Covid-19 vaccine is a struggle for people with no hospital connection

Many states chose to distribute the vaccine to hospitals first, which then became the primary administrators of the injection to their own health professionals and others who qualified. In many cases, people need to have a general practitioner attached to the hospital, or receive care from the hospital to receive an injection there.

That means that people who live in poorer communities without large hospitals often have an even harder time accessing the still scarce vaccine. The problem highlights one of the challenges government officials face in their efforts to vaccinate people fairly.

When Texans 65 and older and with certain medical conditions became eligible for Covid-19 vaccines, Jovana Sanchez-Melendez, a 35-year-old associate director of technology near Dallas who has an autoimmune disease, received an email. email her doctor to sign for an appointment.

Mrs. Sanchez-Melendez quickly received the vaccine. But she said she couldn’t get appointments for her parents, who work on the front lines as a custodian and construction worker and have medical conditions that put them at high risk for Covid-19. Her parents were not patients of a hospital on doses.

“You have to know someone who knows someone who knows how to get it, and even then it’s not certain,” said Mrs. Sanchez-Melendez. Her parents eventually found doses, with her dad getting his first shot on Wednesday, about a month after she got hers.

A similar dynamic has been reported across the country, in states as diverse as California, New York, Iowa, and Alabama. The situation has improved slightly in recent weeks as more hospitals begin to make way for non-patient registrations, health officials said. Also, in some states, large pharmacies, such as CVS, now distribute doses, increasing access.

Dennis Andrulis, a senior researcher for the Texas Health Institute, said nationally, 27% of white men, 31% of black men, and 41% of Hispanic men do not have a GP. He said hospitals also tend to locate in more affluent areas, leaving poorer neighborhoods with fewer options.

“You have a history of steroid neglect,” said Dr. Andrulis. “If people have access to a doctor in their community and insurance, the door will be more open to them.”

Dr. Georges Benjamin, executive director of the American Public Health Association, said some of the people who need the vaccine the most – workers in dangerous, public jobs – are the least equipped to fight for doses when they don’t have a connection to a doctor. . Bus drivers, custodians, grocery workers and others can’t spend their days refreshing computer screens in search of vaccine doses, the way people working on computers at home can, he said.

Many physicians and clinics not affiliated with a major hospital were disregarded in the initial vaccine distribution efforts, said Dr. Benjamin. On Wednesday he said the situation is evolving. “There has certainly been an increase in availability, but many of the community physician rescuers still do not have easy access,” he said. “The retail pharmacies should help the situation to some extent.”

In Texas, there are facilities that prioritize their own patients, including some that are designated by the state as vaccine hubs. Hospitals said they have expanded access as they could. A spokesperson for the UT Southwestern Medical Center, where Ms. Sanchez-Melendez received her vaccine, said it treats extremely ill patients and tried to give priority to those most likely to be hospitalized if they contract the virus. The hospital has allowed periodic access to registrations for non-patients and has set up a vaccination site in an area of ​​south Dallas that has historically been under-served by health care providers.

John DeFilippo, a 72-year-old in Houston, enrolled in vaccine appointments along with his wife, Marylyn, in January. Her doctor at Memorial Hermann Health System emailed her an appointment link. A few days later, he received a call from a hospital representative asking who his doctor was. Mr. DeFilippo had previously been treated at Memorial Hermann and recovered from back surgery, but his GP was not directly connected. He said the hospital had canceled his appointment.

A health system spokeswoman said it had such a limited supply of vaccine and such a large qualified population that it had to go through it in waves. “Like many health systems across the country, we have started offering vaccination to established, active patients,” the hospital said. “However, in mid-January, we hosted a number of massive drive-through vaccination clinics in and around Houston.”

Mr. DeFilippo said he was surprised not only by the hospital’s policies, but also that it would spend resources tracking down and weeding out non-patients during the pandemic.

“I’m no stranger to the hospital, but I don’t think I’m enough of a client,” he said. “She must have examined me and my doctor – all for one patient.”

He said he could later get the vaccine from another hospital.

Write to Elizabeth Findell at [email protected]