Last week, I scored a major coup in my informal, one-woman “medical concierge vaccine finder” service. Since COVID-19 vaccine access has been expanded around the country to accommodate older adults, I have made it my personal mission to assist eligible relatives and loved ones in getting appointments. I’ve been monitoring numerous counties in Oregon, Missouri, Massachusetts, Vermont, California, Washington, and my home state of Utah, where Artemis Health is headquartered.
Each morning before I start my work day at Artemis, I pull up about a dozen websites from county health departments around the country. Last Tuesday, I finally struck gold. Missouri, where my father and his partner live, had published a new resource on their website: a COVID-19 vaccine finder map. I zoomed in on their rural town, and saw the map listed about 10 locations within an hour's drive of their home. Two Walmart locations, three county health departments, and a handful of hospitals and clinics. I called my dad immediately and shared the intel. He started calling around, and managed to book appointments at the health department’s drive-thru clinic on Friday, just three days away.
I couldn’t believe it. It seemed too easy to be a “real” clinic, but Friday rolled around and they did indeed get their first doses of the COVID-19 vaccine. The relief was so intense that I cried tears of joy. I had finally done something (besides staying home and watching Netflix) to help end this miserable pandemic. I stopped obsessively following Missouri’s vaccine rollout in favor of other states where other loved ones live.
And then I wondered, “What about the people who don’t have time for this? Or don’t have healthcare-savvy relatives to help them navigate this? Who is going to score vaccine appointments for them?” Kaiser Health News tackled this very question in a recent piece called, “Older Adults Without Family or Friends Lag in Race to Get Vaccines.” The article highlights the difficulties people are facing, including transportation, technology, and fierce competition. One expert interviewed in the article notes:
“The question is ‘Who’s going to actually get vaccines?’ — older adults who are tech-savvy, with financial resources and family members to help them, or harder-to-reach populations?” said Abraham “Ab” Brody, an associate professor of nursing and medicine at New York University.”
This issue is playing out in counties across the nation, where beleaguered public health officials are struggling to reach those most in need of vaccines: the homebound, the isolated, and those living below the poverty line.
Afton January, Communications Manager for Salt Lake County’s Aging and Adult Services, shared her department’s strategy for vaccinating those without other means of support. “We’re calling them, going through lists of clients who visited senior centers. We’re using every avenue available to us to find older adults who otherwise might not have a way to get to the vaccine clinics. Almost every county department is pitching in with cold calling.”
The most vulnerable among us when it comes to accessing the vaccine are also the most likely to become infected with or die from COVID-19. Health equity issues have already arisen, with early data showing racial inequities in who is getting the vaccine. Additionally, the nature of online portals create a socioeconomic barrier. People getting appointments are, like me, those who have the time to repeatedly refresh a browser window, check websites multiple times a day, and wait in long lines at vaccination centers. Those working hourly jobs, those without fast internet connections, and even those whose jobs don’t involve a computer screen won’t be able to help relatives get fast access to the vaccine.
Each state and local government is taking a different approach to prioritizing vaccine recipients and distributing them to the public. Some are still focused on healthcare workers and haven’t opened appointments for older adults. Some have opened to people 65 and older, others 70+, and others 75+. Some states have moved teachers up in the line in an effort to make schools safe for reopening. Some are vaccinating anyone who is eligible, while others are requiring proof of residency or restricting people from seeking a vaccine outside their home county. Certain states are verifying eligibility and issuing QR codes for residents to present at their appointments, while others are leaving verification up to the individual vaccine clinics/events.
This tangled web of rules and regulations is, sadly, a perfect corollary for the healthcare system itself. Patients seeking a COVID-19 vaccine are confused, scared, and desperate. They don’t know how to navigate this system, and while health officials are doing their best, there seems to be no one source of truth. Unless they have a savvy friend or family member to help, they get lost in the complexity of the system.
The same is true for many people with a new cancer diagnosis, a sudden knee injury, or a chronic condition like diabetes. They are scared, sick or injured, and facing a mountain of confusing information about how to get better. They don’t know how to find an in-network doctor, seek a second opinion, understand deductibles, compare costs, or evaluate quality care. For over 50% of Americans, that’s where employers enter the picture. Half of us get our healthcare through our employers, and they see it as a duty to help us lead healthier lives.
Artemis Health was founded to help self-insured employers and their advisors optimize health benefits using data. Benefits leaders take on the responsibility of educating members and helping them navigate the healthcare system, and COVID-19 has only increased the urgency of this task. We hear from benefits brokers and consultants who are fielding daily phone calls from their employer clients during the pandemic. They’re asking clinical experts about the best PPE for essential workers, the latest therapeutic drugs, guidelines for safely reopening offices, and how to help employees access the vaccines. Employers see it as a duty to provide the best information possible to their members. In our recent research study, one employer shared this insights:
“During this turbulent time, more than ever, I need to figure out how to take care of our employees.”
-Director/Senior Director at organization with 50,000+ employees
Artemis Health wants to help employers everywhere find the best way to take care of their employees. We’re doing it with proactive data insights, holistic information on population health, and visibility into what matters most for employee well-being. We’ve built a number of COVID-19 resources for our customers, including risk assessment dashboards, chronic condition information, and helpful tips from other employers.
In that spirit, I want to share some tips I’ve learned in my own COVID-19 vaccine monitoring, as well as some ways employers may be able to help employees.
While statewide COVID-19 dashboards and health departments are helpful, most places in the U.S. are handling vaccine distribution and appointments at the county level. Each county is receiving doses based on population data, and you may be prohibited from driving across county lines to get your shot. If you’re looking for a vaccine appointment, start at your home county’s health department website. Many are updated several times a week with information on how many doses they received, when and where they’ll be holding clinics, and when appointment scheduling tools will open up. Keep these websites in your bookmarks and refresh, refresh, refresh.
Because each state is handling the vaccine rollout differently, each will have its own eligibility tiers/phases/groups. A little digging on state websites will reveal a chart that looks something like this:
This chart is for California, which if you read the fine print at the top, is now vaccinating Phase 1B Tier One individuals. Keep an eye on these charts, as they are periodically updated when a state moves to another tier.
Small, rural county health departments do not have large PR budgets, and many are utilizing social media platforms like Facebook to get the word out about available appointments and eligibility. Follow your local health department’s page, like all of their posts (so they continue to pop up in your feed), and check back daily to see if there’s new information. One county I’m tracking (Umatilla County, Oregon) posts twice a day in English and Spanish: once with the COVID-19 infection numbers for the county, and once with an update on their vaccine clinics. The posts always go up at the same time of day, so now I know to check Facebook at 3pm Pacific to see when appointment slots will be available to book.
With overwhelmed staff and limited budgets, it may take some time for counties or vaccination centers to post updates or open appointment slots. Many are taking appointments over the phone to help ease the tech burden on older adults. One family friend scored her appointment by calling all the Walmart pharmacy locations listed on her county’s vaccine finder website after she found “No Appointments Available” messages on their websites. If you’re not getting through using web tools, try calling. Make sure you’re polite to the people you reach. Keep in mind that they are overwhelmed and probably hearing from a lot of anxious people.
Local newspapers remain a great resource for getting the word out to older adults, and you’ll find helpful information in their pages and on their websites. They’re keeping the public informed of new eligibility phases, doses coming to the state, and vaccination locations. One colleague scored an appointment for her elderly parents after seeing an evening news report that the local university’s stadium would soon become a vaccination site. National news can also be useful for practical information, like vaccine side effects or recommendations for those with pre-existing conditions. I saw a helpful report just the other day advising vaccine recipients to avoid taking common pain relievers prior to their shots, which may affect the strength of the immune response (my dad hadn’t seen this report, so I shared it with him before his appointment). The CDC’s website also has great information for vaccine recipients to prepare for their appointment, including info on how you’ll be monitored for allergic reactions, what your vaccine record card will look like, and more.
I know I’m not alone in my quest to secure vaccine doses for the people I love, and I’ve been sure to share what I learn with friends and colleagues. Many have called me to see if I could help with their efforts or shared their own success stories. If you find a tip, a useful web resource, or a helpful person, let others know. Even though the vaccine is scarce, this situation is the epitome of “the more the merrier.” The more people who receive the vaccine, the sooner we can control this virus.
Reports are popping up around the country of people who are bending the rules (or just getting lucky) to get their vaccine doses. This is an unprecedented health crisis, and it will take collective action to solve it. Keep trying, be persistent, but be patient as you try to secure a vaccine for yourself or your loved ones. It’s easy to get discouraged and even outraged at those who aren’t waiting their turns, but I’ve found it helpful to keep in mind that vaccines work on a population level. If we all get our shots, we’ll all be safer. I’m happy to be waiting my turn and delighted for friends and family who are now better protected from COVID-19.
Self-insured employers would love to order their own doses and hold their own COVID-19 vaccine clinics, but at this point in the distribution plan, all doses seem to be going through government channels. But that doesn’t mean employee benefits experts don’t play a role in the vaccine process. They are crucial pieces of the healthcare education puzzle, and they can help members access and educate themselves about the vaccine. Here are a few ways they can contribute.
Use your member education experience and resources to help your population understand the safety and efficacy of the COVID-19 vaccines. Some employers are deploying clinical experts to educate members and encourage them to seek the shots. Artemis Health employees will be treated to an info session next week by a doctor of pharmacy (Pharm.D.) on our clinical team. He’ll walk us through some facts and helpful info as more of us become eligible.
While adults over 65+ likely don’t represent the majority of your employee population, many employers have retirees or adult dependents on their plans. These members can benefit from mailers, phone calls, and emails to help them understand the process for getting a vaccine in their state. If possible, localize the information to better reflect the rules and regulations where they live.
Employers can also begin helping younger members understand the vaccination process. Messaging could include instructions on how to verify your eligibility, what to bring to your COVID-19 vaccine appointment, how you’ll be monitored for side effects, walk-up vs. drive-thru models, and what to expect from your second dose. Again, these education materials should be tailored by member location whenever possible. Communicating these expectations in advance will help people feel confident and prepared when it’s their turn to get the shot.
My uncle works at a chicken processing plant, and he will be eligible in the next phase of his state’s rollout as a food supply worker. He told me the other day, “I think my company is going to do all our shots, so I don’t need to go through the county health department.” While it’s possible that this will indeed be the case, I advised him to verify with his HR and Benefits team. I know in many states, teachers and school employees are going through the county’s system like everyone else. If your employee population falls into upcoming tiers in your state, it’s crucial to let them know how the vaccine will be available to them. If you don’t have clarity on this yet, workers should be prepared for seeking the shot on their own. Whether it’s through your clinical partners or a local government agency, essential workers should be prepared now for navigating the process once they’re eligible.
We recently highlighted the strategy Dollar General is rolling out to incentivize and allow employees to seek the vaccine. They’re giving employees extra paid time off to travel to vaccine appointments, and removing barriers that would prevent people from getting the shot. This method could be the right balance between mandating a shot, which many employers are exploring, and leaving it up to employees.
While I joked about providing an informal “vaccine concierge service” for my relatives, benefits professionals will recognize that these programs actually do exist. A recent piece in Employee Benefit News highlighted one vaccine management solution, VaxAtlas, which created a digital platform to help employees find vaccine providers, book appointments, and keep a record of their shots. Other similar apps have been developed for general consumers to prove their vaccination status, particularly as the world slowly returns to international travel. Many countries already require certain vaccines in order to grant entry to foreign visitors, and COVID-19 may well join the list of requirements.
Employers play an essential role in helping employees lead healthier lives, and that’s why we partner with them and their benefits advisors. We hope these tips and experiences will help you address the impacts of COVID-19 and plan for your own vaccine rollout efforts. Artemis Health is committed to solving the very healthcare challenges presented by COVID-19, and we are grateful to partner with innovative, forward-thinking leaders in the employee benefits industry.