CVS and Walgreens have the chance to make the rollout of Covid vaccine more equitable

Dr. Virginia Banks says if the US really wants to end the pandemic, they will take mobile trucks with vaccines in neighborhoods where people have not been transported – and even take shots in hair salons and barber shops.

As thousands of pharmacies receive doses this week and begin vaccinations at their stores, the country is taking an important step toward reaching more Americans. However, public health officials and advocates say it will not go far enough in communities where people were the sickest.

More black and Hispanic Americans were hospitalized and died of Covid-19. They also often have greater barriers to getting vaccinated: lack of transportation. A juggling of various works. Hesitation due to past abuse by the medical community.

CVS Health and Walgreens will play a bigger role in the effort, as a federal program sends doses to more of their stores and those of other retail pharmacies. The expansion is a business opportunity for the country’s two largest pharmacy chains, as they are paid for each vaccine and attract more foot traffic to stores. Vaccination of vaccines will also test the commitment of businesses to expanding access to healthcare in black and Spanish communities.

Banks, a physician in Infectious Diseases in Ohio, is part of a stakeholder group of the Infectious Diseases Society of America that consists of black doctors, scientists, and public health officials focused on tackling health inequalities. She said healthcare providers will need to be creative and show commitment. She said they should set up clinics in well-known places, such as in churches, and call in ‘trusted messengers’ such as pastors and community leaders.

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

Vaccination of the vaccine in the US was slow and complicated. The demand for doses is much heavier than the number of shots available. Online dating systems were difficult to navigate and caught by heavy traffic. Only two vaccines have so far had emergency permission from the Food and Drug Administration, and these must be stored at cold and ultra-cold temperatures. And only some Americans qualify for the shot, with each state having slightly different criteria to weigh factors such as a person’s age, medical conditions, or job.

About 48.4 million vaccines have been administered in the U.S. since Friday, according to the Centers for Disease Control & Prevention. Nearly 12.1 million people received both doses of the vaccine – just a small fraction of the 331 million people living in the US.

The country’s goal is to vaccinate between 70% and 85% of the U.S. population – or about 232 to 281 million people – to bring about herd immunity, according to Dr. Anthony Fauci, the chief’s medical adviser to the president.

The messy roll out resulted in some getting shots and not others. Most of the nearly 13 million people who gave at least one shot of a Covid-19 vaccine within the first month of drug distribution were women, 50 years or older and probably not Spanish and white, according to ‘ a CDC study.

For the distribution of vaccines, equity is not just a matter of fairness. It is also an important way to slow the spread in communities where Covid-19 cases, hospitalizations and deaths are higher. According to data reported by the CDC at the end of November, black and Hispanic Americans are hospitalized 3.7 times and 4.1 times more by Covid than white Americans. Both minorities are 2.8 times more likely to die from the disease than white Americans.

In a hard-hit environment, the impact of each shot can be even greater: they reach people who are more at risk if they work in grocery stores or at other front-line jobs or live in a dense apartment or multigenerational households.

There is also a greater reluctance against vaccines among black and colored people, stemming from the history of the medical community that they abuse minority groups and open fewer health care practices in their neighborhoods. A New York City poll by the Association for a Better New York found that 78% of White residents would take the vaccine as soon as they could compare to 39% of Black residents, 54% of the Spanish population and 54% of the Asians. .

For providers such as CVS and Walgreens, it is a business opportunity to have more doses of the vaccine. They are paid for each vaccine and the government will cover the cost if someone does not have health insurance. Jefferies has estimated that each shot will have a gross margin of $ 13 to $ 15 and could generate approximately $ 1 billion in incremental gross profits for CVS next year.

Both pharmacy chains have established their strategy to add more health services from primary care clinics to diabetes screening. They also addressed the obligations to address racial inequalities in response to George Floyd’s assassination and nationwide protests. CVS plans to invest nearly $ 600 million over five years to support public policy initiatives and internal efforts, such as mentoring black employees and offering free in-store health tests for blood pressure and cholesterol.

Walgreens has launched a pilot project in the Chicago area aimed at lowering hospitalization rates by making it easier for patients to take their medications, get free deliveries and get in more frequent contact with health care professionals about their medical conditions. It recently appointed former Starbucks chief operating officer Roz Brewer as its next chief executive. When she enters the role in mid-March, she’s the only black woman to run a Fortune 500 company.

Karyne Jones, The CEO of Washington, DC-based National Caucus and Center on Black Aging, said expanding vaccines to hard-hit communities is a way for CVS and Walgreens to “put their money where they are.” Her organization is a founding member of the Covid-19 Vaccine Education and Equity Project, a coalition of nonprofits and trade groups backed by vaccine maker Pfizer.

Jones said she would like to see CVS and Walgreens open 24-hour vaccination sites and set up tents in neighborhoods where people did not have transportation.

“If you want to show really good corporate responsibility, it’s time to say we need to use resources to alleviate this pandemic,” she said.

Banks, the doctor on infectious diseases, said it would require out-of-the-box strategies, such as redirecting bus routes through vaccine clinics. She pointed to an attempt where pharmacists teamed up with barber shops to detect high blood pressure when black men went to bed – a clinical study that could detect the condition and intervene earlier.

She said she was hopeful that the Johnson & Johnson vaccine – which requires just one dose and can be transported more easily – could be a game changer to distribute it and make it easier to give shots where people are. The company applied to the FDA for emergency use last week.

“We have pharmacy deserts,” she said. “We have deserts in grocery stores. We do not have church deserts.”

Walgreens and CVS have donated Covid vaccines to thousands of nursing homes and relief agencies. They fired shots at some stores after receiving vaccine doses from states. With the federal program, they will offer shots in more neighborhoods.

Walgreens has Covid vaccines in stores in 15 states and two additional jurisdictions, New York City and Chicago. A company spokesman said it would be available in 1,800 stores as part of the federal program – or about 20% – of U.S. stores.

CVS has them in 18 states and Puerto Rico. A company spokesman said as of Friday, about 420 of its approximately 9,900 stores have donated doses from a state or federal program.

Both pharmacy chains said they chose stores in neighborhoods with greater need. About half of each company’s stores with Covid vaccines are located in medically underserved areas or places that are high on the CDC’s social vulnerability index, based on factors such as the prevalence of poverty, lack of access to vehicles and pressure housing.

Walgreens will also allow people to schedule appointments in person or by phone, so people can not be excluded if they do not have internet or a computer, said Rina Shah, vice president of pharmacy operations at Walgreens. CVS has a 1-800 number as an alternative to online booking.

Walgreens has partnered with Uber to offer free rides for vaccine appointments to people living in parts of major cities like Atlanta and Chicago. Charity partners will help identify people who need transportation.

CVS is taking proactive steps to make sure locals can get vaccinated at their nearby store, said Chris Cox, senior vice president of pharmacy. He said staff call some customers to schedule their appointments, especially those with lower incomes and older.

Along with the inclusion of pharmacies, Biden’s government will next week send doses to community health centers that serve millions of Americans living below the poverty line and racial minorities.

The vaccination program enables 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 with the goal of helping people on their path to better health,” he said. “What this opportunity really offers us is to demonstrate to our patients and other stakeholders what we have been saying for several years, is that community pharmacy plays a big role in healthcare.”

Many patients visit their pharmacists more often than their doctors, as they have to pick up high blood pressure pills or other prescriptions for maintenance, he said. Those frequent interactions mean that CVS can play a greater role in ensuring that people take their medication properly or can intervene before possible complications.

As Walgreens gets more stock, Shah said he will extend his hours and provide weekend shots for people who cannot skip a day of work. It will open clinics at community centers, such as for flu shots.

Shah said pharmacists can play a key role in educating and answering questions, which is why people are eager to shoot rather than be afraid. But, she said, the company ultimately needs more supplies to reach more people in minority communities.

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