MIAMI — Win the lottery or nail an appointment for a COVID-19 vaccine dose? For thousands of seniors, their friends and family members and caregivers, getting a shot might feel like winning the lottery.
That’s how valuable — and seemingly hard to get — that appointment is given how demand far outstrips supply. And it’s also telling how technology tools are not always accessible to every member of a community.
In a world where many seniors don’t have computers or computer skills, asking an older population to constantly check websites, navigate links, monitor Twitter alerts as appointments open, close, then open again, has been a challenge.
“We are hearing more deep frustration than success stories from seniors 65-plus trying to sign up to receive the COVID-19 vaccine in Florida,” said Jeff Johnson, state director for AARP Florida.
“The sign-up process is cumbersome and time consuming, even for younger adults helping parents or older relatives,” he said. “There is a lack of sign-up process standardization among vaccine providers even in the same city and the state’s vaccine locator does not always offer a phone option for providers.”
Lourdes Diaz knows how it is. She said Mount Sinai Medical Center reached out to her 91-year-old mother on Dec. 23 because her mom is a patient. Diaz said she called the Miami Beach hospital to get an appointment for her, left messages and emails. “I even used Twitter, but no luck.”
Her mom, she said, does not know how to use the internet.
“I was finally able to get my mother an appointment at Jackson Health. I got lucky,” Diaz said. “They were supposed to open the appointment portal at 11 a.m. but it was already open when I checked in around 10 a.m. Registering was quick and I had no problems. The appointment itself went great. We were ushered in right away and everything was very organized. My mother has her second appointment this week.”
But Diaz said trying to secure those shots at both hospitals pulled her away from her own work responsibilities for about 10 hours as she spent time researching and reaching out.
Thankfully, I was working remotely and had the flexibility to be persistent,” Diaz said. “But this has been a very frustrating experience. I believe everyone is trying their best, but there are so many barriers. It’s like winning the lotto.”
According to Pew Research Center, Americans 60 and older are spending more time with computers — on desktops, laptops or smart phones.
In 2000, 14% of those ages 65 and older were internet users. Now, 73% are, according to Pew. “And while smartphone ownership was uncommon at all ages around the turn of the 21st century, now about half (53%) of people 65 and older are smartphone owners.”
At the same time, Pew’s research found that about 30% of adults in low-income households below $30,000 a year don’t own a smartphone. More than 40% lack home broadband services or a traditional computer and even fewer own tablets. “By comparison, each of these technologies is nearly ubiquitous among adults in households earning $100,000 or more a year.”
But that doesn’t mean that seniors who have the technology use it to full benefit. Sometimes the digital divide also widens because of declining health. Maybe it’s a vision problem. Or, simply, some people of all ages just don’t care to use computers.
But even among those who do, that may not be enough. Vaccine appointment alerts are coming fast and furious on social media, in places beyond the comfort of Facebook.
Take Mirna Miranda from Miami-Dade. She has the kind of computer tech-savvy that might impress producers of a “WarGames” movie remake.
Like many of the 4.5 million seniors 65 and older living in Florida, the 70-year-old and her 75-year-old husband, Carlos, wanted COVID-19 vaccines. Seniors 65 and older are eligible for the two-dose Pfizer-BioNTech or Moderna vaccines.
The Mirandas called appointment hotlines like Mount Sinai Medical Center and left voicemails. No one ever called them back, they said.
They tried online portals in Miami-Dade and Broward, but appointment slots were always closed.
So Mirna decided to set up three computers inside her Tamiami-area home so the pair could work together to search and book appointments online. They were willing to drive across county lines to Broward, the Keys or Palm Beach to be vaccinated.
The couple’s strategy worked. Or so they thought.
Two days before they were set to receive their first shot at Baptist Health in Kendall, the hospital canceled all first-dose appointments because of supply constraints.
The Mirandas, and many like them, were back to where they started. Then Carlos saw a Miami Herald article that had tips on how to use Twitter to be notified about vaccine availability. He followed Jackson Health and set the account to send instant alerts any time Jackson tweeted. Last Saturday, while having coffee, his phone pinged with an alert: Jackson Health System was opening slots.
“We rushed to our three computers, working side by side and were able to book the appointments for that same day in the afternoon,” Carlos said.
The couple received their first dose at Jackson South Medical Center and said the process went smoothly.
After first-day bugs, common to every location, Jackson streamlined the vaccine-delivery process. Seniors, for the most part, have reported that they have been greeted by friendly staff. Well-organized, the whole process has generally taken about 30 to 40 minutes at Jackson-run sites.
But you have to get to that point — and for many seniors and their caretakers, the digital divide to secure an appointment can feel like a bridge too far.
Health care providers are trying to make it easier. On Friday, Florida opened a new website to help seniors and other eligible residents opt in to a “save their place in line” feature through a pre-registration process.
Health care workers with direct patient contact and long-term care residents and staff can also preregister for the COVID-19 vaccine. The website is myvaccine.fl.gov.
To help bridge the gulf, some South Florida institutions have altered the process as they see what works and what hasn’t worked so well.
“Aside from creating an online enrollment portal for people to book appointments, we have created key partnerships to make sure people in hard-to-reach areas have access to the vaccine,” said Jackson Health spokeswoman Lidia Amoretti.
Among them: Jackson began collaborating with more than 50 houses of worship in Miami-Dade County — churches, synagogues, mosques. The goal is to reach seniors in underserved communities who may have challenges with technology and are unable to secure an appointment online, Amoretti said.
“Our goal is to continue dedicating one day of the week to vaccinate members of these houses of worship as long as we continue to receive vaccines from the state and there is demand from this group. So far, we have filled more than 5,550 appointment slots through this partnership,” she said.
There is demand, the Rev. John White of Immanuel Temple AME Church in Pembroke Pines told the Miami Herald in January.
“There is a great need in the African American community,” White said. “ I challenge all health care providers to partner with African American churches if you want inroads to get people the vaccine. We all have members who want it.”
Florida’s vaccine partnership with Publix as a major dispensary of the doses has also faced criticism for leaving large numbers of low-income and Black neighborhoods at a disadvantage. There aren’t enough Publix supermarkets in these neighborhoods or close by, an analysis by the Sun Sentinel found.
As of late January, the only Publix supermarkets in South Florida that are on board are those in Palm Beach County and two stores in the Keys — Islamorada and Key West.
In late January, Dr. Anthony Fauci told The New England Journal of Medicine that people of color in underserved communities should receive prioritization in the vaccination rollout.
Jackson Heath is trying out partnerships with a few non-religious community groups such as Haitian Neighborhood Center Sant La, the Little Havana Activities Center, Southwest Social Services and the Center for Haitian Studies, Amoretti said. The hospital chain is also working with the Homeless Trust to expand vaccination of shelter clients who are 65 and older.
In addition, the county hospital partnered with different Miami-Dade County Commission districts as part of its outreach efforts by offering each commissioner 100 slots to fill. Miami-Dade Mayor Daniella Levine Cava also received 1,300 slots.
Levine Cava also announced a new telephone hotline option where seniors can call 305-614-2014 to book an appointment. The website, at miamidade.gov/vaccine, is still active, too.
The county is also planning to launch a website and phone system, possibly next week, that will allow people 65 and over to pre-register for a vaccination appointment at county-run sites like Tropical Park and Zoo Miami.
Rachel Johnson, spokeswoman for the Office of the Miami-Dade Mayor, acknowledged the partnerships the county has undertaken are to help get more seniors vaccinated since it’s so difficult to book in the traditional sense, via online or even telephone.
“A huge priority is to make sure we are distributing the vaccines not just efficiently but … we are working to make the process more equitable. We can’t just be delivering information online and sharing the phone number but we need to reach people in other ways, where they are,” Johnson said.
“We know the online system doesn’t work for everyone. It’s frustrating for a lot of people,” she said.
As of Jan. 29, according to Florida’s COVID-19 vaccine report, more than 1.3 million people have received the first dose of the coronavirus vaccine and 273,249 people have completed the two-dose series of either Pfizer or Moderna.
Of those who completed the two-dose vaccination, 41,045 were Miami-Dade residents, 28,799 were Broward residents, 17,513 were Palm Beach residents and 485 were Monroe residents.
But we’ve a way to go. There are about 454,000 people 65 and older in Miami-Dade and about 334,000 in Broward, for instance, according to Census figures.
Other savvy South Floridians have also thought outside the box to help seniors during the crisis.
Katherine Quirk, a Broward Health nurse, and her fiancé, Russ Schwartz, started a Facebook group to share information about appointment availability in South Florida and help book slots for seniors. The couple’s Facebook group, South Florida COVID-19 Vaccination Info, has more than 17,000 members.
Johnson, the state director for AARP Florida, says every improvement and novel idea couldn’t come at a more critical time.
“It would be very helpful to have a standardized sign-up process for any provider in the same city, widely promoted telephone options for those that are not tech savvy or do not own a computer or smart phone, options for the homebound and those that do not have their own transportation, and finally a vaccine supply that is deployable and that matches the demand,” Johnson said.
“We have digitized most social and health services, a shift that has left older seniors and underserved communities without access,” Johnson said. “While there is efficiency in online vaccine sign-up, we must include options for those that are unable to navigate the technology or do not have access to a computer or a smart phone.”
Barbara Solomon, 72, and her church sewing group make quilts and pillowcases for children with cancer.
But since March, Solomon says she hasn’t been able to gather with her group and rarely leaves her West Kendall home because of the pandemic. Even with a mask on, she’s still scared it might not be enough protection because her heart condition and diabetes put her at “at risk” of severe COVID-19 complications.
“Everything is booked,” the retired Miami-Dade County Public Schools assistant principal said.
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