The article about the Philadelphia Black Doctors Covid-19 Consortium does not say it was “first come first serve.” It says:
The effort was designed to target people in phase 1B and seniors over the age of 75, all of whom had to come from a Philly ZIP code that the BDCC identified as having higher occurrences of the virus and death. (The group’s founder) wanted the ZIP code requirement in place as a way to bring greater equity to a vaccine rollout that has disproportionately reached white Philadelphians.
Later in the article it mentions some young people who are described as essential workers including food service. It also says that they made a conscious effort to get the elderly indoors as quickly as possible. My daughter lives in Philly – Center City so not one of the targeted zip codes. The situation with Philly Fighting Covid (the clinic run by a young inexperienced Drexel student) was a true fiasco. The Black Doctors Consortium by contrast is much more professionally run and respected.
Sure a drive thru clinic is safer but it would not have reached the targeted goal of these underserved people in urban zip codes in Philly. Drive-thru clinics are what we’re using here in AZ and predictably the wealthier zip codes are benefiting. ZIP code data suggest that fewer eligible people have been vaccinated in lower-income areas in Phoenix and Mesa than those in higher-income areas in Scottsdale and Chandler. My point is just that the Philly clinic in the WHYY article was set up to reach a very targeted group.
Less than 15% of those who are eligible have received a first dose in the central Phoenix ZIP code 85009, the county reports, even if it borders one of the county’s major vaccination sites at the state fairgrounds. Yet 102% of those eligible have received a shot in the north Scottsdale ZIP code 85255.
Most cities have a football stadium, shopping mall, or other place with extensive parking. They should be utilized more. For residents without cars, a timed ticket system works well-people have an assured spot, and can disperse to wait at nearby locations or even their homes. Alternate tickets can be provided for those hoping for any leftover vaccines from no shows. There is no reason for thousands to wait, often in vain, in frigid temperatures. Moreover, Convention centers and stadiums should have room for at least 1000, even socially distanced, inside.
It isnt just Philly that is so inept. Montgomery county, Maryland, had hundreds of elderly line up outside a closed high school for hours in frigid weather. The school, unused since March, has over 50 classrooms, plus gyms, auditoriums, cafeterias, etc. Did no one consider putting 10 people in each room- they could have easily distanced and stayed warm.
The problem around here at the moment seems to be second doses. Many appointments for first doses but virtually none for second. And they don’t preemptively give you a second dose appt unless you go through a non health department site (Walmart and private hospitals do give the second appt). So we’ve got A LOT of folks who are now overdue by 2-3 weeks. And yet the HD continues to add first dose slots but no second dose slots.
There is no perfect one size fits all system. I trust the Philly Black Doctors Consortium to have the better ideas of how to get the vaccine to a targeted underserved population. Their clinic was in an arena on the Temple University campus, which is accessible by public transportation especially for the population in North Philly. As mentioned in my post above, here in AZ we are using football and baseball stadiums, the state fairgrounds etc and emphasizing drive-thru. Lots of people getting safely vaccinated but the data shows that the wealthier zip codes are getting the greatest access.
I thought the first dose and second dose content was identical (thought reaction supposedly could be worse for #2 for some people) … are they different?
The two doses are the same, but they were supposed to reserve a second dose for the people getting the first shot, so there wouldn’t be any issue being fully vaccinated on time. But it doesn’t seem like every place did that.
It was ridiculous to make people, stand for hours tightly packed in lines, ( outside) when apts can be made and people accommodated better than what I saw on the Philly news.
At 5 am the line snaked for blocks, temp this morning 28. Wind chill ? Standing on concrete sidewalks, even worse.
“ The 24-hour, walk-up coronavirus vaccine site is facilitated by the Black Doctor’s COVID-19 Consortium for Philadelphians [over the age of 75 or those who fall into the 1B category and live in specified “hardest-hit” zip codes.]
The site, open until 12 noon Saturday, attracted mass crowds Friday.
As of 6:30 p.m. Friday evening, those joining the line should expect to wait upwards of 10 hours for a vaccine. If there are more people in line than available doses, the people waiting will be informed, said Dr. Ala Stanford, founder of BDCC.”
“ The 24-hour, walk-up coronavirus vaccine site is facilitated by the Black Doctor’s COVID-19 Consortium for Philadelphians
The site, open until 12 noon Saturday, attracted mass crowds Friday.
As of 6:30 p.m. Friday evening, those joining the line should expect to wait upwards of 10 hours for a vaccine. If there are more people in line than available doses, the people waiting will be informed, said Dr. Ala Stanford, founder of BDCC.”
Clarification, I meant first come first serve of those Eligible, meaning they weren’t making appointments. They had 3500 doses, so if you got in line and waited for HOURS, you were vaccinated,
In MA< the pharmacies will either schedule dose 2 or, if they have supply (and none of them do) doses 1 and 2, but non appointments for only dose 1 at pharmacies. Not sure about the mass sites in stadiums etc.
Doesn’t it seem we could do better ? Discouraging to see the freezing people, it was horrible to see the lines in Florida, but at least it wasn’t 25 degrees,
Completely agree. I’m really flummoxed why this is so difficult. Couldn’t the state/health department assign numbers like they do for jury duty and you get an email or a phone when your number is coming up? They could confirm you comply with the current phase requirements, no one is frantically searching on line or standing out in the cold or heat?
No method of managing the vaccine scarcity in the US will avoid complaints and problems:
Wait in a queue outside → exposure to weather.
Wait in a queue inside → greater risk of getting COVID-19 from other people in the queue nearby.
Pre-arrange appointments → then access to the vaccine becomes more based on who is better equipped to enter the appointment competition, with unsurprising results when you see vaccine receipt by demographic group.
Vaccine distributor calls people for appointments → some people may miss out because they are not in the vaccine distributor’s list of eligible people. It should not be surprising that people less connected to health care and therefore less likely to be on such lists are more likely to be in the usual marginalized demographics.
Have people pay money (price set to balance supply and demand) for vaccine appointments → the usual way scarce goods are rationed in the US, but likely to produce an enormous backlash in this case, and obviously will skew the vaccine even more toward the higher SES than it already is. People in the US say that they do not like health care rationing (which is happening now with vaccines), but are likely to dislike rationing explicitly by ability to pay even more.
In other words, scarcity in the face of demand means rationing. Pick how you want to do the rationing.
No method is perfect, but some are a whole lot better than others. I have participated in 2 mass vaccine events. One had assigned times to enter a building by ticket, and then hundreds of folding chairs spaced 6 ft apart. You were directed to the next line of chairs, and the lines were processed in order. Worked fine and they did 1500 shots that day. The other was drive thru, and that was even faster. Neither involved people waiting in inclement weather.
When you’re trying to specifically target an underserved population in one of the poorest neighborhoods in the city, it makes sense to listen to the community leaders like the Philadelphia Black Doctors Consortium. They have the trust of the target group and I think they are best positioned to know how to reach them. That doesn’t mean that this event was perfect, but comments calling it “criminal” are overly harsh. My daughter in Philly tells me that the founder, Dr. Ala Stanford, is considered a local hero for her efforts to bring Covid-19 tests and vaccines to the poorest residents. [I couldn’t figure out how to get rid of the hyperlink created by the doctor’s name.]