Equitable access to coronavirus vaccine emerges as next challenge amid slow rollout
Washington — As state and local officials work to speed up the administration of coronavirus vaccines to the first segments of the population eligible to receive them, local leaders are already looking ahead to when the shots become available to the general population.
For some, among the list of concerns about how best to get shots into arms is the fear that communities that lack access to pharmacy services will be left out, given the role that retail pharmacies like CVS and Walgreen are expected to play in administering the vaccines.
"I understand there is benefit for us to treat the vaccine like we do the flu shot — we want it to be easy and accessible — but I also know when we had testing and it came out and the corporations were doing it, poorer places like Dayton didn't get the tests, and that's not fair," Mayor Nan Whaley of Dayton, Ohio, told CBS News. "If that happens again, that is wrong, and people like me are going to say it's wrong because it's going to hold up our economy."
In November, the Department of Health and Human Services announced partnerships with large chain and independent community pharmacies to boost access to coronavirus vaccines, including Costco, CVS, Rite Aid, Walmart and Walgreens.
But in some cities, there are few pharmacy chains. In Dayton, Whaley said most are located in the suburbs, raising concerns that lower-income neighborhoods will not be able to easily access the places administering the vaccines.
"I'm just worried about this corporate piece," she said. "When that gets involved, it becomes incredibly inequitable."
The coronavirus vaccines developed by Pfizer, with Germany's BioNTech, and Moderna are so far going primarily to health care workers and residents of long-term care facilities. The Centers for Disease Control and Prevention (CDC) has recommended that the next two groups prioritized to receive the vaccines include frontline essential workers, people ages 65 and up, and those with underlying medical conditions.
Still, states have discretion with regards to the populations that get the doses. At least one, Florida, has split from the CDC's recommendations and is moving senior citizens to the front of the line to receive vaccines.
Availability to the general public, however, remains months away, giving local leaders some time to develop plans to ensure harder-to-reach communities have access.
Dayton began preparing for this new phase of the pandemic this summer, and Whaley wants to ensure her city gets the same access to the vaccines as Ohio's larger cities like Cleveland, Cincinnati and Columbus.
To make sure people in communities with fewer pharmacies or grocery chains get their shots, she is pushing the establishment of pop-up vaccination sites, and said federally qualified health centers should be early to receive vaccines once the rollout expands.
In Pennsylvania, the state is working with federally qualified health centers for both coronavirus testing and vaccinations to ensure urban and rural areas have access, as well as groups like Pittsburgh's Black Equity Coalition to educate Black communities about the safety of the vaccines.
"Pharmacies will be very important and necessary, but not sufficient," Dr. Rachel Levine, Pennsylvania's secretary of health, told CBS News. "It's not the vaccine that's the issue. It's vaccination. We have to get them administered to people. We need to get the vaccines into arms."
Levine said in Pennsylvania, the category of health care workers in the first group getting vaccinated is broad and includes janitorial staff, those working to distribute meals to patients and employees in outpatient settings. The next group to receive their shots will also be expansive.
"That gets at the health equity aspect of looking at vulnerable minority populations," she said.
But Pennsylvania, like other states, has been slow to administer the vaccines it has already received. According to data from the CDC, the state has received 592,125 doses of vaccines as of Monday, out of a total 797,000 that have been allocated for delivery. Just 163,207 doses have been administered, representing 27% of doses the state has received so far. Nationwide, roughly 29.5% of doses that have been delivered have been administered.
At the federal level, equitable access to the coronavirus vaccines is an issue President-elect Joe Biden appears ready to confront. During a speech on the coronavirus last week, Mr. Biden said his transition team is planning a "whole-of-government effort" to tackle distribution of the vaccines that will include setting up vaccination sites and sending mobile units to hard-to-reach communities.
To address the vaccine hesitancy among Black, Latino and Native American communities, the president-elect said his administration is also planning a public education campaign to increase trust in the coronavirus shots.
"We will do everything we can to show the vaccines are safe and critically important for one's own health and that of their family and community," Mr. Biden said. "That means we will also make sure the vaccine is distributed equitably, so every person who wants the vaccine can get it no matter the color of their skin or where they live."
Jeff Williams, the mayor of Arlington, Texas, said he believes his city is "well prepared" to administer vaccines. But his biggest challenge is the number of people willing to get inoculated.
Williams estimated between 30% and 40% of those he has spoken with are hesitant to get the coronavirus vaccine. To build public trust, his city is planning to distribute information from medical professionals and is encouraging local leaders to publicize when they get their shots. For their part, Vice President Mike Pence, Mr. Biden and Vice President-elect Kamala Harris, among other federal health officials, were vaccinated on camera in an effort to reassure wary Americans the coronavirus vaccines are safe.
"We have been fortunate that we have tools that do help fight this virus, which have been the mask, social distancing and good hygiene," Williams said. "Now we have an incredible gift here, the vaccine that we need to take advantage of so we can get somewhat back to normal and get rid of this virus. When it relates back to being able to provide for our families, it's really, really critical."
In anticipation of the coronavirus vaccines becoming available to the broader public, Whaley hopes national and state leaders can learn from the testing disparities and apply those lessons to the distribution and administration of vaccines.
"If we don't learn from how terribly testing was rolled out, we have really messed up," she said. "Let's learn from that and do better on the vaccine."
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