By: Lingying Chang

In January, at a press briefing, Alex Azar, the Health and Human Services Secretary, announced that the U.S. federal government urged states to vaccinate anyone over 65. However, vaccine appointments remain complicated and vaccine supplies remain limited. According to this survey from the Kaiser Family Foundation (KFF), most American seniors have not yet been vaccinated as of early February. Officially, anyone over 65 years old is eligible for the COVID-19 vaccination. In reality, not all older Americans have what’s needed to snag a vaccine offer: English fluency, a computer, internet access, and the capacity to devote hours to complicated online paperwork. Thus, states need to undertake feasible strategies to improve vaccination access for the elderly, ensuring official "priority" really works. 

The KFF survey shows that nearly 6-in-10 older Americans don't know when or where they can get a COVID-19 vaccine, and the elderly are frustrated by the information gap. States are supposed to create and implement plans that lead to a navigable patchwork of policies. Yet, the timelines and age eligibility appointment processes vary from state-to-state. Thus, available online vaccination information is difficult for seniors to navigate. Moreover, uneven access to the Internet and computers prevent seniors from obtaining vaccination information. Nationwide, nearly 4-out-of-10 elderly Americans did not use the Internet in 2018, as reported by Pew Research Center. In many states, no one has taken responsibility for reaching these uninformed populations. But, perhaps the most frustrating hurdle is the language barrier. Online vaccination information is mostly offered in English and not translated into other languages, making it near impossible for those who do not speak English to understand instructions fully. 

If an innavigable application process wasn’t enough, there remains a significant vaccine shortage across the nation (although the rollout has picked up in recent weeks). The elderly population exceeds vaccine supply in many states, thwarting full-scale elderly vaccination efforts regardless of registration barriers. What's worse is that 39 states have not yet finished vaccinating the essential workers, even as they attempt to vaccinate their seniors. 

As the group most vulnerable to COVID-19, the elderly deserve a better vaccination process. Urgent action is required. Outsourcing doctors to contact patients directly and letting older adults seek help from their children have been two standard solutions to the chaos. Still, they are temporary and unsustainable, considering labor expenses and those who live alone. 

Two possible strategies from East Asian countries that have successfully responded to COVID-19 are the Chinese "One Card Travel" System to bridge the digital divide and Japanese "vaccination tickets" to bridge the information gap. The "One Card Travel" system allows citizens to show their ID cards for vaccine access, eliminating the need to have a computer or numerous hardcopy materials to register. Japanese paper tickets with vaccination information and instructions will be sent to seniors in Japan by mid-March. Similarly, vaccination information and detailed instruction could also be disseminated to seniors in the U.S., potentially via mail or on prime-time radio or television advertisements. If we are creative and age-friendly, we can effectively mobilize social resources and ensure the elderly access to vaccinations. 

The information gap, complex online appointment registration systems, coupled with limited doses, are preventing older Americans from accessing COVID-19 vaccinations, while this population compromised at least 75% of all COVID-19 deaths every month since Spring 2020. Bridging the digital divide in the vaccination appointment process and expanding the vaccine supply are imperative actions. Fortunately, the solutions are within reach.