Last April, Dr Clarence Kelley Sr, 64, a pastor in Chicago’s West Side, contracted Covid-19. The disease nearly claimed his life, forcing him into the hospital for almost two weeks and on a breathing machine.
“I was afraid that I would never ever see my wife again … it was devastating to me. I would not wish this on anyone,” Kelley told the Guardian.
Now, out on the other side of this near-death experience, Kelley wants the Covid-19 vaccine. And as an older individual with multiple serious health issues including a previous stroke and congestive heart failure, Kelley should be a perfect candidate. But he hasn’t been able to get vaccinated.
Like other non-white Chicagoans, Kelley has struggled to get the vaccine despite Chicago’s reported efforts to deliver the vaccine equitably. Early statistics of vaccine distribution show worrying trends about which communities and demographics are getting vaccinated. As of 30 January, only 19% of vaccinated Chicagoans are Black and just 19% are Latinos v almost 50% being white.
The need is dire: despite Black people only accounting for 30% of Chicago’s population, Black Chicagoans make up 60% of all Covid-19 cases. And lack of hospitals, prominence of food deserts, and other inequalities has turned Covid-19 into an even more lethal health crisis for these communities. But even during Chicago’s Phase 1A, when only healthcare workers and longterm care facility residents and staff were eligible for vaccination, the majority of those vaccinated were from more affluent areas such as downtown and the North Side.
Kimberly Smith, a patient care technician at Northwestern Memorial hospital and union chief steward for the Service Employees International Union Healthcare Illinois, Indiana, Missouri, Kansas (SEIU), hasn’t received her vaccine despite working in proximity to Covid patients. Though told she would get vaccinated at Northwestern once she opted in, she was later directed to far away hospitals in Lake Forest and McHenry county. Smith was set to get the vaccine at Loretto Hospital on Chicago’s West Side on Friday, thanks to arrangements made by SEIU.
“[It’s] the fact that my union is advocating for me [to get the vaccine] and I have to get it at another hospital that’s a safety net [when] I work at Northwestern Medical Hospital … [they] just tell me to go anywhere and don’t really care,” said Smith, an Englewood resident.
City officials have publicly committed to funneling the vaccine to Chicago’s most vulnerable areas. Last week, Chicago mayor Lori Lightfoot in coordination with the Chicago Department of Public Health (CDPH) announced “Protect Chicago Plus”, a plan meant to make sure that “vaccine reaches the individuals and communities most impacted by the Covid-19 pandemic,” as stated on the official City of Chicago Covid-19 informational website.
Dr Allison Arwady, the Commissioner at the CDPH, told the Guardian, “it’s not just that equity is in our plan. Equity really is our plan. And it’s a space that we care about as a health department probably the most.”
In a response to concerns about vaccines being concentrated in more privileged areas, Arwady said to the Guardian that more marginalized Chicagoans are being signed up for vaccinations under “Protect Chicago Plus” as Phase 1B continues (it launched last Monday). As for Phase 1A, she said, the majority of doctors and nurses that signed up for early vaccination spots were mostly white (as pre-surveying results show that minority health officials are more hesitant).
Arwady also mentioned the severe lack of vaccines available to vaccinate everyone who qualifies – a mere 5,700 doses per day. However, questions and concerns still remain given the number of access issues around vaccine distribution.
For one, Chicago’s plan to use pharmacies to distribute vaccines (vaccines are being supplied directly to pharmacies via the federal government) may mean that some Chicagoans struggle with access as Chicago contains several “pharmacy deserts”: a term coined to describe a community with limited access to a pharmacy. The majority of “pharmacy deserts” are concentrated on Chicago’s West and South Sides, correlating with the same communities hardest hit by Covid-19.
Dima Qato, associate professor at the University of Southern California School of Pharmacy and senior fellow at the Schaeffer Center for Health Policy and Economics, has extensively studied pharmacy access in Chicago. “Access matters and if we know that pharmacies matter for medication adherence, of course it’s going to matter for vaccines,” she said.
Even when pharmacies are available in vulnerable communities, they’re more likely to be independent stores versus retail chains and less likely to offer vaccination services, according to Qato. Arwady confirmed that many independent pharmacies have not wanted to be vaccinators.
Technology barriers have also emerged as a potential issue with vaccine sign up. So far, tech challenges have already been an issue for many seniors trying to secure their vaccine. Some fear that for those in vulnerable communities, technology difficulties could be exacerbated given that many West and South Side communities lack internet access – almost 50% of all residents in some neighborhoods.
“As you open [vaccine sign up] to a larger workforce, a lot of people may not have smartphones or computers and even if you do, the queue is so difficult to get into,” said Dr Marina Del Rios, an emergency medicine physician at the University of Illinois hospital.
Even without the technology component, some feel that education has been limited within vulnerable communities who are sometimes hesitant to take the vaccine. Some employers, like Northwestern hospital, have been lax when it comes to scheduling educational sessions for employees. Smith and Anne Igoe, vice-president of Health Systems at SEIU described to the Guardian how the union has taken charge of vaccine education sessions such as bringing in medical professionals to speak with workers.
Alfred White, who has been working in food warehouses throughout the pandemic, said he hasn’t been vaccinated or received any vaccine education or information on sign up from his employers despite qualifying as an essential front line worker. White, a South Shore resident, hasn’t received any information from the temp agency he works with or the companies he is contracted to. He works around hundreds of people everyday and with food. “I don’t have a clue if I wanted to get the vaccination as soon as possible how to go and do it … I just don’t know how to even go and apply.”
“Both [Illinois governor] JB Pritzker and [Lightfoot] have attempted rollout plans that do address the needs of more vulnerable populations … I don’t think all of our employers have embraced that,” said Igoe.
Kelley, like many others, has struggled to find intel on signing up for the vaccine despite calling Covid-19 helplines: “It never took me directly to who you call, how to sign up for the program, or how to get on the list. I never could find that out. Maybe I didn’t dig deep enough but it shouldn’t be that hard.” Some Covid information is also not being translated into Spanish, as mentioned by Del Rios, adding a language barrier for some residents.
Arwady and other CDPH officials point to the initiatives within “Protect Chicago Plus” that are supposed to work around these foundational access issues. Strike teams dispatched to vulnerable communities to make vaccine appointments and educate those with technology issues, hospitals calling elderly patients to schedule Covid-19 vaccinations, and the creation of vaccination point of dispensing (POD) sites for residents of the hardest hit communities are just some of the adopted proposals to increase vaccinations among minority demographics.
Furthermore, showcasing minority community leaders (such as Del Rios who was the first person in Chicago to receive the Covid vaccine) is meant to demonstrate the vaccine’s safety and effectiveness.
For now, there are still lingering questions and concerns about ensuring that everyone in the city, not just the most privileged, are vaccinated.
“We want to make sure we’re preventing Covid by getting people vaccinated in [high risk] neighborhoods at equal rates as other neighborhoods. Otherwise we’re going to be worsening the problem,” said Qato.