“I think we need to do more than talk about equity. We need to really put plans into place to correct the trends we're seeing now,” said Dr. Leo Morales, chief diversity officer at the University of Washington School of Medicine.
“Working with communities that are more difficult to access, or have access barriers, is going to be a slower process,” Morales said. “And it's going to require investment of resources, material and time.”
Take Sokha Danh, a community organizer who grew up in White Center. Danh was tasked with finding vaccine appointments for three Cambodian elders, including a 79-year-old Buddhist monk from Tacoma. He turned to Facebook for help.
“Man, I remember how QUICK they were to put the first ever quarantine facility in White Center when there were so many unknowns about the virus. Wished they were just as fast and intentional about bringing vaccinations into our community,” he wrote on Facebook earlier this month, referring to the opening of quarantine sites in King County at the beginning of the pandemic for those who tested positive for the coronavirus. The introduction of quarantine sites in cities where large populations of communities of color live, as opposed to the majority white and wealthy areas where COVID-19 diagnoses and related deaths first occurred, caused an uproar at the time.
Danh, 31, said he had already spent several hours scouring a long list of vaccine providers before scribbling his plea on Facebook. The elders Danh was trying to help weren’t fluent in English and weren’t sure where or whom to turn to. In the end, Danh found appointments through a private Facebook group: “Find a Covid Shot WA,” which has 28,000 members who pipe in when they have leads on a vaccine appointment.
The roundabout way of scoring appointments for the vaccine lays bare gaps in a system in Washington state already prone to dysfunction because of an unpredictable supply of vaccine doses from the federal government.
Just last week, 90% of vaccine shipments were delayed by inclement weather in the eastern U.S. The state expected about 200,000 doses, but the delays led to the temporary closure of the state's four mass vaccination sites. Appointments needed to be rescheduled. Appointments at King County’s two vaccination sites, in Auburn and Kent, were also postponed. Overall, Washington state is currently vaccinating an average of approximately 26,000 people a day, still far short of the 45,000 the state Department of Health aims for. Approximately 30% of the 1.2 million Washingtonians over age 65 have had at least one vaccine dose, according to the state Department of Health.
But there are bright spots on the horizon with regard to vaccine distribution. In addition to the number of pop-up clinics orchestrated by the Seattle Fire Department, community groups, faith organizations and others, pharmacies are beginning to receive vaccine shipments directly from the federal government as part of a new program.
And in a briefing late last week, state Secretary of Health Dr. Umair A. Shah said more specific data indicated that the racial disparities in vaccination rates were not as great as once thought, although they still existed.
For example, 3.6% of those 65 and older in Washington state identify as Latino, yet only 2.5% of that population has been vaccinated. And 2.1% of Washingtonians older than 65 are Black, but only 1.2% have been vaccinated so far. Seattle Mayor Jenny Durkan, for her part, said she has focused on adult family homes, affordable housing buildings and pop-up clinics, with roughly 70% of the more than 4,000 individuals vaccinated by the city identifying as Black, Indigenous, or People of Color.
When the vaccination numbers are compared with the racial breakdown of people affected by the coronavirus, the disparities seem more stark. Latino and Black communities have been disproportionately impacted by the coronavirus. About 32% of people who had the coronavirus statewide identified as Hispanic, while 13% of the population is Hispanic or Latino. About 5% of coronavirus cases affected Black people, who make up 4% of the state population. Unlike the numbers in some other states, Latino and Black people are not disproportionately represented in Washington COVID-19 deaths, according to state data.
Improvements going forward
Washington state is attempting to better serve BIPOC communities by now reserving 20% of vaccine appointments for those made over the phone rather than through an online system, which has been difficult to navigate among those with limited internet access or English skills.
Dr. Mark Del Beccaro, who is helping lead south King County vaccination sites, said in addition to establishing a multilingual, more robust phone system with greater capacity, the county is looking at opening a third community vaccination site.
Still, some would rather turn to more well-known entities, such as community health clinics, than mass vaccination sites, in part because they are familiar with these clinics as the place to go for other health care. Fear of the vaccine is another factor in how slowly it has been given to some communities.
Teresita Batayola is president of International Community Health Services, which provides care in 11 locations to thousands of patients, many of them Asian Americans, Pacific Islanders and Latinx. Her clinics are part of a new program that will receive vaccine shipments directly from the federal government. The pilot program for now involves only 25 community health clinics and also includes the Yakima Valley Farm Workers Clinic. The aim of the program is to prioritize health centers with community connections. ICHS hopes to receive its first shipment of 2,200 doses this week.
Irene Danysh, left, attempts to sort out why Maria Gonsalez’ appointment is not on the schedule to receive a COVID-19 vaccine, at a city pop-up clinic in West Seattle, February 18, 2021. After some deliberation, Danysh was able to get a new appointment for Gonsalez for the following week by letting her friend have an appointment that was made for her father. (Shaminder Dulai/Crosscut)
Reaching elders at home
But for other populations, such as elders who live alone and who might not have family to help or ready access to transportation, coronavirus vaccines remain largely out of reach. Mobile vans or pop-up clinics help, but can’t get to everyone. Seattle Fire Department Chief Harold Scoggins said that right now his department is focusing on reaching those who need second doses and aren’t yet visiting individual homes.
Daniel Marsh, a 41-year-old independent tech support worker in Bellevue, said he’s helped several of his elderly clients sift through “a hodgepodge of different systems.”
“We just created this system that the elderly are not able to navigate on their own,” Marsh said, noting that older people might not be adept at browsing through the hundreds of different vaccine providers on the Washington State Department of Health website. “I am a pretty sophisticated computer user, and I have difficulty.”
Marsh said even pharmacies and mass vaccination sites can be problematic for older people who might have to use the bathroom more regularly, take pills on a schedule or are otherwise unable to stand in line for long periods of time.
“We’re just not meeting these people where they’re at with their limitations,” Marsh said. “Not everybody has that person in their life to advocate for them, and I think a lot of those people are falling through the cracks.”
A group of students and former Microsoft workers recently unveiled a new website that consolidates all the disparate scheduling tools, which they hope will simplify the search for an appointment. The Washington state Department of Health is now collaborating with the team of tech volunteers to make improvements to the state's system.
Geraldine Lee, a 43-year-old nurse practitioner in Fremont/Wallingford, said she had trouble getting her 83-year-old Asian American dad, who is on dialysis, vaccinated.
“Once you’re on dialysis, you’re extremely immunocompromised,” Lee said. “If you get COVID you’re pretty much finished.”
A pop-up clinic in West Seattle provides COVID-19 testing and vaccines by appointment, February 18, 2021. With a goal of reaching more underserved communities, the city dedicated this particular morning to reaching Latinx community members who were referred by El Comite or Villa Comunitaria. King County Latinx residents make up 24.1% of confirmed COVID-19 cases and 17.7% of hospitalizations, despite making up 10% of King County’s population. And West Seattle, South Seattle, Delridge, and Highline have the lowest vaccination rate of people 65 or older among all Seattle neighborhoods tracked by Public Health – Seattle & King County. (Shaminder Dulai/Crosscut)
A more targeted rollout
Lee, who was finally able to get an appointment at a Safeway, thinks primary care doctors who can already identify the most vulnerable patients and whom patients trust should be more of a priority in terms of vaccine distribution.
“I think the rollout could have been a lot more targeted,” Lee said.
Minh-Duc Pham Nguyen, executive director of Helping Link, an organization aimed at empowering Vietnamese communities, said there are cultural differences that the state may have not weighed enough, such as families who traditionally take care of elders at home. These families should be given as much consideration as those who have loved ones in nursing homes, she said.
“I’m holding him accountable for this. He’s had so much time to work this out,” Nguyen said, referring to Washington state Gov. Jay Inslee. “You’re pitting vulnerable people against one another and that doesn’t work.”
“Why weren’t we more proactive? It should not be a crisis,” she said. “We got so lazy that now we think everyone can get on and get the info in a flash, but we're the privileged ones.”
Michael Byun, executive director of Asian Counseling and Referral Service, said he agrees leaning into certain cultural traditions, whether that involves churches, ethinic newspapers or other methods, is a good way to inform people and overcome vaccine hesitancy.
“It’s not that it’s not happening, but we need to amplify and need to make it happen more,” Byun said. The state, for example, recently contracted with The Black Lens, an independent community publication in Spokane, to produce a radio show that speaks to vaccine hesitancy. It is also working with the nonprofit Wenatchee CAFÉ to set up a hotline to help members from the Latinx/Spanish-speaking community through the vaccine registration process.
Additional cash could soon fuel efforts to reach communities most impacted by the pandemic. Community and philanthropic leaders and public officials from across the state recently announced a new public-private partnership that aims to raise $15 million in private donations matched with another $15 million from the state. The money will help fund transportation for those who want to be vaccinated, translations of vaccination information, mobile and pop-up vaccine clinics and phone and text banking.
Still, many experts insist the biggest obstacle remains the limited supply of vaccine doses. Dr. Del Beccaro, who is setting up the south King County vaccination sites, said both capacity and distribution are big problems.
“Basically, right now, we’re dividing a very small pie and nobody is satisfied,” he said.