The state’s patchwork approach has left particularly at-risk residents and communities at a tremendous disadvantage. (Dan Nott / For Spotlight PA)
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HARRISBURG — In the weeks since Pennsylvania began its coronavirus vaccine rollout, the Wolf administration has stood by its localized, do-it-yourself system for finding and booking appointments, despite widespread frustration among residents.
“The relationship that folks have with their provider or with their pharmacists is what was best suited to actually administer the vaccine,” acting Health Secretary Alison Beam said in January. “And so we are allowing those providers and those pharmacists to be able to use their scheduling systems.”
But the state’s patchwork approach has left particularly at-risk residents and communities at a tremendous disadvantage. Older Pennsylvanians, who are supposed to be among the first in line to get the vaccine, are struggling with clunky and disjointed online sign-ups and phone numbers that get them nowhere, while those who are more tech-savvy jump ahead.
And more than a month into the rollout, the Pennsylvania Health Department hasn’t done any targeted outreach on the vaccine to communities that don’t speak English, many of whom have been disproportionately affected by the pandemic.
The state’s map of vaccine providers — which includes information on how and where to book coveted appointments — appears only in English. And a translated fact sheet on the vaccine for Spanish speakers hasn’t been updated since late December, before adults 65 and over and younger people with select health conditions became eligible.
Roughly 1.4 million people — more than 11% of the state — speak languages other than English at home, according to U.S. Census data. The majority of those who have been vaccinated so far, state data show, have been white or of an unknown race.
In the absence of official messaging from the state, advocates who serve these communities said they have been deluged with requests for information on the vaccine. Misinformation has circulated quickly.
“The communication of who is eligible for the vaccine has not been done adequately in any other language besides English,” said Laura Perkins, an organizer at Casa San Jose, an organization that serves immigrants in Allegheny County and elsewhere in southwestern Pennsylvania.
“We work primarily with the Latinx community,” Perkins added, “but we also have a large Russian population, Chinese population, Nepali population, Somali Bantu population, many folks that speak Arabic. And the only attempt at another language is in Spanish and that information is not updated.”
Officials are “working diligently” on improving language access, Lindsey Mauldin, Department of Health senior adviser, said at a news conference last week. On the department’s website, information about COVID-19 can be auto-translated, though the governor’s task force on COVID-19 health disparity recommended in August that related materials “be properly translated by professional translators, instead of machine translation.”
“We are working with our health equity response team to ensure more equity among our vaccine distribution,” Mauldin said, though she did not offer a timeline for updated materials.
But this isn’t the first time the Wolf administration has failed to prioritize outreach and materials for those who do not speak English. Last year, after Spotlight PA reported on the lack of coronavirus-related information available in other languages, Pennsylvania added Spanish captions to its daily briefings and updated its website to include fact sheets and other materials translated into Spanish. The state also launched a much-needed rental relief program without forms available in languages other than English.
The situation for Spanish speakers is slightly better in Philadelphia, which is managing its own vaccine program. The city has an online interest form in both English and Spanish. But it’s not enough, some residents and advocates said.
“We need numbers where we can call people who speak our language to ask questions and to be able to get answers around the vaccine that understand what we’re saying,” Claudia Garcia of Philadelphia, who cleans houses and provides in-home elder care, told Spotlight PA through a translator.
Language access isn’t the only problem vaccine-seekers have sought help with, said Nicole Kligerman, Pennsylvania director of the National Domestic Workers Alliance.
“There is limited knowledge of using tech,” Kligerman said.
Philadelphia officials are using a system that collects information, like age and occupation, on users who are interested in receiving the vaccine. On its website, the city’s Department of Health says it uses the information to alert residents to places they can receive the vaccine when it’s their turn.
But many members of the National Domestic Workers Alliance do not have access to smartphones or computers, much less the internet or even an email address.
“And even if they do, the registration page is not necessarily user-friendly for everybody,” Kligerman added of the Philadelphia platform.
Accessing information has been similarly dire for older Pennsylvanians, who told Spotlight PA the state’s provider map — the only vaccine access tool the Department of Health has released — is essentially useless. Adults over 70 account for almost 80% of those who have died from the virus in Pennsylvania. And while most residents of the state’s nursing homes have been offered a vaccine through a federal program, the rollout is going much slower in other long-term care facilities. Many seniors who live independently, meanwhile, are on their own.
“It’s been frustrating,” said 70-year-old Richard Schuetz. “And what happens when people get frustrated? They lose confidence in the government.”
When vaccine seekers called providers directly to make appointments using numbers listed on the state’s map, some told Spotlight PA they were directed back to online portals. Voice mails, many reported, went unreturned. And when they were available, vaccine slots were snapped up quickly.
Fred Hunt, who lives in Bradford County, even synchronized operations with a family member to sign up for appointments online for himself and his wife through a hospital’s online portal.
“By the time my daughter-in-law and I got it coordinated so we’d both have [appointment] times that were similar, all the times were gone,” the 80-year-old said.
“It was five minutes,” he added. “In five minutes all 400 slots were gone.”
“It’s like you’re trying to get concert tickets,” said Sue Burnside, who lives in the Lehigh Valley area, describing her struggle to make vaccine appointments for her mother, 85, and father, 90, who live in Harrisburg.
“I’ve literally spent more than five days on the computer checking the various links,” Burnside said, detailing the process of finding appointments. “Checking on all the links — minimally — every half-hour. Six o’clock in the morning until nine or 10 at night.”
Eventually, she was able to book vaccine appointments for her parents — in two different places on two separate dates.
A spokesperson for the state Health Department said older Pennsylvanians can call 877-PA-HEALTH to get help finding a vaccine provider.
“They cannot make the appointment for people, but they can help them locate providers near them and give them the contact information to make the appointment,” a spokesperson said. “Meanwhile, we are working with the organizations that support older Pennsylvanians to increase the avenues available for them to connect with a vaccine provider.”
The spokesperson did not know how many multilingual speakers staff the hotline.
Pennsylvania officials are grappling with problems outside their control, primarily a limited supply of vaccines from the federal government. President Joe Biden has promised states more doses in the coming weeks, but Pennsylvania officials say this still won’t be enough to vaccinate all 4 million people eligible in the first phase in a timely manner.
Still, some states — including California, New Mexico, and New Jersey — have implemented centralized sign-up systems that alert residents when they are eligible to schedule an appointment.
Pennsylvania’s plan, meanwhile, has been “a competition in which the fittest and most technologically adept — who frankly, aren’t the people we are really charged with serving first — get the prize,” Susan Friedberg Kalson, CEO of Squirrel Hill Health Center in Pittsburgh, told a state House panel last week.
A centralized system could minimize the problem caused when appointment seekers schedule visits at several places then fail to show up to a planned appointment, Kalson and other administrators said at Wednesday’s hearing.
“Many people register at multiple locations, compounding the problem of no-shows and potential waste,” she added.
Centralizing the state’s vaccine sign-up system would likely present additional technological considerations, other experts said. To be able to schedule appointments and share records, hospital IT systems would have to work together, something they don’t usually do, Spotlight PA previously reported.
Speaking to the House Health Committee last Wednesday, Beam, the acting health secretary, again defended the agency’s response, saying that states that centralized their systems “have failed to be successful.”
“There is not enough vaccine, with or without a registration system,” she added. “And a registration system won’t fix that limiting factor.”