COVID-19 vaccines do not reach the needy. Blame the broadband gap

Between school and other commitments, cousins ​​Jaqueline Teague (16) and Amelie Beck (14) spend their time training seniors in Kentucky for the Covid-19 vaccine. It all started after an ordeal to report their grandparents – and then their grandparents’ friends also needed help.

So the Louisville, Kentucky, high school students set up an email address and phone number, and then a Facebook page, and it was more widespread. They call it VaxConnect Ky.

“People call us and they just have landlines, and they don’t have internet or a computer or email,” Beck says. “It’s more common than I realized.”

At the time of writing, Beck and Teague also got about 700 people scheduled or vaccinated and another 900 emails and 700 phone calls awaited them. They recruited their siblings to help and reached out to the governor and local senators with recommendations on how to improve access.

“The most important thing is to get the vaccines out as quickly as possible,” says Teague.

The digital divide is a major problem for the US, with the pandemic and the consequent closure, a strong reminder that adequate broadband is no longer a luxury. But the vaccination appointment signing process, which requires you to navigate labyrinthine registration sites and programs, adds a new twist to an issue affecting seniors and many people in color communities in the U.S., where access to the Internet is difficult is. The result: people who need the vaccine the most are struggling to sign up.

About 27% of American adults over the age of 65 do not use the Internet, according to the Pew Research Center. Pew also reported that a third of black adults in the U.S. do not have broadband. ABC News reports that the situation is even worse for elderly people of color. Meanwhile, the Centers for Disease Control and Prevention said people aged 65 and over, as well as members of racial and ethnic minority groups, were dying at exorbitant prices of COVID-19.

Problems signing up for the vaccine are just the latest way the digital divide is succeeding in the US. Microsoft estimates that more than 160 million people can not use the Internet at broadband speeds. If so much of modern life needs an internet signal to do everything from completing schoolwork to applying for a job to ordering groceries, especially during the pandemic, the inability to catch a vaccine through online means , affects people’s survival.

“These technological tools, which are so amazing and so promising, do not work for people who need them the most,” said Kelly Hirko, assistant professor of epidemiology and biostatistics at Michigan State University.

But because the U.S. crossed half a million deaths from COVID-19 in February, people are struggling to register those who are unable to register themselves.

The bias of technical tools

Although Teague and Beck have gone to great lengths to lend their technological skills, similar scenes are taking place across the country as friends, family and strangers try to find appointments for those who are struggling to do so for themselves.

After 38-year-old Jennifer Fugel from Olivebridge, New York, registered her father – who does not have an email address – his friends started calling her for help.

He “pimp me to his friends, he’s like ‘my daughter gave me an appointment!’ and they call me, ‘How did you do that?’ ‘Now I check CVS, Walgreens and Rite Aid daily, several times so I can get his friends’ appointments, his girlfriend’s an appointment and my aunt,’ says Fugel.

She is part of a Facebook group where people post tips on the availability of vaccines, and she uses her ability to address quickly 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 give it.

Several people I spoke to compared the situation to trying to get concert tickets, or giving them to Comic-Con, which offers an extra challenge: speed.

“A lot of my older patients are not that comfortable with the Internet,” says Muriel Jean-Jacques, co-chair of diversity, equity and inclusion in the Department of Medicine at Northwestern Medicine. “They may have internet, they have cell phones with wireless access, they may have text, but they are not using it fast, they do not feel comfortable.”

What this underscores is the false assumption that using the Internet is inherently easy and natural for everyone. If you turn up against more technological people, who want to find out more quickly about the availability of vaccines and then make appointments, some elderly people will not be happy.

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

Reach communities of color

The elderly are not the only ones left behind in trying to get the country vaccinated, in part because of inequalities due to technology.

Research has shown that communities of color usually have less access to broadband. The Brookings Institute, for example, found that households in black and Spanish had lower broadband adoption rates than in white and Asian households. North Carolina State University showed that about 75% of those in urban areas without broadband were people of color, and that too much of the focus on getting broadband to rural areas could leave people of color out.

Meanwhile, the Kaiser Family Foundation has found that adults in color communities are less likely than white adults to say they have information on where and when to be vaccinated.

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

Even when a local government makes an effort to get vaccines in color communities, it does not always work. The Los Angeles Times reported that special access codes created in California specifically for hard-hit black and Hispanic communities to sign up for vaccinations and distributed by community organizations, ended up in ‘more prosperous professional and social networks’.

The New York Times reported that places like medical clinics in color communities have seen significant increases in white people from outside the neighborhood picking up appointments online. The report notes that many in out-of-service neighborhoods are stimulated by sites that are difficult to navigate, transportation problems and phone lines that may take hours – something that may be impossible 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 should be a way to balance the receipt of something as essential as a vaccine for protection, with the highest need for vaccination, “Jean – Jacques says.

If technically proficient is not enough

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

Through the joint efforts of Childs, her son Pierre Cadieux, who has been working in the computer industry since the 1990s, plus Cadieux’s wife, it took about two weeks to fold through glistening sites, fill in endless fields and fight for confusing user interfaces before Cadieux gets a tip from a friend via Slack that has opened up the availability of appointments in the area.

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

Childs says she has friends who are also elderly people who are waiting to be told they can get the vaccine. They do not know how to search the information online.

“They do not like computers,” she says. There are seniors who [won’t] promote their technical knowledge. Some of them refuse to get a cell phone. These are the ones that are hard to reach. ‘

Thụy Nguyễn (71) holds a master’s degree in computer engineering. Registering himself and his 77-year-old brother and his 82-year-old sister, who do not use many computers and speak mainly Vietnamese, was a frustrating exercise. Residents of Orange, California, encountered website crashes, differences in information between the app and the website, and a confusing user interface.

Without him he says’ my sister and my brother would not be able to register.

Alison Lombardi, 41, of Corona, California, is a small business owner who says she’s comfortable working with technology. Eventually she tried to help her parents, who were trying to help their parents get appointments and had to sort out a lot of confusion to finally get her family slots at the Dodger Stadium vaccination center.

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

Cadieux sees a bias in assuming that trust in a website or app is usually the best way to get people to sign up.

“It’s not necessarily easy for the target audience,” Cadieux says. “If you’re trying to reach people who are not technically aware, or are very broad and reach a lot of demographics, you need to think of non-technical solutions.”

Bridging the gap

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

Montgomery County, Maryland, will begin prioritizing the vaccinations for the zip codes hit hardest by COVID-19. President Joe Biden’s administration has launched a program to get vaccinations to community health centers, specifically in underserved communities.

Jean-Jacques proposes that a certain number of vaccines be reserved to be allocated to the communities with the greatest risk, and to make better use of websites within communities such as churches and schools – to do so in vaccination sites that are not pre-registered .

Adkins-Jackson and colleague Tamra Burns Loeb, who is an interim deputy professor at the UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, talked about billboards and posted information in places like windows. And not just to promote information about people, but to create spaces, especially for color communities that may have reservations about long-term racial injustices in medicine.

“To be able to make informed vaccination decisions, they need to have all the information they need to make a decision, and that requires the ability to speak out openly and discuss what happened to them,” Loeb said. .

The most important thing is to create connections to communities and build the kind of infrastructure that can be requested again in the future, should another similar crisis occur.

“The solutions exist,” says Adkins-Jackson, “they just exist. [not] without creating strong relationships and connections with the community. ‘