No child care, no transportation, no tech-savvy, no trust: Parents of color and older adults are still facing obstacles when it comes to getting vaccinated. So how do we fix a broken system and get to that coveted herd immunity?

By Melissa Mills
April 22, 2021
Advertisement

Over a quarter of Americans—more than 87 million people—have been fully vaccinated against COVID-19 already, but we've still got a long way to go. All adults are now eligible for a vaccine, but that doesn't mean that they'll easily be able to book an appointment, get to a vaccine distribution center, or trust the health care system or vaccination process to begin with.

Every adult who wants to get a vaccine should be able to do so, but that's not always the case. And even those who may be eligible have lost all faith in a system that's consistently worked against them. To keep Americans healthy and achieve herd immunity, a substantial portion of the population—at least 70 percent—needs to get vaccinated for their family's sake, but also for the sake of other families in their communities and the country as a whole.

An image of a women's hands reaching for a vaccine vial on a colorful background.
Credit: Getty Images (5). Art: Jillian Sellers.

What Aren't People Getting Vaccinated?

Natasha Williams, Ed.D, MPH, MSW, an assistant professor in the department of population health at the NYU Grossman School of Medicine in New York, says some of the main barriers to vaccination include "access, understanding eligibility, and convenience." In fact, a recent survey showed about 3 in 10 Americans said they did not know whether they were eligible in their state.

Experts also cite widespread vaccine hesitancy as a huge problem facing the country.

Sonia Sroka, head of multicultural communications at Facebook, which is running a worldwide campaign to promote COVID-19 vaccine information and help stop the spread of misinformation, says the vaccines felt like a light at the end of the tunnel. But even within her own family, she said there were some people who were skeptical or scared—even with her around to quell their fears. "Add in factors like not being near testing sites, work schedules, family responsibilities, language barriers, and even fear of not having immigration status, it really worried me," she says.

Vaccine hesitancy and obstacles to getting shots in arms existed long before COVID-19. During the pandemic, Black people, Latinos, and even Trump supporters in rural areas—like Mississippi, Tennessee, Arkansas, Alabama, and Georgia—are less likely to be vaccinated. A new poll by the Kaiser Family Foundation found that while some Americans are coming around to the idea of getting vaccinated as they see others do the same, 13 percent of respondents still say they would "definitely not" get a vaccine.

We broke down these five main roadblocks to parents getting vaccinated—and what still needs to happen to tackle the vaccination barriers that could jeopardize the pandemic coming to an end.

1. Lack of access for marginalized communities

According to the Centers for Disease Control and Prevention (CDC), Black and Hispanic people are at a greater risk of hospitalization and death from COVID-19, but less likely to get vaccinated than white or Asian people. They're also more likely to be disadvantaged and living in poverty, lack access to the internet, hold jobs where working remotely isn't an option, have limited access to care, and potentially even be undocumented and not speak English—all factors that make getting vaccinated more difficult.

Children of color are disproportionately struggling during the pandemic and, since kids aren't yet eligible to be vaccinated, it's crucial that their parents and relatives can get the COVID vaccine to help protect the whole family.

Dr. Williams says poverty is a key factor in getting people vaccinated.

"There are less vaccine sites in areas with high concentrations of poverty and more vaccine sites in neighborhoods with low levels of poverty," says Dr. Williams of her work in New York City. "So if we can develop clear messaging around eligibility, cost, and make it easier for people to access the vaccine in a way that is convenient (i.e. walk-ins accepted), we are likely to continue to see an uptake in vaccinations."

2. Difficulties getting appointments

Vaccine eligibility may be opening up, but securing an appointment has proven difficult across the country as demand still proves greater than supply.

Many people have likened getting a vaccine appointment to hitting the lottery—but access to crucial health care shouldn't rely so much on luck.

Locking in a time to get vaccinated could take hours online with hundreds of refreshes on vaccine sites. For those who aren't digitally savvy or don't have the time, getting an appointment is nearly impossible. "Vaccine angels," or volunteers who help others—primarily the elderly—navigate and lock in shots, are even popping up to help with the flawed system.

3. Lack of child care

While some exceptions exist, many vaccine distribution centers only allow the person with the appointment to enter the site. And, sure, some parents might be able to bring their kids along to their appointment, but it requires them to decide if they're willing to risk bringing their unvaccinated children around so many other unvaccinated individuals.

"I think barriers impacting vulnerable groups exist for a few reasons," says Héctor E. Alcalá, assistant professor of public health at Stony Brook University. "The first is unequal access to resources like health care, income, and child care. To ameliorate this, we need to invest in government programs like universal health care, universal child care, and universal paid time off. This will help break down the financial barriers that exist to care."

4. No transportation

Volunteers across the U.S. are helping those with no vehicle, no license, or medical conditions where travel isn't an option, but there's more work to be done, especially since access to transportation is limited for low-income families.

In rural areas, even finding a pharmacy or health center proves difficult. According to a February study by the University of Pittsburgh's School of Pharmacy and the West Health Policy Center, many residents in urban counties in Atlanta, Houston, Dallas, Detroit, and New Orleans had to travel over a mile to get to a vaccination site, though it wasn't uncommon for Black residents to have to travel at least 10 miles.

5. Vaccine hesitancy

Jennifer Haythe, M.D., is an associate professor of medicine at Columbia University Center for Advanced Cardiac Care in New York and worked in the cardiac intensive care unit treating COVID-19 patients in March 2020. She says vaccine hesitancy has been the biggest barrier she's seen in her community.

Dr. Haythe cites a lack of trust in the federal government, feelings that the vaccine has not been tested long enough, misinformation about how mRNA vaccines work, and religion as the reasons she sees for people not wanting to be vaccinated. And some people, specifically many BIPOC individuals, have a lack of trust in health care stemming from years of discrimination and implicit bias. 

This vaccine hesitancy is often supported and intensified by false messaging on social media. According to an independent report, Facebook users viewed health misinformation 3.8 billion times in 2020. Case in point: It's almost impossible not to see anti-vaccine sentiments or conspiracy theories on social media and in parenting groups.

How to Break Down Barriers

"As a society, we all have a responsibility in addressing barriers to vaccine uptake," says Dr. Williams. On a large scale, she says political figures, communities, pastors, role models, and other community leaders sharing clear, consistent, and simple messages about vaccinations would help reduce hesitancy in many populations. On a personal level, there are things parents can do to help at home or in their communities.

Offer help to friends and family

One of the simplest ways to help in your community? Reach out to your loved ones, ask how they're doing, and offer assistance. Babysitting, helping to make appointments, driving people to appointments—no good deed is too small. 

"It may also help to reach out to organizations, like schools, churches, or employers that you are a part of, and ask them if they're willing to host vaccine educational sessions, that include showing people how to navigate the vaccine registration procedure," says Alcalá.

It's also more than OK to ask for help if you need it. Moms are bearing the brunt of responsibility at home—even making vaccine appointments for their partners, parents, and children—and it's time we divvy things up.

Support organizations making a difference

Organizations around the country are already doing some of the heavy lifting to break down vaccination barriers. Considering volunteering or donating to nonprofits like Project HOPE that have been helping with the global response to COVID-19. 

You can also reach out to your local health department or health care centers and ask how you can help.

Stop the spread of misinformation

Social media use is up during the pandemic—but so, too, is the frequency of posts you'll see with fake or misleading COVID information. A 2019 report found that half of all parents of small children were exposed to negative vaccine messages on social media—and that was before the pandemic when families became even more glued to their devices. With around 7 in 10 U.S. adults on Facebook and 3 in 4 new or expectant parents in a Facebook group, it's no wonder there's an entire campaign to help stop the spread of misinformation. 

Facebook's COVID-19 Information Center connects people with accurate information about COVID-19 and vaccines, including a vaccine tool that will help people find out where and when they can get vaccinated.

And by sharing relevant vaccine information from trustworthy sources on your own social media accounts, you can help be part of the solution.

Share the news

There's one super simple way you can let others know how easy (and safe) the vaccination process is: Share the news of your shot. After all, you did your part to help the U.S. get back to normal—it's OK to brag!

"In general, people want to conform to others in the groups with which they identify, so sharing your reasons and experience with getting vaccinated might also be helpful," says Dr. Williams. "We do need to make it easy for people to get vaccinated and to provide reputable information."