn’t be able” to register.

Alison Lombardi, 41, from Corona, California, is a small businesswoman who says she feels comfortable working with technology. She ended up trying to help her parents, who were trying to help their parents get appointments and had to deal with a lot of confusion to finally get vacancies for their family at the Dodger Stadium vaccination site.

“I think that [my grandparents] may have ended up … giving up “, she says, thinking about what would have happened without her technical support.

Cadieux sees a prejudice in the assumption that relying primarily on a website or application is the best way to get people to subscribe.

“It is not necessarily easy for the target audience,” says Cadieux. “If you are trying to reach people who are not technically aware, or have a very broad base and reach a large amount of demographic data, you have to think about non-technical solutions.”

Filling the gap

The digital divide between vulnerable people and vaccine registrations seems wide, but researchers believe it can still be bridged. And not every solution needs to involve technology.

Montgomery County, Maryland, will begin prioritizing vaccines for the postal codes most affected by COVID-19. President Joe Biden’s administration launched a program to deliver vaccines to community health centers, specifically in underserved communities.

Jean-Jacques suggests reserving a number of vaccines to be allocated to the most at-risk communities and making better use of sites within communities, such as churches and schools – by turning them into vaccination sites that do not require prior registration.

Adkins-Jackson and his colleague Tamra Burns Loeb, who is an associate associate professor at the UCLA Semel Institute of Neuroscience and Human Behavior, Department of Psychiatry and Biological Behavioral Sciences, spoke about billboards and information posts in places such as shop windows. And not just by imposing information on people, but by creating spaces, especially for communities of color that may have some reservations based on long-standing racial injustices in medicine.

“To be able to make informed decisions about vaccination, you need to have all the information you need to make a decision and also the ability to express and openly discuss what happened to them,” said Loeb.

Possibly, the most important thing is to create connections with the communities and build the type of infrastructure that could be activated again in the future, in case another similar crisis occurred.

“Solutions exist,” says Adkins-Jackson, “They exist, but [not] without creating strong relationships and connections with the community. ”