Inequities in Technology Contribute to Disparities in COVID-19 Vaccine Distribution

Abstract

As states have begun administering COVID-19 vaccines to those 65 years and older and essential workers, they face substantial challenges.These challenges include the race against more contagious virus variants; the continuing death toll, particularly in vulnerable subgroups 1 ; concerns about vaccine supplies; and insufficient funding for vaccine distribution.The National Academy of Medicine and the Centers for Disease Control and Prevention's Advisory Council On Immunization Practices (ACIP) have emphasized the need for equitable vaccine allocation and urgent prioritization of subgroups most negatively affected by COVID-19.Because of social distancing measures, vaccine scheduling has predominantly relied on technology such as mobile apps and internet portals.Despite ongoing efforts to ensure equity, longstanding systemic disparities in technology access and literacy are hindering equitable vaccine distribution and raising bigger questions about how technology disparities may be affecting social and health disparities.A recent JAMA editorial offered several important recommendations to promote equity in the distribution of COVID-19 vaccines.2 However, national guidelines and expert recommendations have not proposed solutions to technology-related equity challenges.Ameliorating these inequities will require a deeper understanding of how technology may exacerbate disparities in vaccine access and to consider potential solutions.3 Internet Connectivity and Access to TechnologyIn 2019, more than 40% of older adults did not have broadband in their homes, and more than one-quarter did not use the internet.Both broadband and cellular coverage vary significantly across geographic locations; the largest dead zones more frequently occur in rural areas, lower-income neighborhoods, and minority communities.Beyond connectivity, disparities in ownership of computers and tablets further contribute to the digital divide among vulnerable groups.Although most adults 65 years and older own a cellular phone, nearly half do not have a smartphone.Within this older age group, those with advancing age, presence of disability, or low income and those who are Black or Hispanic are more likely to lack access to computers connected to the internet.The pandemic has made clear that technology can be a powerful tool for those with access, as technology quite literally enabled social distancing across the US in order to "flatten the curve."However, what was previously a digital divide has now become a digital chasm.Despite state-based efforts to improve connectivity and technology access in response to the CARES Act, connectivity deserts and limited technology resources remain among disadvantaged groups, limiting their access to health care resources.Policies to promote universal connectivity are overdue, and more efforts like this one in Chicago are needed to inform policy. Technology Usability and LiteracySimply having access to technology does not ensure usability when seeking COVID-19 vaccines.Usability concerns include complicated websites for registering, requiring email addresses for registration, needing to frequently monitor appointment availability, and narrow windows for scheduling appointments.The heavy reliance on technology to access COVID-19 vaccines is problematic for many of the groups hit hardest by COVID-19.In a Chicago Tribune op-ed, we

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