March 26, 2023

Seniors without family or friends left behind in the race to get vaccinated

Hispanic seniors lagging behind in the race to get vaccinated against covid

A gap is emerging between those who have resources and those who don’t, as older adults across the country scramble to receive the Covid-19 vaccine.

Older people with family or friends who help them are getting vaccinated appointments, even if it takes days to get them. Those without reliable social support are being left behind.

Older adults who can drive, or who can get others to drive them, travel to places where vaccines are available, even across city or county lines. Those without private transportation are caught up in what’s available nearby.

Older adults who are comfortable with computers and have Internet service are notified of vaccine availability and can register online for their appointments.

Those who cannot afford the internet, or who do not use computers or cell phones, are probably missing out on that vital information.

The extent of this phenomenon has not yet been documented. But experts are discussing it in various forums, as are older adults and family members.

“I am very concerned that barriers to receiving vaccines have an uneven impact on our older population,” said Dr. XinQi Dong, director of the Institute for Health, Health Policy and Research on Aging at Rutgers University.

Disproportionately, these barriers appear to affect older blacks and Hispanics (who can be of any race), as well as non-English speakers; older adults living in low-income neighborhoods; frail, seriously ill, or homebound older people; and people with vision and hearing problems.

“The question is ‘Who is going to get the vaccines?’: Older adults who are tech savvy, with financial and family resources to help them, or the populations that are harder to reach?” Said Abraham Brody, associate professor of nursing and medicine at New York University.

“If older people of color and those living in poor neighborhoods cannot find a way to get vaccinated, you will see more disparities than have already arisen during the pandemic,” he said.

Preliminary evidence from a KHN analysis indicates that this appears to be happening. In 23 states that report vaccine data by race, blacks are being vaccinated at a much lower rate than Caucasians, based on their percentage of the population.

The data on Hispanics suggest similar disparities but are incomplete.

Although the data is not age-adjusted, older adults of color have been far more likely to become seriously ill and die from covid than older Caucasian adults, other evidence shows .

Myrna Hart, 79, who has diabetes and high blood pressure and lives in Cottage Grove, Minnesota, a southern suburb of St. Paul, fears missing the vaccine. Hart, who is black, is eager to receive it, but cannot travel to two large senior vaccination sites in the northern suburbs of Minneapolis, more than 30 miles away.

“It’s too much for me to drive; I don’t know the way and I could get lost, ”he said. “I wouldn’t feel safe going alone.”

Family members cannot carry it. Hart’s husband is in a rehab facility after his leg was amputated due to diabetes. Your son is in the hospital with complications from kidney disease. The daughter lives in Westchester County, New York.

So far, Hart has not been successful in getting an appointment online at smaller, closer vaccination centers.

“I don’t know how much I can take this,” she said, her voice cracking, as she described her fear of contracting COVID and her frustration.

“I’m afraid they’re going to run out of [vaccines] before they reach people my age, now that they’ve changed the plan to include 65-year-olds who are getting ahead of us.” (Like many states, Minnesota expanded eligibility for people 65 and older in mid-January, following recommendations from the federal government.)

Although Hart, a former accountant and bookstore owner, knows computers, many older adults are not.

According to a new 2020 survey by researchers at the University of Michigan, nearly 50% of black older adults and 53% of Hispanic older adults do not use their doctors’ patient portals, compared with 39% of older white adults.

What’s more, a significant portion of older black and Hispanic adults lack Internet access: 25% and 21%, respectively, according to the Census Bureau.

“It is not enough to offer technological solutions to these older people: they need someone, an adult child, a grandchild, an advocate, who can help them get involved with the health care system and get these vaccines,” said Dr. Preeti Malani, Director. from the University of Michigan National Survey on Healthy Aging.

In Birmingham, Alabama, Dr. Anand Iyer, a pulmonologist who specializes in caring for the elderly, runs a clinic for more than 200 homeless patients with various types of chronic lung disease, conditions that put them at risk of becoming seriously ill if infected. with the coronavirus. 70% of his patients are black and many are older.

“I would estimate that between 10% and 20% are at risk of missing vaccines because they are homebound, live alone, have no transportation, or lack reliable social connections,” he said.

Every week, he receives a call from a 90-year-old black patient living alone in Tuskegee with chronic obstructive pulmonary disease, heart failure, cancer, and severe arthritis. “She’s older, but she’s resilient and keeps me informed about what’s going on,” Iyer said.

To the knowledge of the physician, this patient has no children, other relatives or friends to help her; instead, he relies on a handyman who comes by from time to time. “How the heck is he supposed to get the vaccine?” He asked himself.

Kei Hoshino Quigley, 42, of New York City, knows that her parents, Japanese-American immigrants who have lived with her since last March, could not have done it without her help.

Although Quigley’s father, 70, and mother, 80, speak English, they have a heavy accent and “it can be very difficult for people to understand them,” she said.

Also, Quigley’s father does not know how to use computers and his mother’s eyesight is not good. “For older people who don’t speak English as their first language and are intimidated by the computer, the systems that have been set up are just insane,” Quigley said.

Knowing that they couldn’t navigate the immunization record systems themselves, Quigley spent hours online trying to secure appointments for his parents.

After encountering a number of problems – frequent error messages, information she entered suddenly got erased on vaccine registration sites, calendars with appointments disappearing by the second, incorrect notices her parents didn’t rate, Quigley arranged for her mother to get vaccinated. in mid-January and his father receives the first vaccination a few weeks later.

Language issues are a major barrier for older Hispanics, who “are not offered vaccine information in a way that they understand or in Spanish,” said Yanira Cruz, president and CEO of the National Hispanic Council on Aging.

“I am very concerned that older adults who are not fluent in English, who do not have a family member to help them navigate online, and who do not have access to private transportation will be left out,” added Cruz.

None of the older adults living in two low-income housing complexes run by his organization in Washington, DC and Garden City, Kansas, have received vaccinations, Cruz said.

“We should take the vaccines to the place where the elderly live, not ask them to take a bus, to expose themselves to other people to try to get to a clinic,” he said.

Nothing can replace a friend or family member determined to ensure that an older loved one is protected against covid. Joanna Stolove has played that role for her father, 82, who is blind and has congestive heart failure, and her mother, 74, who has dementia.

The couple lives in Nassau County, on Long Island, New York, and receives 40 hours of home care each week.

Stolove, a geriatric social worker, took time out at work to try to get her father out on a date, but many people can’t afford that luxury. She works in a retirement community in Morningside Heights, a diverse neighborhood on the Upper West Side of Manhattan.

With great effort, Stolove arranged an appointment for his father at a large vaccine center in Jones Beach on January 26; her sister arranged an appointment for her mother at the same location for the end of February. At work, where many of her clients live alone and have no family or friends they can trust for help, she advises them on vaccinations and tries to get appointments on their behalf.

“I have so many advantages to be able to help my parents,” Stolove said. “Without the help of someone like me, how can people cope with this?”

This article was originally published on Seniors without family or friends left behind in the race to get vaccinated

Sydney Boles