A man receives his vaccination at the Five Star Pharmacy pop-up. Photo: Sean Waltrous
Neighbors

New York’s vaccine problem is no longer supply. It’s even harder than that

A pop-up pharmacy over the weekend. photo: Sean Waltrous

By S. Mitra Kalita with reporting from Epicenter volunteers Abby Gewanter, George Hagstrom, Grace Lee, Robin Morris, Millie Rose and Elena Tate

 

Now that eligibility in New York has expanded to everyone 16 and older, it felt a good time to assess how it’s going. 

As of this writing, Epicenter has helped 4,000 New Yorkers (and a few stray New Jerseyans, Pennsylvanians, Marylanders and one Kansan) secure vaccine appointments. 

We published our first progress report in early February. A second, more comprehensive update in March drew much more attention. We admittedly structure these with an eye toward an audience of policymakers, journalists and politicians. 

Where we spend the bulk of our time, though, is community journalism, delivered via phone calls, ethnic news sites and WhatsApp groups, text messages, livestreams and training videos, public folders of flyers, letters and other documentation. All that is purposefully structured with an eye toward utility and action. 

This week’s bottom line: New York is no longer in a supply crunch. Every day, literally thousands of appointments are opening up. (Note: This could change if the anticipated J&J shortage comes to pass.) Pharmacists and vaccine sites are calling us saying they have extra doses and would like to help get more shots in arms. 

But but but … their calls expose the heart of the problem. Spreading word about vaccine availability is the main challenge. It’s even harder in a pandemic where the key means of communication – word of mouth, via places of worship, dinner parties, senior bingo, weddings, school pickup and dropoff – have been muted. 

New York ranks 45th among states in getting people over the age of 65 vaccinated. We still hear from teachers, restaurant workers and taxi drivers every day asking if we can help. These groups have been eligible for months now. 

Why aren’t people getting vaccinated? 

One cashier at a restaurant in Jackson Heights said she wants to wait until the rush is over. As we have said before, this is less about vaccine hesitancy (white evangelicals have higher percentages here) and more about vaccine accessibility. Our takeaway here hasn’t changed even as eligibility has: The online system of registration is still really hard, fragmented and requires time and internet. 

Solution: We have pivoted to offering training videos and one-on-many calls to show New Yorkers how to register for their own vaccines. Because this week’s first how-to in our livestream focused on CVS, which uses a national registration system, we heard from folks all over the country saying they used the video to book. Take a look here. We want to roll these out in different languages but nothing stops other community organizations and media outlets from doing so first (please beat us to it!). 

One size doesn’t fit all

Our focus has been on helping people who cannot spend hours trying to book an appointment, and we are seeing more “special cases.” Our volunteers increasingly spend hours of their day on individuals, finding the current one-size-fits-all doesn’t work for them. Some examples from the last few days: 

  • A man with severe allergies needs J&J in a hospital setting. 
  • The mother of a disabled teen wants to avoid a megasite for fear it’s too overwhelming. 
  • A family of Koreans don’t speak English and can only go on a certain day and prefer a particular location. 
  • A taxi driver lives in New Jersey but works in New York City and doesn’t know how to navigate these circumstances. 
  • An undocumented immigrant knows she needs a vaccine, can’t get a letter from her employer and has no proof of living in New York City; also her passport from her home country is expired and she fears deportation if anyone finds out. 

Increasing numbers of homeless are calling us; they might be crashing among friends or family and wondering how to prove address. 

Solutions: Our documentation folder is growing with examples. Some volunteers have sent mail to the individuals to prove they exist. Others have attested that a bakery cashier, for example, really works there. 

My mantra continues to be “Make it easy. Keep it legal.” And every few days, I post this quote from W.E.B. Du Bois in our Slack and WhatsApp groups, where we are coordinating outreach, bookings and communication: 

“Rule-following, legal precedence and political consistency are not more important than right, justice and plain common-sense.”

Ramadan is coming

Earlier in the week, our Muslim neighbors were desperate to get vaccinated before Ramadan, which begins around April 12. Now some are telling us they might wait until Ramadan ends because they:

Imams and Islamic leaders around the country are assuring their communities it’s okay to get the vaccine, but this is one area where policymakers could meet them halfway. 

Solutions: I joined the Brian Lehrer Show this week on WNYC and mentioned an idea he loved (yay): Send vaccines and someone to administer them to mosques across the city on Friday, the holiest day of the week. Offer J&J since it’s one-and-done. You really want this community to be vaccinated before a month of iftar and other functions. 

Spread the word on pop-ups

We saw them in some unlikely places this week, such as yoga studios and the embassies of Ecuador and Jamaica. This is welcome news as the vaccines push into communities and other familiar, gathering spots. 

One of our original volunteers, Elena Tate, did this post on how to bring a pop-up to your neighborhood

On our livestream, we got the most questions around popups: Are they legitimate? How do I hear about them? 

Some pop-ups are limited to nearby residents or zip codes. This is great as long as they actively get the word out. Occasionally, we hear from well-intentioned organizers who say they only want to help “local communities” and want to keep out suburban dwellers or Manhattanites – but they are not doing the necessary outreach to Black and Brown communities in our languages, or on our terms, or in true partnership. (Also, remember Black and Brown people live in the suburbs, too.)

Solutions: Spread the word about pop-ups’ existence beyond Facebook and Twitter. When we hear about a pop-up, we scour our lists for zip codes nearby and start making calls. People LOVE the idea of walking nearby and possibly being booked with family or friends to go together. 

The basic questions people are asking

For months last spring, the top Google search term was “symptoms of Covid.” Even if we feel like we have informed people of basic news and information, we need to tell them again and again and again in order for the information to be internalized. Often, that doesn’t happen until it’s relevant to them. 

As access has expanded, it is clear that basic info still needs dissemination. (It’s also hard to fight misinformation if we frame it in terms of debunking misinformation. We should offer access to easy-to-digest facts and utility – over and over. Also it’s okay to note that guidance on Covid has changed and some aspects are still being studied.)

Some of the basic questions we are hearing: 

Does my 16- or 17-year-old need to be accompanied by a parent or adult? (yes)

What vaccine is this site giving? 

I did not get an email confirmation. Can I still show up on site with a screengrab of my appointment? (yes)
Will they make my second dose appointment there? (yes)

I need to cancel my booking. (watch our video on how; minute 42)

Solutions: The volunteers share what questions we are hearing over and over with each other. That informs what videos we create and share. Example: How to cancel or rebook appointments. Show people, don’t just tell them.

Vaccine shopping is a thing

The CDC philosophy of “the best shot is the first shot you can get” does not seem to be getting through to all. 

People have a lot of thoughts on the best vaccine for them: Moderna, Pfizer versus J&J. Like all things vaccine, some of this is driven by schedule. We’ve been admittedly torn on indulging the preferences because the alternative might be that these individuals don’t get vaccinated. And it feels worth honoring, say, a resounding preference for J&J from a restaurant worker with three jobs who can’t juggle TWO doses and wants to be one-and-done.

Sites need more upfront clarity about WHICH vaccine they are administering. To not do so poses a problem for people who have been advised by doctors to take a specific one; who have a personal or logistical preference; and for people to understand what they got in their first dose when trying to schedule their second. We’ve also heard of a handful of discrepancies between what pharmacies say they offer (J&J is often the culprit) and what people find when they show up for the vaccine. 

Walk ins

This week, New York expanded a program whereby people over the age of 75 can walk in and just get vaccinated. SO CAN THE PERSON WHO ACCOMPANIES THEM. 

We should frame this as an opportunity for anyone who helps a senior get vaccinated to skip the line. It might help folks grappling with the current system look out for their elder counterparts. 

Pharmacies are getting better

We spent last week asking the pharmacies to clarify the discrepancy between their stated policies and what we were hearing on the ground. Here’s the story I wrote, where Walgreens said its own pharmacies were wrong to ask for a doctor’s note in New York.  

We also followed up with a documentation letter after hearing from more folks with underlying health conditions being denied vaccines. And we asked pharmacies to address concerns over IDs and people being asked for Social Security numbers. 

Walgreens has announced it will do the second dose of Pfizer after 21 days not 28 as it had been scheduling prior. (We broke this story on Epicenter on March 25 and the New York Times and USA Today made it official this week.) 

Second-dose help needed

We are seeing more requests to book the second dose. Some of this has stemmed from problems with pharmacies and other vaccine sites canceling or moving appointments. 

An elderly couple in their 80s from Queens whom we had helped booked is a case in point. Their daughter’s cell phone was listed as the contact and she received this text message from CVS: We canceled your COVID-19 vaccine(s) because you requested it, missed it, or for another reason. Tap this link to reschedule: e.cvs.com/covid

Panicked, she called us for help to book another. I emailed CVS’ corporate office and someone from the pharmacy reached out to the family to fix the issue. We worry about folks who do not have daughters or former business reporters-turned-publishers advocating on their behalf. 

As life returns to “normal,” more people are saying they can’t make a second dose appointment because they have conflicts. We’ve really tried to dissuade this (of course, life happens) and to treat getting the second dose as sacrosanct as the first. We do not want to create more friction or scheduling snafus in a system overloaded with them. 

How do the vaccine overlords work? 

This week, we noticed that the city online system seems to favor people over age 65 (they get more appointments) but we wondered if they know that. Technical glitches have been rampant but that’s to be expected when there’s a significant expansion in eligibility. 

The erratic timing of appointment drops remains a concern. One volunteer writes: “Drugstores and sites posting appointments in waves beginning at midnight and continuing to 3 a.m. is bad news. Who stays up for these!!??” They, meanwhile, welcome CVS drops of appointments at 6 a.m. 

Indeed, we DO NOT want to lose people to apathy or fear that the process is too hard for them to book an appointment.

QUEENS still needs more vaccine sites

We can’t say it enough: There is simply not enough supply to meet our hundreds upon hundreds of requests from Jackson Heights/Corona/Elmhurst/Flushing neighbors – among the hardest-hit areas. We have high concentrations of frontline restaurant and other workers who need appointments to meet their restrictive schedules, and needs around transport or language. 

Solution: Consider Sunday popup vaccine sites in major small-business hubs – all the Chinatowns, Jackson Heights, Astoria, Flushing, Woodside, College Point, Elmhurst – and offer vaccines to restaurant workers on Sunday; many have Monday and Tuesday off. Make it J&J so they are one and done. 

Remember: We want to make it easy. 

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