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George Washington University student Sarah Boxer is one of the lucky Washingtonians who successfully booked a COVID-19 vaccination appointment. The 20-year-old did not skirt the priority scheme and reserve a coveted dose for herself, but booked an appointment for a 60-something-year-old man living in a neighboring state. She doesn’t know much about him. They’d spoken only briefly by phone after being matched through a school project intended to help seniors get vaccinated. All she really knew is he lives in Bethesda and signed up for every vaccine alert he knew of.
“I don’t really know how difficult the last 10 months have been [for him],” says Boxer. “But I would assume that it’s been difficult for everyone.”
“The only reason why my grandparents were able to get the vaccine—they were able to get appointments—is because my mom is so tech savvy,” she continues. “I just wanted to do whatever I could to help out because I know how frustrating it is.”
Boxer, who lives in the West End, spent an hour and half researching how to get a vaccination appointment in Montgomery County on Monday. Maryland opened eligibility to residents 65 and older that day, but Montgomery County had yet to do so. If you check the county’s website, it still says appointments are only for those 75 and older. After identifying the vaccination providers in the county and scanning their respective websites, she learned Giant pharmacies in Montgomery County moved onto the next priority group, 65 and older. Boxer successfully booked an appointment for one of the three seniors she was assigned to help.
“He was so happy,” says Boxer. “It was honestly, like, the best feeling ever. I felt so good.”
Trying to get a vaccine appointment has become analogous to getting a Beyoncé ticket. The stakes are undoubtedly higher for a vaccination appointment, but the process can feel similar. Wake up early. Check multiple websites. The odds are unlikely with so few spots. Officials are aware of how stressful it’s been for seniors. The District government is looking to launch a program similar to the one operating at GW. (Seniors in the District are also signing up through their own medical providers that became vaccination providers.)
“I wouldn’t say I necessarily have any special skills that make me better than the people I’m helping … It’s more that I am just another set of eyes to help them out,” says Boxer.
“I don’t really like how the conversation has been framed generally—that people aren’t capable or that they are so old they don’t understand,” she continues. “That’s not the problem. The problem is that the system itself is kind of broken and disjointed and a mess and that everybody is just doing the best with what information they have.”
Mary Anderson, the spokesperson for Montgomery County Department of Health and Human Services, says there is no centralized system for booking vaccination appointments. “Every jurisdiction is moving at a different pace because there is not a national plan. States are left to their own devices,” she says. Montgomery County is not following the state’s priority scheme because the county is not receiving enough vaccine doses to open up appointments for more people. Approximately 60,000 to 70,000 of the county’s 1.05 million residents are 75 or older. As of Jan. 26, the county administered 24,378 doses.
A Giant spokesperson says its pharmacies are using federally allocated vaccine doses from the state of Maryland, so it’s in line with the Maryland Department of Health. “We cannot mandate that they follow the priority groups that we happen to be in. It’s unfortunate because it adds to the confusion,” says Anderson. “The bottom line is everyone is craving vaccines because we have heard for the last 10 months that the vaccine is going to save us. I truly get it. I spent a day and a half with my sister trying to get an appointment for my 92-year-old mother in Northern Virginia. The reality is the supply is not meeting the demand.”
Not every senior has support to help them through this trying time. More than 1 in 5 Americans older than 65 are, or are at risk of, aging alone with no family available to offer caregiving support. While some seniors are capable of booking an appointment online without the guidance of their kid or grandkid, extra support increases the chances of getting a vaccine that is in scarce supply. Seniors who get paired with GW students only stand to benefit. As programs like this emerge, inequities could widen as select populations get more help than others. In the District, for example, Black residents are not only dying of COVID-19 at a higher rate, but majority-Black wards are not booking as many vaccine appointments.
The student project is the brainchild of Dava Schub, the chief executive officer at the Edlavitch Jewish Community Center of Washington, D.C. “We know the roll out has been bumpy and the registration process is quite cumbersome and the supply falls well short of the demand,” says Schub. “In my role as a community builder, I was really thinking about what community looks like at its best. And that sort of birthed this project, where we connect younger people who are technology natives with older adults who I think of as technology immigrants. They weren’t born into a world of digital devices and web portals in a moment where that so truly matters.”
Schub reached out to Adena Kirstein, the executive director of George Washington University Hillel, who was eager to help. They talked Jan. 13, requested student volunteers and emailed the Edlavitch DCJCC listserv to promote the project last week, started making senior-student matches on Sunday, and one student (Boxer) booked her first appointment for a senior on Monday. Schub wanted to move fast because she understands that another day that goes by where a senior can’t get vaccinated can be a matter of life or death for them. Matching students with seniors is intended to make the appointment process easier, quicker, and less isolating.
The demand for extra support exists. More than 300 seniors from the D.C. region requested to be matched with a student who can help them sign up for a vaccination appointment. People seem willing to help—more than 35 students have volunteered so far.
Sam Proulx-Whitcomb, a 20-year-old GW student, is helping two District residents book vaccination appointments this week. The residents are in their late 60s to early 70s and live in Northwest. They requested help because by the time they typed their information into the system, appointments had been filled. Last Friday, 740 appointments through DC Health were reserved within 10 minutes. The seniors are hoping to get help from someone who can type a little bit faster, says Proulx-Whitcomb.
Proulx-Whitcomb learned about the project from her roommate, Boxer. She is a public health major so it piqued her interest. “It’s amazing how confusing this whole process is. I consider myself relatively technology savvy,” she says. She spent thirty minutes to an hour reviewing research about the District’s vaccination rollout that other students had prepared, so she could be ready for Thursday and Friday, when residents 65 and older can book appointments.
“I have it a lot easier than she does,” says Proulx-Whitcomb of her roommate, Boxer. “It seems a little more streamlined in D.C. Even with that, it’s very confusing. It’s very time consuming as well. I’m not expecting to get vaccines for them on the first try.”
The D.C. Council is trying to simplify the process for seniors. Six councilmembers wrote to the Office of the Deputy Mayor for Health and Human Services this week, asking for DC Health to create a waitlist instead of the weekly enrollment process. The idea is the District would notify people on the waitlist that they are eligible to sign up for appointments within a 24-hour window whenever the health department receives a new supply of vaccine.
“The weekly scramble to access scarce appointment slots for COVID-19 vaccinations is causing extraordinary stress and frustration for many of our District seniors,” the letter says. “For many seniors, who may not own a computer or struggle with this technology, a 20-minute free-for-all to sign up for appointment slots is an intimidating and confusing process.”
In a press conference Monday, Mayor Muriel Bowser did not sound interested in a waitlist. “You can have anxiety for one week or you can have anxiety waiting for months with a waitlist or date. We are carefully considering all of our options,” she said in response to this reporter’s question.
In a conference call with the Council on Wednesday, DC Health Director Dr. LaQuandra Nesbitt says her agency is working to implement a new system, one that separates registration and scheduling. “What we’re talking about here is having the ability for DC Health to set rules once a person registers or once individuals register for when they would be notified that they should schedule an appointment,” explained Nesbitt. DC Health will consider phase and tier, zip code, and date of registration. The current system cannot support the new system, so it is not clear when DC Health will implement it.
“DC Health does not support the concept of a waitlist,” says Nesbitt. She did not explain why. Ward 3 Councilmember Mary Cheh sounded excited about the new system, saying it would end what’s become the Hunger Games.
The District has already made several tweaks to its vaccination rollout so far. Most notably, DC Health first frees up appointments to seniors living in communities hardest hit by COVID-19 on Thursdays and then to the rest of the city on Fridays. On Wednesday, the District announced several tweaks to the vaccine website and call center, from improving the user experience of vaccinate.dc.gov to quadrupling the number of call takers to more than 200 people.
The limited supply of vaccine only compounds the logistical obstacles for underfunded health departments all across the country. Absent national leadership, states have taken different approaches, from a free for all to a waitlist.
“The infrastructure for signing up really varied,” says Adriane Casalotti, the chief of government and public affairs of the National Association of County and City Health Officials. “How well practiced it was, how quickly it was put together. We have some areas of the country using SignUpGenius and Eventbrite.”
The frustrations seniors in the D.C. region have are similar to those across the country. It would seem solving for one problem presents another obstacle. “Every way that we’ve heard of has positives and and challenges,” says Casalotti, including the waitlist approach.
In Montgomery County, the health department sends vaccination appointment links to individuals who pre-register. About 30,000 individuals registered in the first 24 hours, according to Anderson. The health department caught wind that some started sending their link to friends and family or to neighborhood listservs so they too could get vaccinated. Montgomery County has had to cancel appointments for those who booked an appointment but weren’t sent a link.
“We continue to improve and revise our process,” Anderson says.