Texas’ decentralized, internet-reliant system for vaccine appointments leaves many eligible people unable to access a shot

Texans face many obstacles to getting vaccinated against coronavirus. These hurdles contribute to racial and ethnic inequities in who is getting vaccinated. Stay up-to-date on our COVID-19 coverage by signing up for our evening coronavirus newsletter here.

Despite spending hours trying to get a vaccine appointment, Wanda Davis still doesn’t know when she’ll be able to see her children again. The 81-year-old has been trying to get a vaccine so she can leave her Kingsland home, about 60 miles outside Austin, and safely visit her family. But it hasn’t been easy.

She said she doesn’t have internet access at home, and she has had trouble navigating the computers at the local library. When she called multiple pharmacies, none had appointments available. After calling her local pharmacy, she is finally on a waiting list. But she still doesn’t know when she’ll get the vaccine.

Davis said the unorganized system has created obstacles for vaccine access, especially for elderly Texans without internet access. She thinks local officials need to do a better job providing information about where vaccinations will be offered and what days people should sign up for them.

“Out here in the country, we don’t really have newspapers, so how are we going to get the information? Well, they could call us. They could put it on the radio,” Davis said. “They could put it on TV, like specifically in your town, ‘You can sign up for this on this day between these hours.’ It would be helpful.”

Davis is among an unknown number of Texans facing challenges trying to book a vaccine appointment through a time-consuming process that inherently favors people who have easy access to internet and transportation. The situation is contributing to inequitable access for many people in the state — including Black and Hispanic Texans — who are at a higher risk of dying or experiencing severe symptoms from COVID-19, experts and local officials said.

Health care workers, teachers and child-care workers, long-term care facility residents, people 50 and older, and people 16 and older with certain medical vulnerabilities are eligible for the vaccine in Texas. But many of those people can’t get a shot because they can’t spend hours navigating the internet or waiting in line.

Vaccine appointments are often scheduled through a city’s online portal or a pharmacy’s website. Many elderly Texans struggling to navigate the decentralized system are instead resorting to calling local pharmacies or relying on friends, family or networks of volunteers to find them an appointment.

Some areas are offering vaccinations through drive-thru locations, which excludes many Texans who don’t have access to their own vehicle. Even for locations that don’t explicitly require a car, people still need to have access to transportation to get to their appointments, and they may have to stand and wait in line for long periods of time.

Pamela Rogers, a 70-year-old living in Austin, said she spent at least five to six hours every week for months looking for vaccine appointments, but a lack of familiarity with the internet and difficulty finding information on the city’s website made the process frustrating and confusing.

After getting an appointment at UT Health Austin shortly after last month’s deadly winter storm, she and her husband had to walk to their appointment after their car had a flat tire. Once she arrived, she said she faced long lines with no obvious location for people facing mobility issues to wait for the vaccine.

“There was no mention made at the table about low mobility at all, and I could tell there were several people in front of me who were not used to standing for 20 minutes,” Rogers said. “People were struggling a lot. They’re not looking out for people with low mobility.”

Douglas Loveday, a spokesperson for The Texas Department of State Health Services, said people can call vaccine providers, local pharmacies or 211, the state’s free 24-hour helpline, if they need help finding information about appointments and available doses. In many areas of the state, he said there are organizations helping people without internet access to connect with local providers to receive a vaccination.

“As supply ramps and more doses are allocated weekly to Texas, vaccine(s) will become available to many more providers across the state,” Loveday said in an email. “There are now more than 7,000 enrolled providers in 238 of Texas’ 254 counties. When (a) vaccine is available to all of them, it will be much more accessible to those now challenged to make and keep vaccine appointments.”

Melissa Vannoy, a 43-year-old health care worker in Houston, said she became exhausted after trying to help her parents schedule appointments to get the vaccine. Neither of her parents are very familiar with technology, and she said she lost all her energy after facing difficulties trying to navigate the system and find information about when vaccines would be available.

“We need transportation. We need communication. Give us direct ways to do it, don’t just give us the number,” Vannoy said. “Give us locations. If you can give us locations and transportation to get us there, that would be great, instead of having to rely on looking for a ride and getting turned down for a ride.”

Dr. Vivian Ho, a professor of health economics at Rice University, said many people who don't have a regular caregiver may not know how to access a vaccine. She said government officials need to take more aggressive steps to distribute vaccines equitably, such as mobile clinics and vaccination drives.

“Vaccination drives at houses of worship in low-income neighborhoods should be organized, because many of these facilities are well trusted by their surrounding community, and they eliminate transportation as a barrier to access,” Ho said in an email. “Local officials should also work to open some vaccination sites that are available 24/7.”

Chris Crookham, the interim program manager of Austin Public Health’s immunization program, said Austin has an “equity line” for people experiencing difficulties with access to transportation, internet or other accessibility issues. People working the hotline help create accounts for callers through APH’s vaccine registration portal and schedule appointments for them, he said.

Crookham said APH plans to start a partnership next week to vaccinate Meals on Wheels clients who are homebound, and they plan to expand it to help more people who don’t have easy access to a vehicle or transportation if the initial launch is successful. APH also has a mobile vaccination program that is helping vaccinate people in senior living facilities, he said.

“We’re not reaching 100% of the people that we need to,” Crookham said. “We know that our demand in terms of call volume is still greater than the supply of staff that we have to answer all the calls, and I expect that to continue.”

He expects that people 50 to 64 years old, who recently became eligible, will have an easier time navigating websites to schedule appointments. But he acknowledges that barriers for many Texans will remain persistent.

“I still expect us to have technological issues that we'll have to face,” Crookham said.

Disclosure: Rice University has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.