Understanding Accessibility and Equitability for Vaccine Distribution

In the first month of the COVID-19 vaccine distribution, it is reported that around 13,000,000 people have received a dose; and now about 10% of the U.S population have had at least one. However, as we look closer, it becomes evident that there are underlying issues within vaccine distribution regarding accessibility and equitability. Early data has shown that a small proportion of American adults who have received the COVID-19 vaccines are Black and Hispanic people. As some of the more impacted populations by the pandemic, health care inequities have affected these communities the hardest, raising concerns about fair and equitable access to healthcare. In addition to the Black and Hispanic communities, the senior population has struggled to receive their vaccines despite being eligible.

Overall, accessibility has been highlighted as the biggest issue. The registration system set up for vaccine distribution relies heavily on technology, including access to the internet, a printer, or even social media for site updates. Additionally, many people could experience difficulties securing reliable transportation or navigating work schedules in order to make their appointments. Inevitably, these obstacles make it more difficult for communities that do not have steady access to the tools and resources that other populations are used to. Vaccine distribution sites have also been experiencing issues providing a comfortable environment for vaccine recipients. In combination with long queues, with some individuals waiting as long as four hours, many sites did not adequately plan for weather conditions, portable bathrooms, lack of seating, and other necessities.

In order to provide a fair, accessible, and equitable experience for all populations during this pandemic, vaccine distribution sites should continually implement and consider new strategies for improving the process and experience for all recipients. Below is a list of recommendations that we recommend considering in planning an equitable and accessible vaccine distribution site:

  • Use a social vulnerability index or map in your communities to identify underserved populations and those with less access to health insurance
    • Ensure vaccination sites are located in or within reach of these communities (and within reach of public transportation)
  • Leverage existing community-based organizations (CBOs) to address vaccine hesitancy in underserved populations
    • Consider asking them to evaluate and provide feedback about how to ensure accessibility, equitability, and inclusivity at planned distribution sites
  • Review registration processes for ease, access, reading level, etc.
    • Provide multiple methods for people to register for their vaccine (e.g., internet, phone, in-person); ensure those methods are accessible to those with vision and/or hearing impairment, limited English proficiency, and limited access to technology, transportation, etc.
  • Consider access and/or entry to the distribution site
    • How will people without vehicles get there safely? If it is enclosed, how many parking spots are reserved for people with disabilities?
    • How accessible is the site for people with mobility impairment?
    • Consider alternate sites that are not drive-through dependent for those without vehicular access
    • Are distribution sites located in areas where people disproportionately impacted by COVID-19 can easily reach them?
  • Evaluate the distribution site for health and safety issues 
    • Ensure social distancing measures
    • Provide access to hand washing or sanitizing stations
    • Provide accessible bathrooms that are easy to identify and navigate
    • Is there a need for emergency medical staff and/or resources, especially if the population being served has pre-existing medical conditions or is reliant on medical devices?
  • Ensure hours of availability take into consideration the variability of schedules for front line workers, people with dependents, etc.