CVS and Walgreens have a chance to make implementation of the Covid vaccine fairer

Dr. Virginia Banks says that if the United States really wants to end the pandemic, it will take mobile vans with vaccines in neighborhoods where people don’t have transportation – and even give injections in beauty salons and barber shops.

While thousands of pharmacies receive dose shipments and begin vaccinations at their stores this week, the country is taking a significant step towards reaching more Americans. Public health officials and advocates, however, say this does not go far enough in communities where people are most sick.

More black and Hispanic Americans were hospitalized and died from Covid-19. Often, they also face greater barriers to getting the vaccine: Lack of transport. A juggling of several works. Hesitancy due to mistreatment committed in the past by the medical community.

CVS Health and Walgreens will play a larger role in the effort, as a federal program sends doses to more of its stores and other retail pharmacies. The expansion represents a business opportunity for the two largest drugstore chains in the country, as they are paid for each vaccine and attract more people to the stores. The vaccine launch will also test the companies’ commitment to expanding access to health care in the black and Hispanic communities.

Banks, an infectious disease physician from Ohio, is part of an interest group at the Infectious Diseases Society of America that is made up of black doctors, scientists and public health officials focused on addressing health disparities. She said health professionals will have to be creative and show commitment. She said they should establish clinics in familiar places, such as churches, and recruit “trusted messengers” as pastors and community leaders.

“You have to look from a cultural point of view ‘Where are we?’ and come to us, “she said.

The launch of the vaccine in the United States has been slow and complex. The demand for doses far exceeded the number of shots available to inject into weapons. Online appointment systems have been difficult to navigate and overwhelmed by heavy traffic. So far, only two vaccines have emergency authorization from the Food and Drug Administration and should be stored in cold, deep-frozen temperatures. And only a few Americans qualify for the injection, with each state having slightly different criteria for weighing factors such as a person’s age, medical conditions or work.

About 48.4 million vaccines were administered in the United States as of Friday, according to the Centers for Disease Control and Prevention. Nearly 12.1 million people received both doses of the vaccine – just a small fraction of the 331 million people living in the U.S.

The country’s goal is to vaccinate between 70% and 85% of the US population – or about 232 million to 281 million people – to achieve collective immunity, according to Dr. Anthony Fauci, the president’s chief medical advisor.

The confusing implementation led some to be shot and others not. Most of the nearly 13 million people who received at least one injection of the Covid-19 vaccine in the first month of drug distribution were women, 50 years of age or older and probably not Hispanic and white, according to a CDC study.

For the distribution of vaccines, equity is not just a matter of justice. It is also a crucial way to slow down the spread in communities where Covid-19 cases, hospitalizations and deaths are greater. Black and Hispanic Americans are 3.7 and 4.1 times more likely to be hospitalized in Covid than white Americans, according to data reported by the CDC in late November. Both minority groups are 2.8 times more likely than white Americans to die from the disease.

In a hard-hit neighborhood, the impact of each shot can be even greater – reaching people who are most at risk because they work in supermarkets or other frontline jobs or live in a dense apartment or in multi-generational families.

Vaccination hesitation is also greater among blacks and browns, due to the medical community’s history of mistreating minority groups and opening up less health practices in their neighborhoods. A survey of New York residents, conducted by the Association for a Better New York, found that 78% of white residents would get the vaccine as soon as they could, compared with 39% of black residents, 54% of Hispanics and 54% of Asians.

For suppliers like CVS and Walgreens, having more doses of the vaccine is a business opportunity. They will be paid for each vaccine and the government will bear the costs if the person does not have health insurance. Jefferies estimated that each injection will have a gross margin of $ 13 to $ 15 and could yield about $ 1 billion in incremental gross profits for CVS next year.

Both drugstore chains set their strategy on adding more health services from primary care clinics to diabetes tests. They also stepped up commitments to address racial inequalities in response to George Floyd’s death and protests across the country. CVS plans to invest about $ 600 million over five years to support public policy initiatives and internal efforts, such as guiding black employees and offering free health tests for blood pressure and cholesterol in stores.

Walgreens started a pilot project in the Chicago area that aims to reduce hospitalization rates, making it easier for patients to take their medications, obtain free prescription drugs and have more regular contact with healthcare professionals about their medical conditions. She recently hired former Starbucks chief operating officer Roz Brewer as its next CEO. When she takes office in mid-March, she will be just a black woman leading a Fortune 500 company.

Karyne Jones, The CEO of the National Caucus and Center on Black Aging, based in Washington, DC, said that expanding vaccines to hard-hit communities is a way for CVS and Walgreens to “put their money where it is.” Your organization is a founding member of the Covid-19 Vaccine Education and Equity Project, a coalition of nonprofit organizations and business groups that is supported by vaccine maker Pfizer.

Jones said he would like to see CVS and Walgreens open 24-hour vaccination posts and set up tents in neighborhoods where people don’t have transportation.

“If you really want to show good corporate responsibility, this is the time to say that we have to put in resources to alleviate this pandemic,” she said.

Banks, the infectious disease doctor, said he would adopt innovative strategies, such as redirecting bus routes to vaccine clinics. She pointed to an effort in which pharmacists joined barbershops to detect high blood pressure when black men went to get a haircut – a clinical study that helped detect the condition and intervene earlier.

She said she is hopeful that the Johnson & Johnson vaccine – which requires only one dose and can be transported more easily – can change the game for distribution and make it easier to apply where people are. The company applied for emergency use authorization from the FDA last week.

“We have pharmacy desserts,” she said. “We have grocery deserts. We don’t have church deserts.”

Walgreens and CVS have given Covid vaccines in thousands of nursing homes and assisted living facilities. They administered injections in some stores after receiving doses of vaccines from the states. With the federal program, they will offer photos in more neighborhoods.

Walgreens has Covid vaccines in stores in 15 states and two additional jurisdictions, New York and Chicago. It will supply photos in 1,800 stores as part of the federal program – or about 20% of its stores in the United States, a company spokeswoman said.

CVS has them in 18 states and Puerto Rico. As of Friday, about 420 of its approximately 9,900 stores will give injections with doses from a state or federal program, a company spokesman said.

Both pharmacy chains said they had chosen stores in neighborhoods with the greatest need. About half of the stores of each company with Covid vaccines are located in areas that are medically underserved or places that are highly rated on the CDC’s social vulnerability index, which is based on factors such as poverty prevalence, lack of access to vehicles and crowded houses.

Walgreens will also allow people to schedule appointments in person or over the phone, so people are not excluded if they don’t have an internet or computer, said Rina Shah, vice president of pharmaceutical operations for the Walgreens group. CVS has a 1-800 number as an alternative to booking online.

Walgreens has partnered with Uber to provide free rides for vaccinations to people living in underserved areas of major cities such as Atlanta and Chicago. Charity partners will help to identify people who need transportation.

CVS is taking proactive steps to ensure that locals can make an appointment for vaccines at their nearby store, said Chris Cox, the company’s senior vice president of pharmacy. He said the team is calling some clients to schedule their appointments, especially those with the lowest income and who are older.

Along with recruiting pharmacies, the Biden government will send doses to community health centers next week that serve millions of Americans who live below the poverty line and are racial minorities.

The vaccination program allows CVS to powerfully demonstrate how it can provide health care in places where it is not normally accessible, Cox said.

“Everything we do is really aimed at helping people on their way to better health,” he said. “What this opportunity really gives us is to demonstrate to our patients and other stakeholders what we have been saying for several years, which is that the community pharmacy has a big role to play in healthcare.”

Many patients see their pharmacists more often than their doctors, as they need to get pills for hypertension or other maintenance prescriptions, he said. These frequent interactions mean that CVS can play a bigger role in ensuring that people take their medications properly or can intervene before potential complications.

As Walgreens gets more supplies, Shah said he will expand his schedule and offer photos on weekends to people who can’t miss a day at work. It will open clinics in community centers, as it does for flu vaccines.

Shah said his pharmacists can play a key role in educating and answering questions, so people are more anxious about injections than apprehensive. But, she said, the company needs more supplies to reach more people in minority communities.

“Our biggest opportunity is to get more vaccines,” she said.