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Story Publication logo January 21, 2021

Elderly Anxious for the COVID-19 Vaccine Face a Confusing Wait

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Image by Manuel Martinez / WBEZ. United States, 2020.
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Since the start of the pandemic, COVID-19 has killed more than twice as many Black Chicagoans as...

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Dr. Amish Desai, senior medical director at Oak Street Health, received the COVID-19 vaccine in Chicago, Ill. in January 2021. Image by Oak Street Health. United States, 2021.
Dr. Amish Desai, senior medical director at Oak Street Health, received the COVID-19 vaccine in Chicago, Illinois, in January 2021. Image by Oak Street Health. United States, 2021.

John Buoniconti, 79, longs for the day when he can end his COVID-19 induced lockdown since March.

For now, like many seniors, he's basically stuck in limbo, just waiting to find out when it's his turn to get a vaccine to stave off the novel coronavirus.

"I've always been in business," said Buoniconti, a retired mortgage broker and three-time cancer survivor who lives in southwest suburban Palos Hills, Illinois. "I've always been able to get the answers. I'm frustrated. I can't get anything, from anybody. Not even my doctor."

Less than a year into the pandemic, the first batch of vaccines rolled out in December to health care workers and those who live and work in nursing homes.

Next in line: seniors who are 65 and older, and certain frontline essential workers, like bus drivers and teachers.

In Illinois, seniors are dying most of the coronavirus, state public health data shows. But answers to so many of their questions remain elusive. When will it be my turn? Who will tell me if I don't have a doctor? Where will I get the shot, and how will I get there?

There's a certain angst with waiting. Buoniconti fills his days with walks and scrolling through news on his iPad. He and his partner, Kirsten Szwed, 43, have mostly stayed home since COVID-19 started growing in March. She's eager for a return to normalcy, too.

"Since we have heard that the vaccines are coming, I think I've gotten more antsy," Szwed said. "I was a little more resolved before this. OK, just take your time. Be patient. It will happen. But it's almost like a teaser that won't go away."

A patchwork system in Illinois

While public health officials say seniors can start getting vaccinated now, it could take some time before that ramps up.

There just isn't enough vaccine to go around.

And trying to find out when it could be your turn somewhat depends on where you live. It's a patchwork system throughout Illinois. In Chicago, people can sign up for alerts through the public health department's Chi COVID Coach app for information about the vaccine. But this can be confusing. People can't book appointments to get shots. And at first, the online registration appears to be only for people who have coronavirus symptoms or have been exposed to the virus.

Cross into the suburbs, and the Cook County public health department survey suburban residents can fill out. Buoniconti did. The idea is to alert him when it's his turn. Many other suburban health departments are surveying their residents to get an idea of how many people want to get a COVID-19 vaccine.

Some parts of Illinois are further along. In small, downstate Greene County, about an hour north of St. Louis, the public health department has already started vaccinating teachers and others who have been exposed to the virus.

That includes Kathy Burkholder, 77. As a volunteer with Meals on Wheels, she delivers food inside people's homes. Burkholder got her shot last week. She recently drew some parallels to growing up in Warm Springs, Georgia, when polio was part of the fabric of her community.

Like COVID-19, polio was a highly contagious, deadly disease. Burkholder said she learned to swim in what had been treatment pools for polio patients. Her mother was a physical therapist who worked with patients, while her father made leg and back braces for them.

"I can remember being in school and getting the first polio shots," Burkholder said. "I've been part of history. I'm ready for this now."

Bob Gallo, state director of AARP Illinois, said the organization plans to host town hall meetings to help inform its nearly 2 million members. Many are confused and concerned, Gallo said, adding that there doesn't seem to be much transparency around basic questions, like how to book appointments for a shot and how to get a ride there.

"What's really needed is that single point of entry, so to speak," Gallo said. "Where do I go to get all the information I need to tell me when I can get this vaccine, where I need to go, and how do I get there? There's no one place."

Barriers to getting a COVID-19 vaccine

Even if more vaccine becomes available, consider the hurdles for elderly residents to get their shots.

Hesitancy is a big issue among Black patients especially. There's a history of medical experimentation and mistrust.

Here's what Dr. Ram Krishnamoorthi does to build trust with his patients. He describes his own experience getting the COVID-19 vaccine. Krishnamoorthi is a primary care physician with the University of Chicago Medical Center on the South Side. The majority of his patients are Black and elderly.

"There hasn't been a better persuasion than people seeing that someone that they know has received a vaccine and has been OK," Krishnamoorthi said, "or has been honest about some of the side effects that they've had, and still told you the benefits outweigh the side effects."

Only after the second dose was his arm sore. He was tired, and he had a mild headache. But within a few days, that all went away.

Still, Krishnamoorthi underscored another hurdle: finding some of his patients. He communicates with many of them by phone and some have government-issued phones. Each time they replace their phones, they could get a new number.

"This is a triple whammy of overlap," Krishnamoorthi said.

His patients are some of those at highest risk of getting COVID-19, yet they have the least resources and already can be hesitant to take the shot.

And there's a digital divide among many seniors. They might not be tech-savvy, yet a growing way doctor's offices and patients communicate is through online messaging systems.

Here's another hurdle to vaccinating seniors: merely getting to the doctor's office. Dr. Ali Khan, executive medical director at Oak Street Health, calls this the last mile — making sure people actually get a shot.

"Our seniors have listened when we've told them: 'Don't leave your house,' " Khan said. "And so that is a correct, yet enormous, impediment to us being able to get to the level of herd immunity that protects those very seniors."

Oak Street Health has more than a dozen clinics in the Chicago area. The majority of patients are at least 65 or older. The organization plans to use its fleet of vans and a partnership with Lyft to bring people in for shots. That's how their clinics typically get patients to and from appointments.

On the Southwest Side, home to some of the highest rates of COVID-19 in Chicago, Esperanza Health Centers plans to offer vaccines to its elderly patients early in the morning, knowing they likely would get rides from their adult children. Esperanza doesn't want those adult kids to miss work. The majority of patients have hourly jobs. They're mostly low-income people of color.

Another hurdle: How do doctors decide who among their elderly patients gets a shot first? Doctors and clinic leaders say they likely would prioritize their sickest seniors. But say someone decides they won't want the vaccine after all. There could be a scramble to immunize someone else or throw the dose out.

Just like patients, doctors and clinic leaders want answers about the vaccine, too. Public health officials are waiting from week to week to see how much vaccine they might get. Then, doctor's offices have to wait.

"One of the big things that's really getting me — we just can't plan, when you don't know how many doses you're going to get and when you're going to get them," said Esperanza CEO Dan Fulwiler.

That's especially difficult for clinics like Esperanza, as they try to set up appointments with patients who might have a hard time finding a ride to a clinic or don't have a cell phone to get a call that they should come in.

"When am I going to get it?"

Even when seniors do get their vaccine, there's another big question for those taking care of the seniors.

"When am I going to get it?" Szwed said. "I spent 11 months protecting him. Now does he have to wait more for me to get it? I won't ask him to do that. But I imagine that's what's going on inside families who have elders in their home."

Szwed lives in the suburbs. But for Chicagoans, Public Health Commissioner Dr. Allison Arwady on Tuesday revealed some big news. The general public ages 16 and older could start to get vaccinated at the end of May, if there are enough doses.


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