Philly vaccine interest registry has built-in disparities, widening the racial divide

Advocates say more outreach and walk-up access could help bridge the gap.

2021 03 02-e lee-philadelphia pennsylvania convention center-fem
Emma Lee / WHYY
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Chef Ange Branca has been bringing restaurant workers by the dozen to Philly’s FEMA vaccination clinic at the Pennsylvania Convention Center.

As service industry pros who mostly work in small, enclosed spaces, they qualify for the vaccine under the city’s Phase 1B. But many don’t speak English. Others are undocumented. Some don’t have access to email. All these factors are major hurdles contributing to the racial equity gap in vaccine recipients in Philadelphia.

“Why don’t you just have them get signed up?” Branca said she was told by health officials. Until this week, the Philadelphia Health Department had been largely relying on its online vaccine interest registry, reserving nearly 6,000 daily doses at the Center City clinic for appointments made via phone or email invitations.

Registration wasn’t going to solve Branca’s problem, she argued. “What we need is a workaround for me to just give you the names of these people, they show up on this day, and they get it.”

The Malaysia-born chef, who earned a formal apology for discrimination she said she encountered getting her own shot at the FEMA site, convinced officials to use her alternate method. She collected about 180 names of restaurant workers, and personally supplied the list to the Health Department to ensure they got first doses.

The workaround highlights how the city’s reliance on the pre-approved appointments helped widen the racial divide.

A Billy Penn analysis of information in the Philly vaccine interest database found major geographic disparities among the 331,000 residents who signed up.

In a particularly hard-hit Latino area that covers a swath of North Philly and Kensington, only 7% of the population had registered — the lowest rate in the city. On the other end of the spectrum, more than 55% of residents in parts of Center City had registered. The vaccine interest form does not collect information on race or ethnicity. However, all areas where 30% or more people had registered were majority white ZIP codes, according to census data.

Unsurprisingly, the registration imbalance is reflected in the actual administration of doses in Philadelphia to date: wealthier, whiter neighborhoods lead the city in inoculation, while lower-income Black and Latino neighborhoods have the worst rates. (Disparities like this are not unique to Philly; they exist in cities across the U.S.)

Quetzy Lozada, vice president of community engagement and organizing at economic mobility nonprofit Esperanza in North Philly, said city leaders should have known they wouldn’t reach most Spanish-speaking Latinos in her area with just an online signup sheet.

“If you know that that is an issue, and you know that’s a hard-to-reach population,” Lozada said, “why in heaven’s name are you going to make that the best way to register? It doesn’t make sense at all.”

The city did add the ability for residents to call 311 and ask to be entered into the registry, and announced six once-a-week neighborhood clinics in areas around Philadelphia. Then health officials decided to go even further. For the next week, half the FEMA site’s doses will go to walk-up patients from the 22 most under-vaccinated ZIP codes — who also meet Phase 1A and 1B criteria.

Branca is now struggling to get walk-up access for eligible restaurant workers who live outside those areas, but officials say the restriction is essential to controlling crowd volume.

Asian vaccination uptick, community leaders say more outreach is needed

The opening of the FEMA site in early March nearly doubled the pace of vaccinations citywide. Since then, the Inquirer reported, the vaccination gap between white and Black residents widened, from 5.5 to 10.5 percentage points.

Asian residents, however, have seen an uptick in the weeks since the FEMA site opened near Chinatown. The city’s Asian population has gone from about 6% vaccinated in mid-February to more than 18% in mid-March, according to health department data.

Steven Lavín, deputy director of the immigrant help hub National Services Center, said more walk-up sites should improve the situation for many, so long as they’re combined with outreach and other supportive services. Many immigrants and underserved residents may not realize they’re eligible for the vaccine, especially with an ever-evolving matrix of medical, age, occupation, and ZIP code criteria.

“Outreach to the community is critical in terms of understanding eligibility, and addressing disinformation and myths about vaccines,” Lavín told Billy Penn.

There’s also worry among some people about encountering immigration officials at the massive government-run facility. (Federal officials have said Immigration and Customs Enforcement is not present at the clinic.)

Latino residents, while one of the least vaccinated groups in the city, did see an uptick in recent weeks. Lozada, of Esperanza in North Philly, said the city partnered with her organization to allow online-savvy staff to sign up eligible people for approval at the FEMA site, similar to what Branca is doing for restaurant workers in South Philly.

Over a couple days in early March, Lozada said, there was a significant increase in the number of Latino residents getting vaccinated at the Center City clinic. Allowing community groups to approve eligible people for the vaccine eliminates many of the existing barriers.

“The majority of the people don’t have access to the link,” she said. “They don’t speak the language and they don’t know who they’re sharing that information with.”

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