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COVID-19, Vaccinating the Most at Risk and Hardest to Reach Communities

COVID 19 Death Rates In America Reveal Racial Disparities

Magazine, Living Well

Many older adults and people with disabilities have experienced substantial challenges accessing COVID-19 vaccination. They are at greater risk of getting COVID as they face barriers to getting vaccinated, especially if they live alone, lack technology, or speak languages other than English. In California, one-quarter of people 65 years and older are not vaccinated. In a panel briefing by Ethnic Media Services, a call to action was made to support community-based efforts to reach this population – whether through phone trees, door-to-door knocks, mobile vaccine units, or other outreach.

Kim McCoy Wade, Director, California Department of Aging, acknowledged that older Adults in assisted living or long-term care facilities represent one out of three of the fatalities due to COVID. Stressing the importance of working together to reach this population she revealed shocking statewide data indicating while over 75% of older adults have been vaccinated Latnx represented only 40%. Those at higher risk represent 80% Asians and whites, black and others 60%. These gaps by age and ethnicity are of concern making the dire need for vaccine access. Getting the word out is primordial, and trust is of utmost importance. We must answer crucial questions and use incentives such as Governor Gavin Newsom gift card rewards, and the lottery.

Dr. Louise Aronson, Author, Geriatrician, and Professor of Medicine at UCSF, author of”Elderhood”, shared that the big differences are not just for older people. While healthier older people are most likely to get the vaccine, older and sicker were most likely not to get the vaccine. The question of why older people are at risk is imperative. Often older and people with disabilities fall under the same category of challenges. We must not assume biology alone as the measure. How we meet their needs is the question we should answer. During this pandemic, 4% of older people live in facilities and account for 34% of deaths. In many states, most older people were sent to nursing homes and facilities with people at higher risks. This brought more spread as workers took this home to their families and communities. Homebound elders are also at risk and we must accept that old is not just a word used if you cannot function. These people are often left behind and are harder to reach. The least communities to reach by the internet are the old and immigrants and so when all strategies are digital it makes it hard. Even more challenging is sending them to go get the vaccine where there are all kinds of people as they are homebound with no resources. All of this is an indication that public health systems lack the knowledge on how to handle older people. To fix this, accurate information is important to get government resources in. We must include answering questions, dispelling myths like ” the chip in the vaccine”. The older you are the more medical problems you have and so need the vaccine.
Anni Chung, Executive Director, Self Help for the Elderly, member of California Commission on Aging, shared that misinformation is prevalent particularly where language is a barrier. To vaccinate the most vulnerable, the immigrant, low-income communities where seniors reside has been challenging. Her organization requested help from the department of health asking to get vaccines out to where they live. This led to approvals for mobile clinics, primary care doc(pcd) to get into communities by February and March. Self-help workers and community doctors began reaching out to more and more elderly. Working together as a team to get Chinatown’s aging vaccinated. These residents were less likely to pick up the phone.
Cindy Cox-Roman, CEO of HelpAge USA, a global nonprofit that advances the wellbeing and inclusion of older people around the world shared a slide about covid-19 and the vaccine: Lifting the voices of older black adults. Research is important as older, low-income black adults are often unheard of which led them to conduct qualitative research of people over 70 years of age. The findings were very divergent in views among black adults with medical abuses and traumatic experiences dating back to slave ships

  • Lack of family information sharing: not talking to each other, an aversion to crossing boundaries, denial, cringing at irresponsible behavior, tension over different versions of the vaccine.
  • Inequitable healthcare system: the expectation of substandard care, trust of people in power not relevant in decision-making
  • Worth noting however that, personal physicians are an exception as they trust their doctors.
  • Access barriers; Feel they are at the mercy of intermediaries due to tech barriers, frustration that others are getting vaccines more easily.

What is the path forward?

  • Ensure that vaccine sites are accessible to all
  • Empower personal doctors to do outreach
  • Improve information dissemination, and quality channels, storytelling, accuracy, relevance, and continuity
  • Communicate rising vaccines rated among black adults for reassurance
  • Equip families to talk about health issues
  • Build self-advocacy

Jessica Lehman, Executive Director, Senior and Disability Action, which mobilizes seniors and people with disabilities to fight for individual rights and social justice informed the panel that one in twelve people died in nursing facilities. Why were they ignored? It took a while to see this trend. Disabled people have also been in the same boat she said. Lack of reporting is also a big issue. As a disabled person herself wheelchair-bound, she has been just as scared. The pandemic has exposed ageism and ableism in our society. The threat of care rationing on oxygen, ICU beds made older and disabled low on the priority list. Whose lives do we value? Seniors and disabled seemed to be expendable. Many doctors assume that the disabled have a lower quality of life and make deadly judgment calls.

In the November election, many facilities were disenfranchised and so when vaccines came they brought hope. However, most people were targeted for vaccines before older and disabled people, people in prisons, etc. Racism and ableism have been the factors that have affected the old, disabled, and communities of color. We have to shift how we feel about disability and age. We have to show that seniors and disabled people are an integral part of our society.

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