Staying up all night. Constantly refreshing the webpage. Trying to book an appointment for the Covid-19 vaccine in Chicago has looked a lot like scoring tickets to your favorite band’s concert.
Ashwini Deshpande of Vernon Hills struggled for nearly one month to book appointments for her 77-year-old grandparents, who live in Chicago. With overloaded call centers for Cook County vaccines, she and her family — five people in total — tirelessly reloaded the ZocDoc website every hour on their phones and laptops until they finally secured two appointments through the University of Illinois Health System.
“Ninety-nine percent of the time there was nothing available,” she says. “It was not what you’d expect for a hospital system that big.”
Deshpande’s experience mirrors that of thousands of other Chicago-area adults and essential workers eligible for the Covid-19 vaccine. Even the city’s mass vaccination sites, which can inoculate hundreds every day, have had only scarce appointments available.
Chicago Department of Public Health (CDPH) and other city leaders say equity is at the forefront of Chicago’s vaccine rollout plan, yet the vaccines still have not reached all at-risk residents who need the vaccine the most.
Rocky roll out to at-risk communities
The city quickly learned that equity requires more vigilant efforts than simply housing vaccine sites in vulnerable neighborhoods.
While Chicago officials placed four of its original six mass vaccination sites in city colleges on the Southwest Side, where Chicago’s residents hardest hit by the virus live, people who live outside of those communities snatched up many of the spots.
Loretto Hospital, in Chicago’s Austin neighborhood, was the first hospital in the city to administer the Covid-19 vaccine. Yet, not all of its doses have gone to the neighborhood’s vulnerable residents. Executives at the hospital arranged for vaccinations at a variety of places outside the neighborhood, including a suburban church that a Loretto executive attends, a Gold Coast steak house, and at Trump Tower, where one hospital executive lives.
Public health and policy experts, city aldermen, and community advocacy groups have called on the city to make targeted vaccine distribution plans for the zip codes that Covid-19 has hit hardest. They’ve requested a set number of vaccines for those areas, along with plans to leverage the people and places the community trusts to distribute them.
They’re also working to craft policies that make vaccine sites more accessible to communities of color. Ald. Byron Sigcho-Lopez, 25th Ward, introduced to City Council the “Take the Vaccine to the People” ordinance, which proposes establishing at least one public vaccination site per square mile in any Chicago community. The ordinance calls for an expansion of vaccination sites to include public spaces such as election polling sites, as well as vaccine appointments available 12 hours a day, seven days a week through the CDPH multilingual call center. The ordinance was sent to the Committees and Rules committee, where it will undergo a vote for further action.
According to data from the city of Chicago as of April 6, 39.5% of first-dose Covid-19 vaccines have gone to Black and Latino Chicagoans, despite making up 59% of the city’s population.
Bypassing those with the greatest need
The Federal Emergency Management Agency has stepped in to help, running the mass vaccination site at the United Center. Located just west of the Loop, it has the capacity to vaccinate 6,000 people daily. Like several other mass vaccination sites, the signup process proved chaotic for many. At its peak, 754 appointments were booked per minute, city officials announced on March 8.
Officials hoped the size and location of the United Center site would accelerate vaccination rates of Black and Latino communities hardest hit by the virus. But of the initial appointment slots made available to Illinois seniors 65 and over — approximately 40,000 — just 37% went to Chicago residents. And 75% of the people who snagged the first appointments were white and Asian.
“Mass vaccination sites are all glitz and glamour, but in reality they’re not addressing the issue at hand. They aren’t improving access,” says Marina Del Rios, an emergency medicine physician at the University of Illinois in Chicago. “Not in the way they are set up.”
Internet-based registration systems favor those who have the luxury of internet access, ample time to wait for available appointments, and safe transportation to vaccination sites — the affluent and privileged, Del Rios says. “That’s not what we generally see in Black and Latino communities.”
After the initial registration fiasco, the United Center restricted eligibility by zip code. Still, inequities and lack of access remain.
“People shouldn’t have to refresh links constantly or wait up all night to get a vaccine,” says William Parker, MD, a pulmonary critical care specialist at the University of Chicago Medicine. “There’s not an ethically sound reason to create a system around that.”
Racking up inoculations without an intentional focus on equity has a cost, especially when vaccine supply continues to be limited, Parker warns.
“It’s important to pour the water where the fire is burning,” Parker says. “We don’t have unlimited vaccines, obviously, so we have to distribute it in a way that will save the most lives and prevent the most infections.
Prioritizing high-risk communities
The city’s vaccine equity campaign, Protect Chicago Plus, partners with community ambassadors to push vaccines and city resources into 15 high-need neighborhoods, as determined by the city’s Covid-19 community vulnerability index.
Belmont Cragin, Gage Park, and North Lawndale were the first communities to host vaccination drives through the effort. The drives’ impact became apparent very quickly, as the percentage of residents who received their first dose of vaccine skyrocketed.