Just the other day, Barbara Felker had to troubleshoot an outreach effort to help seniors sign up for a Covid-19 vaccine.
"We were given a new link to distribute to seniors in this housing complex, and it asked for their mother's maiden name," said Felker, vice president of strategic community partnerships at Northwell Health. "There were some who could not remember, and because of that they couldn't proceed with the process.
"Why does the system need to know that to vaccinate people and risk cutting people who didn't know how to bypass that out of the process?" she asked.
Indeed, they believe, the city could achieve so-called herd immunity, in which a community achieves protection from a virus as the majority are vaccinated, by May at the earliest and the end of the year at the latest. That's a positive sign for the full reopening of businesses and office towers.
Digital divide
The city and the state have put much of their vaccination efforts online—availability and eligibility can be obtained through websites. However, that leaves out many New Yorkers without technological resources, such as the elderly and some in low-income communities.
It's important, experts say, that lack of technical access not be conflated with vaccine hesitancy. According to experts, those who may not have signed up yet to receive a vaccine may actually want one. That includes people of color.
Recent surveys seem to paint communities of color, particularly Black New Yorkers, as hesitant or unwilling to sign up for the doses.
"We hear so often about Black communities and communities of color having vaccine hesitancy, as uptake has been low in those communities," said Dr. Lynne Richardson, system vice chair of emergency medicine and co-director of the Institute for Health Equity Research at Mount Sinai Health System. "But what's at play here is a whole lot of other factors relating to digital resources and social determinants of health."
There are varying degrees at which people might fall in the digital divide, said Dr. Jessica Justman, associate professor of medicine in epidemiology at the Columbia Mailman School of Public Health.
At the end of the spectrum are people who lack a computer at home or a smart device or do not have internet access or a data plan. There are probably more than 500,000 households in the city that do not have access to high-speed internet or devices, Richardson said. Communities that are most likely to lack that access also happen to be in the Black and Latino community, she said.
Then comes people who might have online access but are in so-called digital deserts without stable internet or cell service, said Dr. Bruce Y. Lee, professor of health policy and management at the CUNY Graduate School of Public Health. Lower-income neighborhoods that have not seen adequate infrastructure investments tend to fall in this category, he said.
As of March 24, about 12.5% of city residents and 14% of state residents had been fully vaccinated, according to state data. Although reports that certain segments of the population, such as communities of color, are refusing to get the doses persist, experts say the vaccine effort is actually on track. Many of the challenges relate to online access and computer competence more so than willingness to get the vaccine.
Then there are people with internet and devices who don't have the technical savvy to navigate online forms, Richardson said. Seniors particularly fall into this group, but it also includes low-income adults who do not routinely use a computer at work or did not have much computer education growing up, she said.
When the vaccines were first available to New Yorkers in late December, the Charles B. Wang Health Center locations in Chinatown and Flushing were among the local facilities tapped as distribution points.
"We got over 7,000 phone calls in two hours, and that shut our phone system down," said Ken Shieh, its chief strategy officer.
Many of the callers were 75 and older and did not speak English. Staff went through the list and called every single person back.
"Even though it took us weeks, the response we got back was overwhelming," Shieh said. "They were saying they had no other ways of making a vaccine appointment."
Working the phones can be key, but it's also important to have boots on the ground.
"We had someone in the lobby [of a senior housing complex] register folks," Felker said. When New Yorkers who showed up at a vaccine pop-up site in Queens were asked, many said they were notified by flyer, she said.
With demand currently outstripping supply, certain innovations don't actually increase the rate of vaccination; they merely ensure doses are distributed first to people with technical know-how, said Kaushal Challa, CEO of the Charles B. Wang Health Center.
"It's like searching for a Lady Gaga concert ticket," he said. "They go to the person who knows how to refresh a site fastest and are gone in seconds."
In fact, the initial low uptake rate in communities of color were largely due to supply issues, Kaushal said. He noted that each Charles B. Wang center location is equipped to deliver 500 doses per day. "We never got supplies close to that level," he said.
Additionally, the state had set strict guidance about what facilities could vaccinate which individuals.
"For us, we had to prioritize health care providers and were told to stop reaching out to the elderly, even if they were eligible," Kaushal said. Failure to follow the instructions led to withheld supplies, he added.
Despite the challenges to access and the inevitability that some New Yorkers will never want to take the vaccine, experts said they are confident the city is on track to achieving the 65% to 80% vaccination rate needed for herd immunity at least by the end of this year, if not earlier.
A Pew Research Center survey conducted in February found that the percentage of Americans who said they would not get a vaccine was at 30%, down from 49% in September, Justman noted. It's important to keep in mind that these surveys are just a snapshot in time and people do change their minds, she said.
Also, some people may want others to take the vaccine first. Upon seeing it's safe, they will get a jab themselves, Richardson said. Those who are unsure because of basic concerns, such as side effects, will have their doubts dispelled easily as more people around them become vaccinated, Lee said.
That's not to say actual hesitancy doesn't exist. There are certainly dedicated anti-vaxxers, but they are a very small segment of the population, Richardson said.
And, of course, if a local community doesn't achieve the immunity threshold, an outbreak could occur, Richardson said. The city saw that with the measles outbreak among the Orthodox Jewish community in 2019. But when the city intervened by not allowing children to attend schools unless vaccinated, vaccination rates shot up, she said.
And, hopefully, such events won't repeat themselves when it comes to Covid.
"I don't think we would need such drastic measures for this vaccine," she said. "Most people here want it; they just can't get it at this point."
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City on track for herd immunity, though lack of digital access hampers efforts - Crain's New York Business
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