El Paso COVID-19 vaccine distribution raises equity issues
By the time Penny Andersen pulled up the University Medical Center of El Paso’s website on her smartphone Saturday, online registration for the COVID-19 vaccine had closed. It was 12:44 p.m., just 14 minutes after about 5,000 appointments opened.
The last time UMC opened up appointments, they were gone in five minutes, having been announced only a little earlier via its social media accounts. The registration portal frequently crashes, overwhelmed by the demand.
It’s a frustrating process, said Andersen, 71, who considers herself relatively tech savvy. A retired attorney, she has a laptop, smartphone, home internet and the time to continually check UMC’s website and Facebook page for updates on when the registration portal will reopen.
She also frequently checks her phone and email to make sure she hasn’t missed a message from the El Paso Department of Public Health. She signed up on its waitlist earlier this month, soon after Texas allowed providers to give the vaccine to people 65 and older and those with certain health conditions, like diabetes, which she has. She’s also on Immunize El Paso’s waitlist.
“I do worry about those who are even older than me, who unless they have children or grandchildren helping them out, how in the world are they going to find out” how to register, Andersen said. “And I think a lot of them haven’t.”
Access to the internet and technology aren’t the only barriers vulnerable El Pasoans face in trying to register for the vaccine. Language barriers and lack of transportation pose additional challenges, particularly for lower-income Hispanics, who are dying from coronavirus at disproportionately higher rates in El Paso.
A Kaiser Family Foundation analysis of 17 states that report race and ethnicity data for vaccine recipients found that the share of vaccines among Black and Hispanic people is lower than their share of COVID-19 cases and deaths, as well as their share of the state population. In Texas, 15% of recipients have been Hispanic, though 40% of the state’s population is Hispanic.
“The data, which are still early and subject to a number of limitations, I think point to the importance of prioritizing equity as part of vaccine distribution to prevent against racial disparities in vaccination,” said Samantha Artiga, director of the organization’s racial equity and health policy program.
Many of the inequities that contributed to the pandemic disproportionately impacting communities of color may also result in unequal access to the vaccine.
Local agencies in El Paso haven’t yet provided demographic information on vaccine recipients. El Paso Matters is seeking such data under Texas open records laws.
“(Vaccine) data are really going to be an important component for understanding where there may be gaps or barriers to vaccinations and targeting resources to help address those barriers or gaps as they’re identified,” Artiga said.
It wasn’t until Jan. 21 that the city unveiled a Spanish language webpage with vaccine information that is also ADA accessible. Its Spanish language pre-registration form initially didn’t work, but was fixed Tuesday. Spanish speakers can also call 915-212-6843 to pre-register for the waitlist.
UMC is developing a Spanish language web page about vaccine registration, spokesperson Ryan Mielke said. He did not have a time frame by when it would be ready.
Immunize El Paso’s online waitlist is in English, though the organization is working to install a Spanish translation button, said Operations Director Dusty Warden. Spanish speakers can call 915-533-3414 to be added to the list.
Vaccine rollout remains sluggish across the state and the nation, but El Paso has been more efficient at vaccine distribution than other large Texas counties. More than 64,000 El Pasoans have received at least one dose of the vaccine as of Tuesday, including almost 15,000 who had received both doses.
El Paso leads Texas’ most populous counties for the percentage of the population 16 and older receiving vaccines, according to Texas Department of State Health services data.
Who’s being left behind
Immunize El Paso is seeking to become a vaccine hub that can inoculate 1,000 or more people a day. The Texas Department of State Health Services had yet to acknowledge the request as of Tuesday, Warden said.
The organization will open a drive-thru vaccine site Feb. 3 at the Socorro Independent School District Police Department headquarters at 1180 Joe Battle Blvd. That location was chosen in part because it’s a 15 mile drive from the county’s two other hubs, Warden said. That will reduce travel times for those living in the eastern part of the county who must drive to the UMC-run site at the El Paso County Coliseum or the city-run drive-thru site near the airport.
The state health department is sending most of its weekly doses to hubs rather than pharmacies, private medical practices or community health clinics.
Juliana Gilchrist, 50, is glued to her phone during the day since she’s taken charge of finding and registering her 73-year-old mother with providers. “My mom would have never known how to do this,” she said.
And when her mom can eventually schedule an appointment, Gilchrist worries how she will get there. Though she has a car, her mom is fearful of going places alone because her Type 1 diabetes puts her at greater risk of having serious complications if she contracts the virus.
Gilchrist is prepared to make the nine-hour drive from her home in Austin to El Paso to accompany her mother to her appointment, but that might not be feasible depending how quickly it’s scheduled.
“If it’s tomorrow, then I’ve got to call friends to see if somebody will go and pick her up,” Gilchrist said. “I’m lucky I have such good friends in El Paso, but it’s a big ask as well.”
The health department is working individually with people unable to travel to its hub “to find a solution,” city spokesperson Laura Cruz-Acosta said in an email. The city has driven a handful of people from their homes to the hub, Public Health Director Angela Mora said, noting the city is working with Project Amistad to secure transport for more people.
Immunize El Paso would like to eventually launch an in-home COVID-19 vaccination program, similar to its Flu2You program, which brought the flu vaccine directly to people at their home, Warden said.
El Paso Fire Chief Mario D’Agostino, the city’s emergency management coordinator, said the city has little flexibility right now in opening more vaccine sites, such as walk-up sites, because it is only receiving sufficient doses for its hub. It would need to consistently receive more than 5,000 weekly doses to do this, he said.
How other communities are dealing with inequities
Equitable access is “really hard to do,” Bill Schlesinger, co-director of Project Vida, a South El Paso health care and social services agency, wrote in an email. “‘First come, first served’ gives folk with easier access to internet and/or time to jump on the phone fast when things open up a ‘head start.’”
Some Texas cities and counties have tailored their distribution strategy to address inequities in the registration system.
Harris County announced Monday it will randomly select people on its waitlist for appointments as well as prioritize older residents.
After data revealed Dallas County’s hub vaccinated more white, wealthy residents during its first week of operation, county commissioners decided to limit doses to residents in predominantly Black and Hispanic ZIP codes. They ultimately nixed the idea after the state threatened to cut the county’s vaccine supply.
Tarrant County did something similar, but hasn’t faced state pushback. Unlike Dallas, it’s setting aside half of its vaccines for residents in the 10 ZIP codes with the highest case rates.
And last week, the city of Dallas organized in-person registration events to help residents without the resources to sign up online.
The El Paso City Council and the El Paso County Commissioners Court have yet to take action to ensure the most at-risk residents are able to register for the vaccine, though a handful of officials have expressed concerns with the process, including the lack of a centralized waiting list and shortage of vaccine providers in underserved areas of the county.
Both city Rep. Peter Svarzbein and County Commissioner David Stout have asked the health department to share demographic data with them about El Paso’s vaccine recipients.
“We’ve been told that the faster we get the vaccine out, the faster we’re going to get other shipments of the vaccine, but we cannot in my opinion overlook a lot of these equity issues,” Stout said at Monday’s commissioners meeting. “We have a lot of folks in our community who probably should be getting the vaccine and they’re not.”
Cover photo: Hundreds of vehicles line up along George Perry Boulevard, Global Reach Drive and Walter Jones Boulevard on Jan. 25 as people wait to receive their COVID-19 vaccine at the city-run site. (Corrie Boudreaux/El Paso Matters)