As Hagpop wheels his 90-year-old father, Ara, to the Mission vaccination site, he feels this is his last shot. Ara’s primary care doctor doesn’t have vaccines. The City College mass vaccination site has no available slots online. Tips on where to go instead are non-existent. It wasn’t until Hagpop, who lives on 24th Street, happened to drive by the vaccine site at 24th and Capp streets that he felt hope.
“It was by sheer luck,” Hagpop said. “I did all these proactive things. It’s frustrating.” Would his father, who speaks Armenian, be vaccinated if Hagpop wasn’t there? Probably not.
Despite being eligible for inoculation for weeks, many seniors older than 65 are finding that the easiest way to get a dose may be to wait two to four hours in the Capp Street line.
Doctors, frontline volunteers, and residents reported difficult and often unsuccessful attempts at booking online appointments. They described unfamiliarity with online systems, disparate information, and disability and mobility issues. To top it all off, intermittent vaccine supply from the feds means thousands of pre-scheduled appointments can and have been postponed or canceled without warning.
Those challenges, said seniors and doctors, have forced the elderly to fend for themselves or to enlist the help of sympathetic doctors and friends.
“People are dying every day,” said Dr. Rebecca Parish, a primary care doctor with multiple elderly patients in Contra Costa County. A 92-year-old woman who was not her patient called Parish frantically before sunrise one day, asking Parish to book her a vaccine.
“As a doctor who takes care of older people, I am getting a little bit choked up,” Parish said. “It’s devastating. They are really afraid.”
At the Capp Street site, which UCSF and the Latino Task Force opened Monday, Susan Holder 76, stood next to a chair that a volunteer had loaned her. She had been there since 6:30 a.m., though the site opens at 9.
At 9:40 a.m, she was close to the front. Holder had the virus already and said she “tried to get an appointment through my doctor,” but that proved impossible. “I heard on TV, Channel 14, that I could come here.”
The same thought occurred to Hugo, a 75-year-old 20th Street resident who has no insurance. He showed up and reserved an appointment for later this week.
By the third day, the line of more than 50 or so seniors waiting to book an appointment stretched to 25th Street. Some sat in chairs volunteers passed out to those who needed one, others leaned on canes.
Even if they are adept with technology, many aren’t getting appointments. “They can’t get through, not to insurance, not to doctors and they are out of their minds because they can’t get through to anyone,” said Diane Jones, a retired HIV nurse and a leader in the Mission testing and vaccination campaigns.
For those who are not comfortable with technology, the appointment process is near impossible. Local departments and most major healthcare providers tend to contact eligible patients about open slots through online health portals or email.
It’s the little things that can make the process a no-go for many : some people don’t own a computer or a smartphone, or don’t feel comfortable using these. Married couples who want to be vaccinated each need an email to make individual appointments, but several tend to share one account. Two-step verification, links, and access codes that expire in minutes add to confusion. And, English-only forms can screw up simple data entry: for example, in some cultures, last names are printed first, and in other countries, date syntax is day then month, creating potential hiccups when inputting birthdays.
Suzy Pak, who advocated for and helped digitally register and vaccinate 600 seniors at a Contra Costa County pop up site via a community effort, knows this firsthand. She is a regular volunteer at the senior service nonprofit Lamorinda Village in Lafayette, and additionally has personally aided at least two dozen seniors to secure vaccine appointments through their healthcare providers. Even for Pak, registration was tedious and confusing.
“It got to the point where I was just entering the information myself [and using my email to create accounts] with them on speakerphone,” Pak said.
Phones have proved another source of frustration. Bay Area doctors reported 80 and 90-year-olds hanging on the line for five hours or more. Some counties, like Contra Costa, have tried to mitigate that by asking patients to leave a call-back number. Though ultimately helpful, Dr. Denise Hilliard, a Walnut Creek primary care doctor and internist, said when she left a call-back number on behalf of her mother, she missed the county’s call three hours later. (She was in the shower.) She had to restart the process and get in the queue again, which took two days overall.
“I think some bureaucratic decisions don’t take into account the boots-on-the-ground work, and the real challenges individuals have to navigating these systems,” said Hilliard, who also signed up 10 patients and relatives on her own time, and participated in the Contra Costa vaccination effort. “It should be easier than this.”
To complicate things further, who is eligible for a vaccine depends on the provider, or even county, according to seniors at the Mission vaccination site.
Lou Dematteis, 72, said his insurer, Sutter Health, told him they were only taking patients 75 and older. Kaiser told Bernal Heights resident Eileen Gross, 73, there were no more shots left. Philip Collins, a 66-year-old chef, said his employer, Chavas, requested he get vaccinated. Collins tried to do that through Blue Shield at the Excelsior clinic he generally uses, but could not get an appointment. “They are not doing any shots,” he said.
Perhaps an unforeseen global pandemic could provide partial forgiveness for these roadblocks: medical accessibility issues for older people were probably much more manageable in pre-Covid-19 days, when health departments, doctors, and clinics weren’t swamped, and there wasn’t a dearth of drugs or inoculations for a dynamic, life-threatening illness. “It’s a pandemic. There is no perfect formula,” Parish said.
And Pak, the Lamorinda volunteer, said most of the younger and general masses will be able to navigate online scheduling easily and efficiently — that is, whenever these populations become eligible for inoculations. But right now, Dr. Hilliard said it’s a deadly disease, especially for the elderly, and these issues need to be addressed instead of “letting months go by” in “a system that doesn’t appear to be working.”
Dr. Hilliard and Dr. Parish suggested that healthcare providers reach out to and follow up with patients by phone. And, counties should consider shouldering the rollout with more primary care doctors who regularly work with the elderly. “We’re trying to go from big health system to patient, and we’re skipping the patient’s doctor. We’re making it really hard. The way to get it to communities is to get it from community doctors and clinics,” Parish said.
Grassroots community efforts like the 600-senior-pop-up in Lafayette, or community clinics like the one in the Mission, can also work. Pak urged individuals to reach out to random seniors and their friends and sign them up for appointments now, as she did.
“We need to pay attention,” Pak said, “and make sure they don’t slip through the cracks.”
For eligible groups — healthcare workers and seniors over 65 at present — the vaccination site at 24th and Mission streets will make appointments for those who register at their information desk on Capp Street. It is open from 9 a.m. to 2 p.m. Sundays through Wednesdays. Appointments are generally made for another day. There is no online registration process, unless you have been contacted by Unidos en Salud because you are eligible and have participated in one of their testing campaigns.
Most people will be contacted by their private providers when they are eligible. Vaccinations are available by appointment invitation only. Those comfortable with online appointments can book online at Kaiser Permanente’s website, Sutter Health’s website, or UCSF’s website. Those who prefer to call can find the numbers for these providers here. San Franciscans can sign up for the city’s Covid-19 vaccination notification system to find out when they are eligible.
Rapid Covid-19 testing is available at the same times and days at the 24th Street BART Plaza.
Lydia Chávez contributed to this report.