Chairman’s Blog: Reaching the Hard-To-Reach

James “Jim” G. Scott, Chair, Alliance for Aging Research Board of Directors.

After a year of covering dismal news, the media is filled with stories of joyful reunions. Many of these feature grandparents gathering grandchildren into their arms after long and difficult separations. Other dispatches from this post-pandemic world describe restaurants crowded with celebrating septuagenarians. One recent article in the New York Times, for instance, was headlined, “Fully Vaccinated and Time to Party: If You Are 70.

No one would deny these people the opportunity to see their loved ones or celebrate with friends. But a close look at statistics put out last month by the Centers for Disease Control remind us that there is still critical work to be done. The CDC reported that 71% of people 65 and over had received at least one vaccine dose, compared with 27% of the general population. Almost half of people 65 and over are fully vaccinated. This is good news, but it also reminds us that among older adults, a high-risk population, almost one-third have yet to be vaccinated at all, and more than half are not yet completely protected. Their stories tell us a great deal about the challenges they face individually and what we are facing societally. Some of these challenges may be unique to this pandemic, but many are caused by ongoing and persistent issues that have for decades limited older adults’ access to quality healthcare. Covid has only made them more evident.

One explanation for this vaccine gap is that older adults are not adept at dealing with technology, and this has stymied their ability to navigate complex systems to book appointments. While that may be true, it’s essential that we look beyond that statement to larger, more ongoing issues that are creating vaccine “haves” and “have-nots” among older adults. Research shows, for instance, that more than two out of every five Medicare beneficiaries who live in their own homes or apartments don’t have access to a desktop or laptop computer with a high-speed connection. The Pew Research Center tells us that 25 percent of adults over the age of 65 say they don’t use the internet. If you don’t have a computer, you most likely will not know how to navigate an online system to register for a vaccine. The issue here is not one of older adults adapting to new technology; it more likely speaks to those at or below the poverty level who don’t have the means to afford it.

Likewise, older adults who have mobility issues or live in rural areas—or both— and have no access to dependable transportation are unlikely to seek out a vaccine that they view as unattainable. Language issues, even for those who are computer literate, can pose barriers. Racial disparity has also exacerbated the vaccine divide: according to a new survey by University of Michigan researchers, nearly 50% of Black older adults and 53% of Hispanic older adults did not have online patient portal accounts with their healthcare providers as of June 2020, compared with 39% of white older adults. Without the previous experience of booking and receiving medical help online, these people are unlikely to try to access online medical accounts during a pandemic.

These statistics show that we are at a critical point in delivering vaccines to the 65 and over population. While we are tempted to pause and celebrate with those who have been vaccinated, it’s essential that we double our efforts to find and vaccinate members of hard-to-reach populations. The encouraging news is that networks of local governments, nonprofits, and communications businesses are joining the effort to remedy the technology deficits and other barriers to vaccination among at-risk populations. Grassroots efforts sponsored by senior centers, churches, libraries and even fire departments are reaching out to older adults in their communities. Groups such as the National Association of Nutrition and Aging Services Programs are also working to help provide COVID-19 vaccines to individuals using their services. And, in some locations, mobile clinics are going door-to-door to find and inoculate those who could not access online opportunities for appointments.

Another population that is hard to reach when it comes to getting vaccinated against COVID-19 is long-term care staff. According to a CDC survey, COVID-19 vaccine rates among long-term care staff are low. The Alliance for Aging Research is committed to increasing vaccine confidence among this group. Last month, the COVID-19 Vaccine Education and Equity Project, which is co-convened by the Alliance, hosted a webinar on overcoming barriers to COVID-19 vaccine confidence in long-term care. You can watch a recording of the webinar here.

It’s essential that those of us who advocate for older adults also advocate for activities that will reach the hard-to-reach with life-saving vaccines. Failure to do so will only perpetuate a have and have-not healthcare system and deny us the opportunity to deliver better health to millions of eligible older adults.

Jim Scott serves as the chair of the Alliance for Aging Research’s Board of Directors. He is also the president and CEO at Applied Policy in Washington, D.C.