COVID-19 Vaccine Distribution for Older Adults in Crisis

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Original story posted on: February 17, 2021

Older adults continue to be at risk during the pandemic.

COVID-19 vaccine distribution has prompted headaches across the country. However, older adults have been especially challenged with access; those who “have less” and are dealing with economic and/or health limitations, as well as family and peer support, are struggling. For those who have experienced historical and other types of trauma, these disparities will further impact their functioning, morbidity, and mortality.

A new issue brief by the Kaiser Family Foundation details how severe the issue is.

As one of the major populations living amid factors associated with the social determinants of health (SDoH), adults over 65 have been disproportionately impacted by the virus. This age group has comprised 75 percent of all COVID-19 deaths for each month since the pandemic hit its initial peak last spring; mortality rates reached 82 percent of the population in May 2020. Since then, other concerning numbers have emerged:

  • Hospitalization rates for adults ages 65 to 74 are over 2.5 times higher than those of the 40-49 age group.
  • The difference in mortality rates is vast:
  • Death rates for adults 65 to 74 are over 9.5 times higher than for adults ages 40-49.
  • For individuals 65 and older, the incidence of hospitalizations and deaths increases with age. The rate of hospitalizations is more than 2.5 times higher and deaths 7.4 times higher among those 85 and older, compared to those 65-74.

Disparities in vaccine allocation and distribution for older adults also continues:

  • In theory, persons over 75 should be prioritized for the vaccine, listed in group 1a.
  • However, for states reporting COVID-19 vaccinations by age, the majority of older adults have not yet received their first dose.
    • This range varies, from 10 percent of older adults in Pennsylvania to 34 percent in West Virginia.
  • Nine states reported vaccinating at least 20 percent of their 65-and-older population: 
    • West Virginia, North Carolina, Florida, Mississippi, Delaware, Texas, Michigan, New Jersey, and Wisconsin, plus the District of Columbia.
  • Older adults account for the majority of people vaccinated in less than half of states
  • In 23 states reporting vaccine data by race, Blacks and Latinx are being vaccinated at a far lower rate than whites. Many also lack the necessary Internet access or digital devices to sign up for the vaccine on available portals.
    • A recent survey from the University of Michigan revealed close to 50 percent of Black seniors and 53 percent of Latinx seniors lack online patient portals with their healthcare providers, compared with 39 percent of white elders.

In a number of states, residents in the priority group continue to wait their turn, including my home state of Virginia. As few as 13,000 doses were available for a waiting list of over 180,000 residents last week. While the state’s new vaccine dashboard shows improvement this week, from rising vaccine availability to increased use of neighborhood and community health clinics in the vaccination effort, more must be done to promote vaccine access and distribution, especially for those eligible on priority lists.

Our Monitor Mondays Listeners Survey asked our listeners, how do you rate vaccine distribution in your state? The results spoke volumes about the realities faced by far too many individuals and can be viewed here.

Programming Note: Listen to Ellen Fink-Samnick’s live reporting on the social determinants of health on Monitor Mondays, 10 a.m. Eastern.

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management,  Social Determinants of Health: Case Management’s Next Frontier (with Foreword by Dr. Ronald Hirsch), and End of Life Care for Case Management are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk-Ten-Tuesdays, and member of the Editorial Advisory Boards of Professional Case Management, Case Management Monthly, and RAC Monitor. Ellen also serves as the Lead for Rise Association’s Social Determinants of Health Community.

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