New York’s vaccine rollout has been ruthlessly efficient, confusing and unequal

When I imagined the end of the pandemic, or at least the beginning of the end, it was always that first needle in the arm. Throughout a year of lockdowns and quarantines, I would daydream about that moment taking place in the centre of a big hall, surrounded by hundreds of others, perhaps inside a stadium or some other mass vaccination site. Invariably, there would be some kind of ticker tape parade afterwards, perhaps a sailor kissing a nurse.

Tens of thousands of New Yorkers will have experienced something not far off that scene, minus the parade and the sailor. But when my moment finally arrived, it came at a nondescript CVS pharmacy across from an auto repair shop in the middle of Staten Island.

It was by no means an anti-climax. Even there, waiting in the baby food and nappy aisle, I felt enormous gratitude and relief for the scientists who created the vaccine and the health workers who delivered it (and last but not least to Staten Island). But the experience also offered a small window in the inequity of New York’s coronavirus vaccine rollout, and of the American healthcare system’s approach to the pandemic.

It became apparent after a few conversations with my fellow vaccine hunters at the CVS in the neighbourhood of Great Kills — a ferry ride and two trains from my house — that most of the people queuing for their vaccine had travelled from Brooklyn and Manhattan, and the majority were on the younger side of 30-plus.

There was a reason for that. We had all been pulled to Staten Island by a dizzying online scramble for a vaccine appointment that erupted two days earlier when two million New Yorkers became eligible for a vaccine all at once. All adults over the age of 30 were given the green light to get the jab on Tuesday last week, which led us all to hop on the computer at 9am and begin a frantic search for an appointment on the array of different websites where it was possible to do so.

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There was the New York state health department’s website, which directed users to appointments at mass vaccination sites such as the Javits Centre, sports stadiums and schools. By mid morning there were no vacancies showing on any of them. Then there was New York City’s vaccine finder website, which listed all locations with available appointments in the city — some of which were already out of date or not working correctly. In addition to those official methods you could log on to the website of private pharmacies offering vaccines, large companies such as CVS and Rite Aid, along with smaller outposts.

I spent a good two hours refreshing several web pages at once, trying and missing appointments all over the city, until Staten Island became the only place with availability. It was little surprise then that it was crowded with young travellers from across the river for the following days. This rollout process, designed for speed and efficiency, was exclusionary to all but the most tech savvy and time-rich adults. How could a single parent have found the time to go through this process? How could someone working full time, someone without reliable internet access, someone without technical skills?

The appointment booking process was so convoluted that a Good Samaritan software engineer, Huge Ma, felt compelled to create a simpler version of the myriad websites out there to help people navigate the process. His website, TurboVax, pumped out realtime information about appointments as they became available. New York congressman Ritchie Torres said Mr Ma “managed to do what the federal government and what the local and city government failed to do with much greater resources.”

It was a baffling mix of private and government-provided care that has defined and complicated America’s response to this pandemic. It has its strengths, of course, but also significant weaknesses.

Across the country and here in New York especially, the vaccine rollout has been deeply unequal throughout. As early as January, data provided by the city found that white New Yorkers who had received the vaccine outnumbered Asian and Latino recipients by more than three-to-one, and Black recipients by four-to-one. 

A month later, only 12 per cent of the 210,000 New Yorkers who were over 65 and vaccinated were Black, in a city where Black people represent 24 per cent of the population.

In February, data on vaccine take-up by zip code found that a class gap also plagued the distribution. Vaccination rates in New York neighbourhoods with higher median incomes outpaced less well-off neighbourhoods. Mayor Bill de Blasio blamed “painful disparities” at a news conference. “Folks who have more privilege are best able to navigate this process.”

And so it was in Staten Island on that overcast Thursday. As I stood outside waiting my turn, confused locals looked at us, then at the sign reading ‘VACCINES AVAILABLE HERE’, and back to us again, before heading inside to buy their groceries. Some of them were unaware that the vaccines were being distributed in their own neighbourhood.

As a resident of New York only for the last year, and a Brit used to dealing with a government-funded healthcare system free at the point of care, it was an uncomfortable feeling. I spoke to friends in the United Kingdom who had yet to receive their first dose, but who were, even so, horrified at the way people had to compete for their appointment. Over there, they told me, people are simply contacted by the National Health Service when it’s their turn. The timing of their turn depends on their need, not on the ability to use a computer.

I’m sure many Americans might be conversely appalled at the long wait many Brits have faced to receive both vaccines. The UK, differing from the US, rolled out the first dose to as many people as possible before going full throttle on the second.

That is not to say that there wasn’t something special about that moment in the Great Kills CVS, a place for which I now hold a lifelong affection. I’ll remember sitting on a chair at the end of a quiet aisle while I waited 15 minutes for any side effects to show themselves, alongside my inoculated neighbours, all smiling with their eyes, to the sound of a checkout scanner.