After the state expanded phase 1A of its COVID-19 vaccine distribution plan last month, elderly Pennsylvanians began looking for appointments to get a shot. But since almost all vaccine appointments are booked online, many of the state’s oldest and most vulnerable residents are relying on loved ones to help them get booked.
Appointments fill up quickly after they are made available, and each vaccine provider has its own registration website where users fill out medical information as fast as they can to claim a time slot.
Christine Amabile, a 51-year-old New Castle resident, said she and her brother spent days checking for appointments online for their 80-year-old father. Amabile, a nurse, would run to her computer between patients to make sure she was still in line.
“I was [number] 2,200 in line. I finally got into where I could make an appointment and then it said there were no [more] appointments available,” she said. Days later, Amabile’s sister-in-law found an open time slot at a Rite Aid about 30 minutes away in Youngstown, Ohio.
Amabile said the drive was worth it. “If they’d have told him to be there at 2 o’clock in the morning, he still would’ve gone,” she said. There are currently no guidelines discouraging people from crossing state or county lines to get a vaccine.
Officials estimate there are nearly 4 million Pennsylvanians who qualify for a COVID-19 vaccine under phase 1A of the state’s distribution plan. The state will need 8 million doses of the Pfizer-BioNTech or Moderna vaccines, since both require a booster shot.
New analysis from the Kaiser Family Foundation shows that just 10% of Pennsylvanians who are age 65 or older have received at least one dose of the COVID-19 vaccine. Kaiser, a California-based health policy nonprofit, looked at data from 14 states and Washington, D.C., which all specifically track how many people in this 65+ age group have been vaccinated. Of those 15 jurisdictions, Pennsylvania ranks at the very bottom.
Before the Amabiles found an appointment in Ohio, Christine’s father walked to his neighborhood pharmacies to ask to be put on a waiting list for the vaccine. Christine said she has seen several other elderly people try the same approach. She said she watched dozens of elderly people get turned away by the Youngstown Rite Aid staff while she was there. Staff instructed people walking in to apply online.
Some people were directed to use a computer at a nearby library, according to Amabile.
“These were old people. They’re looking at [the Rite Aid pharmacist] like she’s crazy,” Amabile said. “Right across the street … the staff at the library was helping them schedule their appointments.”
A decentralized online system
There are more than 1,000 registered COVID-19 vaccine providers across the Commonwealth; including hospital systems, national pharmacy chains, locally owned pharmacies, federally qualified healthcare centers and county-operated clinics. As a result of Pennsylvania’s decentralized approach, a person might register with a dozen or more websites before finding an open appointment.
That can require a nuanced understanding of computers, typing and online research. Most elderly people, according to AARP Pennsylvania state director Bill Johnston-Walsh, don’t have an experience filling out medical paperwork online.
“They use it to talk to their grandchildren through FaceTime or something else, or they go on to play games. And that’s it,” said Johnston-Walsh. “They don’t really use it for anything more sophisticated than that.”
AARP Pennsylvania criticized the state’s COVID-19 vaccine rollout in a recent letter, calling for an improved state hotline to help AARP members book appointments.
Problems with phone helplines
The state health department does manage a hotline where operators answer questions about the COVID-19 vaccine and the coronavirus pandemic. A spokesperson for the department said those who need help booking an appointment should contact the 1-877-PA-HEALTH line for assistance.
But an operator told WESA she can’t book appointments for callers herself. She guides them through the process of using the state’s website to identify vaccine providers.
Jack Langdon, a 67-year-old Shaler resident, didn’t even make it to an operator. As callers dial through the hotline’s menu options, they’re encouraged to use the state’s website multiple times.
“I thought, ‘I’m calling you because I’m having problems with the website!’” Langdon said. After getting through the menu, he learned there were more than 100 callers ahead of him. He said he hung up.
A health department spokesperson said the state is in the process of building more support for its hotline and discussing communication strategies to better target the elderly and those who don’t use the internet. The department declined to offer a timeline for these new initiatives.
For now, the state health department’s COVID-19 vaccine provider map is its primary resource to help people get started in their search online for a vaccine provider. The map indicates where vaccine providers are located. It offers phone numbers and website links for some locations, but not all.
An earlier version of the map listed contact names and in some cases direct emails associated with a vaccine provider. It also indicated whether a facility had received any shipments of vaccine. The current version of the map does not list this information. It’s not clear why the change was made.
Last week, Allegheny County announced it would start booking appointments by phone for its Monroeville clinic. Unlike the state’s hotline, the County’s 2-1-1 line could book appointments for callers. The service was established to help accommodate Allegheny County residents over the age of 65. When 2-1-1 started accepting appointment requests, the phone line quickly became overwhelmed with calls. Officials said the line got 15,000 calls per second once operators began booking appointments. In less than four hours, all 750 available appointments over the next few weeks had been claimed.
“We have known for a while that the demand for vaccines far outweighs the supply, and today’s phone registration only underscores that,” said Allegheny County Health Department Director Dr. Debra Bogen said last week after the hotline stopped booking appointments.
Callers reported busy signals, dropped calls and other issues connecting to an operator. Shortly after the hotline began booking appointments, hackers had reportedly begun intercepting calls, according to the county. Scammers requested credit card information or for callers to purchase gift cards before booking an appointment.
A county spokesperson said it’s not clear how many callers were affected. Anyone whose call was diverted or who may have provided credit card information is asked to call the Federal Bureau of Investigation.
With no vaccine appointments available through the 2-1-1 hotline, many Allegheny County residents will continue searching the internet for their chance.
Primary care physicians have no doses
When he found out he’d be able to get a shot, Langdon said his first move was to call his primary care doctor at a UPMC facility. He asked his doctor at a routine checkup why he couldn’t get the shot there. He said his doctor told him UPMC is still working through vaccinating health care workers and long-term care facility residents.
Dr. Donald Yealy, UPMC’s senior medical director and chair of emergency medicine, confirmed that the hospital system is focused on vaccinating employees and unaffiliated health care workers for now. Among the employees UPMC is vaccinating are non-clinical staff who do not interact with patients.
UPMC announced a goal to have reached all of its employees with COVID-19 vaccine offers by the end of January. Yealy said the system met that goal and now the system is following up with employees who did not respond to vaccine invitations to be sure they’re aware of the benefits of the vaccine.
According to Yealy, UPMC has given 110,000 vaccine doses so far. Fifteen thousand went to unaffiliated health care workers. He said about 20,000 people have been given their second shot.
“There is still much more work to be done [for] people who are not affiliated [with UPMC] and then begin a gradual transition,” to other members of phase 1A, said Yealy.
When asked about when UPMC doctors might start offering vaccine to eligible patients in Allegheny County, Yealy said it would require more doses coming into UPMC facilities.
“We got no additional vaccine, particularly for all of those new people who were added to [phase] 1A in the past two weeks,” said Yealy. “We’re ready [to vaccinate these groups] otherwise.”
UPMC is vaccinating some patients in Erie, Pa., where the system has made its way through the majority of health care workers. Yealy said UPMC is learning how to best reach elderly patients in Erie and will take those lessons to Allegheny County when it has enough supply to expand its vaccination program.
One strategy was targeting zip codes with a high concentration of residents over 90-years-old. Doctors have called patients in those areas to offer appointments. “You need more than a singular platform. It can’t be just a website,” where people book appointments, said Yealy. “We want to be more inclusionary.”
When UPMC starts vaccinating its Allegheny County patients, Yealy said the system will prioritize patients by age and comorbidities.
Allegheny Health Network is vaccinating some of its patients already. An AHN spokesperson said staff are directly calling high-risk patients over 75 years old to book vaccine appointments over the phone.
Relying on the kindness of strangers
When her 83-year-old grandmother became eligible to receive a COVID-19 vaccine, Leighann Bacher, a resident of Hampton Township, started researching dozens of provider websites looking for a spot. Her grandmother doesn’t own a computer and suffers from symptoms of dementia.
“I knew my grandma wasn’t going to be able to get one on her own. Unless there was some kind of sign up in-person. But I don’t know how she would know about it.” Information about the vaccine and how to get it isn’t reaching the elderly, according to Bacher.
After several rounds of sleuthing through pharmacy and state websites, Bacher was able to get her grandmother, aunt and several other elderly relatives set up with appointments.
After that, Bacher noticed friends writing frustrated posts on social media, confused about where to look for appointments. Bacher would message them with information about how she got appointments —what websites to check, what information to come prepared with, etc.
Soon after, Bacher and a few other local women decided they should pool their knowhow into a centralized resource. They created a Facebook group called, “Getting Pittsburgh Vaccinated – COVID-19 Appointment Tip Page.” In just over a week, more than 10,000 members joined the page.
It serves as a place for users to alert each other about open time slots, share links, ask questions and vent their frustrations with the entire process. Bacher and the other administrators of the page have offered help booking group members and their relatives.
“Last night, I think I got like between 12 and 15 appointments for other people,” Bacher said. “I’ve reached out to people that seem like they were really struggling and if they’re comfortable they’ll send information to me.”
Bacher, who works in marketing for a real estate agency, said she’s been able to keep up with the page because she works from home. “I have the flexibility where I can check in on the group throughout the day,” she said.
The page has matched dozens of people looking for appointments with willing helpers.
“Thank you and bless you for providing this wealth of information. I was able to schedule an appointment only because of your help,” writes group members Doreen Matune in a recent post.
In at least one case, a user posted they were unable to make their vaccine appointment and offered the time slot to an interested group member. Some users have booked multiple appointments with the intention of sharing spots within the group. This strategy has been criticized by other group members.
Group members have also offered carpools to appointments for those without other means of transportation. "To me, this group is the definition of community. Strangers helping each other in a time where we desperately need support and help from others,” said Allison Ladavat, another group administrator.
Elsewhere online, a website called Vaccinate PA allows users to enter their zip code and find locations with available vaccine. The website relies on a group of volunteers to call vaccine providers and ask whether a location has available supply. The site notes that this information changes frequently and could be inaccurate by the time a user reaches the website.
“But we aim to centralize information as recently-updated as possible and provide residents with an effective starting point to identify their options,” a statement reads.
The goal of websites like Vaccinate PA and Facebook groups like Vaccinate Pittsburgh is to create a centralized resource to help Pennsylvanians get started on their hunt for a vaccine provider.
On a recent AARP Pennsylvania member tele-town hall with acting Secretary of Health Alison Beam, many callers expressed a wish for a more official centralized approach. Specifically, people asked for one place to enter their information for a spot on a list. State health officials have previously said they would consider changing their current decentralized strategy, but cited unspecified issues with a statewide waiting list.
No end in sight
Appointments will continue to be scarce as long as supply of COVID-19 vaccines remains limited. Secretary Beam expressed optimism about how the upcoming Johnson & Johnson vaccine could change the landscape of the rollout.
The Johnson & Johnson Janssen vaccine is a single dose, which resolves a few logistical headaches — the state has to set aside some of its allotment to ensure people who have received their first Pfizer or Moderna shot can get their second shot. A one-shot vaccine could be a game changer.
Johnson & Johnson applied for emergency use authorization for its COVID-19 vaccine last week. The company told NPR its storage requirements aren’t as demanding.
Johnson & Johnson's Janssen vaccine can be stored for at least three months at 36° to 46° degrees Fahrenheit. The Moderna vaccine can be stored at 36° to 46° Fahrenheit, but expires after 30 days. The Pfizer-BioNTech vaccine must be stored in ultra-cold freezers at -112° to -76° Fahrenheit. Most doctor offices, especially in rural areas, don’t have the necessary equipment for the Pfizer-BioNtech vaccine.
While new vaccines could be coming soon, the desperate picture remains the same for families like the Langdons. Jack’s son Ben recently started recruiting additional family members and friends to help find appointments for his parents.
“I’m sharing my dad’s information with them, to see if they can just try it out. I just figure whatever we can do to keep trying,” said Ben Langdon.
He’s optimistic that with more hands filling out forms, he can better the odds for his parents.
“There’s going to be a time where eventually we’re just surprised and have the lucky chance that we scored an appointment,” he said.