Dr. Virginia Banks, an infectious disease specialist, is part of a group of black doctors and scientists focused on ways to resolve healthcare disparities.
Dr. Virginia Banks
Dr. Virginia Banks says if the US really wants to end the pandemic, it will take mobile vans with vaccines to areas where people don't have transportation – and will even shoot at hair salons and barber shops.
With thousands of pharmacies receiving canned deliveries and vaccinations starting in their stores this week, the country is taking a significant step to reach more Americans. However, public health officials and lawyers say this won't go far enough in communities where people have been the sickest.
More black and Hispanic Americans were hospitalized and died of Covid-19. They also often face major barriers to getting vaccines: lack of transportation. A juggling with several jobs. Hesitation about past abuse by the medical community.
CVS Health and Walgreens will play a bigger role in the effort as a federal program ships cans to more of their stores and those of other retail pharmacies. The expansion represents a business opportunity for the two largest pharmacy chains in the country as they are paid for every vaccine and bring more foot traffic to the stores. The vaccine rollout will also test companies' commitment to expanding access to health care in black and Hispanic communities.
Banks, an infectious disease doctor in Ohio, is part of an advocacy group from the Infectious Diseases Society of America comprised of black doctors, scientists, and public health officials who work to resolve healthcare disparities. She said health care providers need to get creative and show commitment. She said they should set up clinics in familiar places like churches, and attract "trusted messengers" like pastors and community leaders.
"You have to look at where we are from a cultural point of view." and come to us, "she said.
More than fairness
The introduction of the vaccine in the US was slow and complex. Demand for cans has far outweighed the number of shots available for stabbing the arms. Online appointment systems were difficult to navigate and blocked by heavy traffic. To date, only two vaccines have emergency approval from the Food and Drug Administration and must be stored in cold and ultra-cold temperatures. And only a few Americans qualify for the shot, with each state having slightly different criteria for weighing factors like a person's age, health, or job.
About 48.4 million vaccines had been administered in the U.S. as of Friday, according to the Centers for Disease Control and Prevention. Almost 12.1 million people received both doses of the vaccine – just a small fraction of the 331 million people who live in the United States.
The country's goal is to vaccinate between 70% and 85% of the U.S. population – or approximately 232 to 281 million people – to achieve herd immunity, according to Dr. Anthony Fauci, the President's Chief Medical Officer.
People without an appointment are standing in line to potentially receive a dose of the Pfizer-BioNTech Covid-19 vaccine after all appointments are administered on Thursday, February 11, 2021 at the vaccination site at the Sun City Anthem Community Center in Henderson, Nevada .
Roger Kisby | Bloomberg | Getty Images
The chaotic rollout meant that some took pictures and others didn't. According to a CDC study, most of the nearly 13 million people who were given at least one shot of a Covid-19 vaccine within the first month after the drugs were distributed were women aged 50 or older and likely non-Spanish and white .
In vaccine distribution, equity is not just a question of fairness. It's also a crucial way to slow the spread in communities where Covid-19 cases, hospitalizations, and deaths are more common. Black and Hispanic Americans are 3.7 times and 4.1 times more likely to be hospitalized from Covid than white Americans at the end of November, according to the CDC. Both minorities are 2.8 times more likely to die from the disease than white Americans.
In a badly affected neighborhood, the impact of each shot can be even greater – reaching people who are at greater risk from working in grocery stores or other frontline jobs, or living in airtight apartment or multi-generational households.
Reluctance to vaccinate is also higher among blacks and browns, which can be traced back to the history of the medical community where minorities have been mistreated and fewer health practices have been opened in their neighborhood. A survey of New Yorkers conducted by the Association for a Better New York found that 78% of White residents would take the vaccine as soon as possible, compared to 39% of Black residents, 54% of Hispanics, and 54% of Asians .
"Put your money where your mouth is"
For providers like CVS and Walgreens, having more doses of the vaccine is a business opportunity. You are paid for every vaccine, and the government pays for it if a person is not covered by health insurance. Jefferies estimated that each shot will have a gross margin of $ 13-15 and could bring about $ 1 billion in additional gross profit for CVS in the next year.
Both drugstore chains have set their strategy of adding more health services from primary care clinics to diabetes screenings. They have also reinforced their commitments to eradicate racial inequality in response to George Floyd's murder and nationwide protests. CVS plans to invest nearly $ 600 million over five years to support political initiatives and internal efforts such as: For example, black workers are looked after and free health checks for blood pressure and cholesterol are available in stores.
Walgreens launched a pilot in the Chicago area that aims to reduce hospital stay rates by making it easier for patients to take their medication, get free prescriptions, and more regular contact with health professionals about their health. The company recently hired former Starbucks Chief Operating Officer Roz Brewer as its next CEO. When she steps into the role in mid-March, she'll just be a black woman running a Fortune 500 company.
Karyne Jones, The Washington, DC-based CEO of the Washington, DC-based National Caucus and Center on Black Aging said expanding vaccines to hard-hit communities is a way for CVS and Walgreens to "put their money where their mouth is." Her organization is a founding member of the Covid-19 Vaccine Education and Equity Project, a coalition of nonprofit and trade groups supported by vaccine manufacturer Pfizer.
Jones said she'd love to see CVS and Walgreens open 24/7 vaccination sites and pitch tents in areas where people don't have transportation.
"If you really want to show good corporate responsibility, this is the time to say we need to invest resources to help alleviate this pandemic," she said.
We have pharmacy deserts. We have deserts for grocery stores. We don't have ecclesiastical deserts.
Dr. Virginia Banks
Infectious Disease Specialist
Banks, the infectious disease doctor, said he will be pursuing outside of the box strategies such as rerouting bus routes to vaccination clinics. She pointed to an effort in which pharmacists teamed up with barbershop to detect high blood pressure when black men got a haircut – a clinical study that helped identify the condition and act sooner.
She said she hoped the Johnson & Johnson vaccine – which only takes one dose and is easier to transport – could change the distribution and make it easier to fire shots where people are. The company filed for emergency approval with the FDA last week.
"We have pharmacy deserts," she said. "We have deserts for grocery stores. We don't have deserts for churches."
Cans in more parts of the city
Walgreens and CVS have administered Covid vaccines in thousands of nursing homes and assisted living facilities. They gave gunshots in some stores after receiving doses of vaccine from states. With the federal program, they will offer recordings in more parts of the city.
Walgreens has Covid vaccines in stores in 15 states and two other jurisdictions, New York City and Chicago. As part of the federal program, recordings will be made in 1,800 branches – or around 20% of US branches, said a company spokeswoman.
CVS has them in 18 states and Puerto Rico. As of Friday, around 420 of the approximately 9,900 branches will take pictures with cans of a state or federal program, said a company spokesman.
Both pharmacy chains stated that they selected stores in areas with greater demand. About half of any Covid vaccine business is in medically underserved areas or in locations high on the CDC's Social Vulnerability Index. This is based on factors such as the prevalence of poverty, lack of access to vehicles and overcrowded housing.
Walgreens also allows people to schedule appointments in person or over the phone, so people aren't left out when they don't have the internet or a computer, said Rina Shah, Walgreens Group's vice president for pharmacy operations. CVS has a 1-800 number as an alternative to booking online.
Walgreens partnered with Uber to provide free rides to vaccinations for people living in underserved parts of major cities like Atlanta and Chicago. Charitable partners help identify people in need of transportation.
CVS is taking proactive steps to ensure locals can get vaccine appointments at their nearby store, said Chris Cox, the company's senior vice president of pharmacy. He said employees call some customers to make appointments, especially those on lower incomes and older.
Along with the recruitment of pharmacies, the Biden government will deliver doses to community health centers next week that will serve millions of Americans who are below the poverty line and who are racially minorities.
The vaccination program enables CVS to vigorously demonstrate how it can provide health care in places where it is normally inaccessible, Cox said.
"Everything we do is really with the intention of helping people on their way to better health," he said. "This is an opportunity for us to really demonstrate to our patients and other stakeholders what we have been saying for several years. That means the community pharmacy is a big part of healthcare."
Many patients see their pharmacists more often than their doctors because they have to pick up high blood pressure pills or other maintenance prescriptions, he said. These common interactions mean that CVS can play a bigger role in ensuring that people are taking their medication properly, or intervening before potential complications.
As Walgreens gets more offers, Shah will extend his working hours and offer recordings on weekends for people who cannot skip a day. It will open clinics in community centers, as it does with flu shots.
Shah said his pharmacists can play a key role in educating and answering questions so that people are more excited than concerned about the recordings. But she said the company ultimately needs more supplies to reach more people in minority communities.
"Our biggest chance is to get more vaccines," she said.