For six weeks, retired teacher Ellen Barrett, 77, said she felt she had a full-time job: searching for a coronavirus vaccine.
She contacted Montgomery County in Pennsylvania. She thought she secured appointments at Montgomery County Community College, she said, and with St. Luke’s health system in Bethlehem, only to be notified they’d been canceled. When a friend or neighbor texted Barrett saying they had made an appointment, she ran to her compter, only to be shut out. Finally in February, Barrett got her first shot at Yorktown Pharmacy, where she had been wait-listed for six weeks.
"It’s like you’ve won the lottery," she said. But the complex, consuming, 24/7 process to get a coveted appointment was "beyond my comprehension." She has friends, she said, who are eligible due to their age and health but are "at their wit’s ends," unable to get appointments. And these people, she said, are computer savvy.
In Pennsylvania and New Jersey, those 65 and older are eligible to be vaccinated. In Pennsylvania, about 44% of seniors, excluding those who live in Philadelphia, had received at least one dose as of early March, according to Department of Health data. In New Jersey, about half its seniors have been vaccinated, according to state data.
But two months into the coronavirus vaccine rollout, many of Pennsylvania’s 2.2 million seniors said they have not been able to get an appointment, according to a statewide AARP survey, and their frustration with the process has only mounted, amid the news of a second-dose shortage and controversy over the southeast region’s vaccine supply.
It is life and death," said Bill Johnston-Walsh, state director of AARP Pennsylvania. "What we’re hearing from our members is they don’t know where to turn."
In February, AARP found that only about 27% of its members had been able to secure an appointment, according to the informal survey of more than 3,000 Pennsylvania seniors. Respondents described the rollout as "the wild west," a "crap shoot" and a "degrading Hunger Games," Johnston-Walsh said.
Those who secured appointments, he added, reported spending hours doing so, with some ultimately making appointments across the state.
In Delaware County, where nearly 17% of the population is 65 and older, Monica Taylor, vice chair of county council, said most of the frustration she hears is from seniors. "They are our most vulnerable population," she said, "and they are having the most difficulty getting the vaccine."
Senior advocates like Johnston-Walsh, as well as the region’s lawmakers and county officials, say those 65 and older are being boxed out of the process by younger people who are eligible due to jobs and health. They are often more tech-savvy and physically able to wait in hours-long lines for walk-up clinics or drive to another county. Without a central phone number for vaccine registration or senior-specific inoculation locations, many advocates worry about what will happen to much of the older population — the most likely to suffer serious illness and death from COVID-19 — when vaccine eligibility expands further.
"I am very concerned that people will be left behind in this vaccine scheme," said Karen Buck, director of the Philadelphia-based SeniorLAW Center.
Pennsylvania is working to ensure this doesn’t happen, Department of Health spokesperson Maggi Barton said, but has been hamstrung by a limited vaccine supply from the federal government. The Pennsylvania Department of Aging is working with Walmart on clinics that seniors don’t need to sign up for online, she said, and pre-enrolling people served by a pharmacy assistance program for lower-income older adults. The state’s 52 Area Agencies on Aging can also help residents get vaccine appointments and transportation, she added.
In Philadelphia, the vast racial and economic inequities that have been barriers to its vaccine rollout are exacerbated for elderly Philadelphians, a large, diverse and economically disadvantaged population. In early March, the city, whose vaccine plan is separate from the state, expanded its eligibility to include people 65 and older. Current data on the percent of Philadelphia seniors who had been vaccinated was not immediately available.
About 19% of Philadelphians are 60 or older, and more than 40% of them live in poverty, the highest percentage of the nation’s 10 largest cities. Of Philly’s seniors, about 53% are nonwhite, people of color, and about 13% are foreign-born residents.
Elderly Philadelphians face immense language, accessibility and transportation barriers when signing up for appointments and accessing clinics, Buck said. If the city does not tap into the existing aging network to find solutions, like mobile vaccine sites, she said, the barriers and inequities will persist.
Some older Pennsylvanians have given up on finding a vaccine. State Sen. Judy Ward, a Republican who represents several counties in central Pennsylvania, said older constituents have "just shut down," overwhelmed by the patchwork system. State Rep. Frank Farry, a Bucks County Republican, said his mother gave up on making an appointment after no success registering on multiple websites.
Senior advocates say these hunts would be made easier by something simple: a central phone line.
"The answer isn’t just ‘well keep refreshing your browser’ for an 82-year-old," said state Rep. Gary Day, a Republican from Berks and Lehigh counties who chairs the committee on aging and older adult services.
While the Pennsylvania Health Department has a hotline for general concerns, it is not vaccine-specific.
Across the state, many providers require patients sign up online and communicate with them primarily over email.
Johnston-Walsh, of AARP, and Buck, of SeniorLAW Center, attend regular meetings with senior groups and the Department of Health where advocates push for better vaccine access for older Pennsylvanians.
Acting Health Secretary Alison Beam recently participated in an hourlong AARP telephone town hall attended by 15,000 members, 650 of whom waited in the queue to ask questions, Johnston-Walsh said.
Johnston-Walsh said he believes Beam and others are listening to residents’ concerns. But "I wish they’d move a little quicker," he said.
Some Pennsylvania counties have tried to fill the gap themselves. In Allegheny, home to Pittsburgh, people who are 65 and older and don’t have Internet access can call 211, noted Angela Foreshaw-Rouse, manager of state operations and community outreach at AARP Pennsylvania.
Chester County launched its own coronavirus call center as did neighboring Delaware. While callers can’t sign up for appointments using it, they appreciate talking to a live person who can answer questions and empathize. "I think having a voice makes people feel better," Chester County Commissioner Marian Moskowitz said.
With staff writers Ellie Rushing, Justine McDaniel and Allison Steele