The United States is racing to vaccinate millions of people for Covid-19, but online appointment registration systems are slowing down or preventing access to vaccinations for some of the people most vulnerable to the virus: older Americans.
Many states and localities across the US are offering online tools like websites and apps as the primary way to register for vaccine appointments. There are usually options for registering for vaccination via phone lines, but those can be overloaded with calls. That means snagging an appointment quickly involves computer skills and internet access, or at least help from someone else. But America’s digital divide is getting in the way: Nearly 30 percent of people in the US over the age of 65 do not use the internet, and more than 40 percent did not have broadband access at home, according to a 2019 report from the Pew Research Center.
“If my husband were to be widowed tomorrow, he wouldn’t be able to register online to be vaccinated,” wrote one 85-year-old woman to her local paper in Maine.
“I know for myself in that process, it was extremely difficult,” Lauren Cotter, a 66-year-old marketing director who helps seniors become computer literate through the San Francisco-based Community Tech Network, told Recode. “It has been extremely frustrating.”
The US vaccination effort has been disastrously delayed by limited supplies, an inadequate federal distribution plan, and the growing threat that more-transmissible variants of Covid-19 are spreading. The unique challenges some older people in the US face with digital access is making a precarious situation worse for them.
Older adults across the country are running into computer challenges
As vaccinations have been rolled out to older Americans, digitally savvy ones, or caretakers and family members with the time and resources, have quickly moved to snag appointments on apps and websites. But that’s left behind seniors who don’t have that kind of help.
It’s also likely exacerbating already apparent racial and socioeconomic disparities in the US vaccination effort, experts say. Members of lower-income, Black, Latino, and Native American communities — as well as rural communities — in the US are less likely to have reliable internet access or tools when compared to white and higher-income communities. An analysis from CNN of 14 states’ vaccination data found that white people are being vaccinated at higher rates than Black and Latino people, despite having comparatively lower hospitalization and death rates.
For older adults, broadband internet access isn’t the only hurdle, explains Becky Preve, who directs New York’s Association on Aging. Some are also struggling because they don’t feel comfortable putting personal health information into internet computer systems. At the same time, some older New Yorkers still don’t have an email address or a printer, which can slow them down when trying to access vaccine appointment documents.
For people without computers, some local health authorities are offering phone hotlines to schedule vaccine appointments. But these hotlines can be low on staff. Sometimes a vaccine-seeker can spend hours on the phone — or they’ll have to wait days to get a call back to schedule an appointment.
“I wish the 1-800 number would have been the end-all, be-all,” Preve said. She says older adults can struggle to get through to a human operator, and hearing impairments can also make phone conversations more difficult. Amber Christ, of the national senior poverty-focused nonprofit Justice in Aging, added that some people using charge-by-the-minute phones may be hesitant to spend a long time on the phone trying to get an appointment.
Sometimes trying to get appointments through official channels is so challenging that older adults simply call phone numbers of authorities they know will pick up. Brad Lander, a city council member who represents a district in Brooklyn, New York, said that his office receives complaints every day about troubles people are having in navigating New York’s phone and computer-based vaccine registration. “More than one-third of seniors in New York City lack reliable internet. Many more are not comfortable online,” he told Recode in an email. “Some are lucky to have family members who can help, but so many don’t.”
The technological barriers go beyond finding appointments to even finding out when appointments are available and where to sign up. “[There’s] that broader education, like even finding out who’s eligible to be vaccinated and education around the safety of the vaccine,” says Justice in Aging’s Christ. “Everything is predominantly being distributed via the internet or online sources.”
Without proper information, older adults don’t just lose out on signing up for a vaccine, they also become more vulnerable to predatory vaccine scams, she warned. Another barrier can be English-dominant websites and phone lines, for those who speak another language.
Of course, not all older adults struggle with or lack access to technology. But for those who do, small barriers can add up, explains Carla Baker, a registered nurse and the chief operating officer of Common Table Health Alliance, an equity-focused health collaborative based in Memphis. Vaccine hotline numbers recited quickly on the news can easily be missed. Screens can be hard to use for people with visual impairments. And the community centers and libraries that used to provide internet access to some older Americans are now closed.
“Little things, or what seem like little things, are really big things in many people’s lives,” Baker said. She says that one improvement would be to more effectively reserve vaccine doses based on different ways people communicate: some people would get vaccine appointments by computer, while others would get them through the phone, mail, and even in-person registration, she said.
The New York Association for the Aging has deployed some of its local offices’ staffers to take digital tablets to seniors residences to help sign them up for appointments. In New York’s Rockland County, officials have set up an ancillary call center, which has at least 35 lines. Older adults are able to speak with someone, get on a waiting list for setting up an appointment, and get help with transportation. Now, the line gets — on average — more than 800 calls a day, and has put about 1,500 on a waiting list, according to the county’s aging office director, Tina Cardoza-Izquierdo.
“Most of my seniors, especially my older, older adults, are very scared, anxious, and frustrated with the inability to register unless they had a computer,” Cardoza-Izquierdo said, saying her office had been “getting inundated with calls from seniors who really didn’t know what to do and where to turn.”
But even if seniors do manage to get appointments, Cotter, of San Francisco’s Community Tech Network, warns that the pandemic has exposed how the digital divide has impacted older people more broadly. It’s not just making it harder to get vaccinated. It’s made everything harder and more perilous since the start of the pandemic.
“The money and the attention hasn’t been put on seniors,” she said. “If they’re not connected, they’re not staying at home [and] sheltering in place. They’re going out. They’re going out to get groceries, going out to get meds. They certainly don’t know how to register to get the vaccine.”
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