Advocating for equity in the state's COVID-19 vaccine program


On Saturday, February 6, I published a 4,300-word blog post that highlighted many of the problems with the state's vaccine rollout and the work we've been doing to advocate for improvements. Thank you to everyone who read that communication — and a special thank you to everyone who responded with positive feedback and/or questions.

Over the past week, my attention remained focused on the vaccine rollout effort. On Friday, the Boston Globe gave the Baker Administration an "F" on its first-ever COVID-19 vaccine report card — and while some improvements have been made in recent days, new problems have also emerged — and overall, the vaccine program remains inequitable and chaotic, even as efficiency is finally improving.

We're now 37th in the nation

Last week, I highlighted the outrageous fact that Massachusetts was ranked 48th in the nation in terms of our overall utilization of the vaccine doses we've received from the federal government.

This week, those numbers have improved somewhat. According to yesterday's New York Times, we are now 37th in the nation, with 72% of the doses we've received having been used. 12% of our state's population has received at least one shot, and 3.8% of the population is now considered fully vaccinated. These metrics are updated daily via the New York Times.

While I am pleased to see week-over-week improvement in the overall efficiency metric, I worry that several of Governor Baker's recent decisions seem geared toward improving efficiency at the expense of equity.

Granted, there may be some tension between efficiency (i.e. utilizing all of our available vaccine doses as quickly as possible) and equity (i.e. prioritizing vaccine for those most at risk and communities most impacted). However, I believe we must strive for efficiency and equity at the very same time. It's possible to achieve both — but it takes great leadership and sufficient resources — two things that have been sorely lacking (and this especially goes for the leadership coming from the Baker Administration and the former Trump Administration).

Improvements to the state's website

As noted in my previous post, I was one of the first to highlight the work of Olivia Adams, a healthcare technology worker and Arlington mother of two, who, while on maternity leave, built her own vaccine website that vastly improved on the state's official website. Adams' website lets users know where and when vaccine appointments are available on one convenient page — something the state's website failed to do.

Rep. Jay Livingstone and I drafted a letter to the Governor asking him to support Olivia's efforts and to incorporate the essential functionality she demonstrated into the state's own website. In response to our letter, the Baker Administration scheduled a meeting with Olivia, and this past Friday, Governor Baker unveiled a new vaccine website that incorporates the crucial features Olivia originally demonstrated.

Here's the link to the state's new website:

It's good the state responded to our calls for website improvements, but the credit goes to Olivia who stepped up and showed everyone what's possible. For my part, I've been calling on Gov. Baker to offer her compensation and an advisory role.

Advocating for asthma (and other health conditions and frontline occupations) to be included in Phase 2

On Tuesday, I wrote to the Baker Administration to advocate that asthma be included among the list of health conditions that qualify for vaccination during Phase 2, and I issued the following statement:

The CDC has recognized that people with asthma may be at increased risk for severe illness from the virus that causes COVID-19. Since we know there’s disproportionately high incidence of asthma in many of the same communities that have been hardest hit by the pandemic — Black, Brown, and immigrant communities in particular — places like Chelsea, East Boston, and even East Somerville in my legislative district — it is incumbent upon the Baker Administration to revisit their priorities for the sake of equity. At the very least, an additional step should be added to Phase 2 to capture all of the health conditions and job descriptions that have so far been overlooked in the state’s vaccine rollout plan.

I have also been making efforts to advocate in support teachers and school staff, a variety of other frontline workers, people who are immunocompromised because of HIV or some other health-related condition, and people with disabilities. All of these folks should, at the very least, be moved into Phase 2 and prioritized ahead of the "general public" in Phase 3.

On the same day that I issued my statement, I was joined by Congresswoman Ayanna Pressley, Attorney General Maura Healey, and other colleagues in calling on Gov. Baker to accommodate people with asthma in Phase 2. There's more about our advocacy here in the Boston Herald.

Governor Baker launches "the Buddy System" — and unsavory ploys to obtain the vaccine immediately ensue, making national headlines

On Wednesday, Gov. Baker announced the vaccination companion program, which quickly became known as "the Buddy System."

Basically, anyone who accompanies a person age 75 or up to certain mass vaccination sites is now eligible to receive the vaccine themselves regardless of age, occupation, or health status. The Baker Administration said the goal is to make mass vaccination sites like Fenway Park and Gillette Stadium more "age friendly." But in my view, this is also a tacit admission that these sites are failing to serve many of our most vulnerable residents where they are at.

While I can appreciate how a vaccination companion program could be useful in specific circumstances (see below) — I spoke out about my concerns with the program in a statement I posted on Wednesday afternoon:

Today, the Baker Administration announced that an individual who accompanies a person aged 75 and up to a mass vaccination site will themselves be eligible for the vaccine, regardless of their age, occupation, or health status. While I appreciate how this change will enhance the overall efficiency of the vaccine program, it seems less helpful (or even dubious) in terms of advancing equity. Life expectancy in some of the areas hardest hit by COVID-19 is actually less than 75 years old. And not everyone has a child, friend, or caregiver who has the time and the means to drive them to a mass vaccination site. While I can see the value and practicality of this move (particularly for couples where one partner is over 75 and one is just under 75, etc.), this must be paired with a more intensive focus on working with the local partners that are best equipped to serve our most vulnerable where they are at. Otherwise the alarming inequities of the state’s vaccine program are apt to persist

Almost immediately after the Baker Administration's announcement last week, ads started appearing on Craigslist and on social media platforms, whereby healthy, young residents were offering hundreds of dollars and free gifts to any senior who would let them be their "vaccine buddy."

Not only does this create obvious inequities (because people who are less vulnerable but more privileged may now be able to get their shots ahead of people who are more vulnerable or less privileged), it also raises concerns about individuals who may try to take advantage of seniors who are looking for a ride to a mass vaccination site.

A pile of criticism ensued, with everyone from the Washington Post, to the New York Times, to the Wall Street Journal quoting my critique of this policy. I also went on NBC10 Boston to call on Gov. Baker to revisit the policy. The idea of a targeted companion program could have its place — but it shouldn't be a free-for-all that privileges younger/healthier folks with time and resources ahead of our most vulnerable residents. In my view, the Baker Administration should limit the scope of the companion program and focus more on partnering with the local entities that can help deliver the vaccine to places that are locally convenient to seniors.

Governor Baker shuts off vaccine supply to hospitals

On Friday, news emerged that the Baker Administration had instructed hospitals to not schedule any further vaccination appointments, putting them on notice that they would not be receiving any additional vaccine for at least another two weeks.

To be sure, this is a nuanced issue — but the way the Baker Administration has handled it raises serious concerns. On the one hand, we know that over the course of the early weeks of the vaccine distribution program, some hospitals were a bit slow to distribute the doses they were allocated, as we heard about overall distribution rates in the range of 65 percent. So I can appreciate the Baker Administration wanting to push for greater efficiency.

However, the Administration's expectations were never made entirely clear — and by late last week we started hearing reports that some hospitals were being forced to cancel vaccine appointments. Overall, this decision is going in exactly the wrong direction when it comes to equity. We should be sending more vaccine doses to hospital systems that have trusted relationships with communities most impacted, such as the Cambridge Health Alliance. I worry that right now, Governor Baker is willing to abandon efforts to achieve equity in an attempt to improve the state's overall rate of efficiency. But we can't turn our back on the communities most impacted.

My advocacy on this point was recently covered in Cambridge Day, and in yesterday's Boston Globe, a related issue of homebound seniors was highlighted — it noted how seniors with disabilities who are living in congregate settings have generally been offered the vaccine — but individuals who are of a similar age and have similar health conditions and are living at home have too often been left out of the process.

This morning, I also received word that the City of Somerville was told its Health Department would not be receiving any vaccine doses this week. Again, this raises concerns. The Baker Administration continues to emphasize mass vaccination sites — but it's our local health departments and community hospitals that appear to be best positioned to reach our most vulnerable and disadvantaged residents in an equitable fashion. Today, I am once again joining with colleagues to make this point to the Baker Administration.

Cambridge and Somerville Resources

The state has also expanded times for the 2-1-1 Vaccine Scheduling Resource Line. Residents eligible for the vaccine may call 2-1-1 between 8:30 am and 8 pm Monday through Thursday or 8:30 am and 5 pm Friday through Sunday. This change comes after my colleagues and I advocated for expanded access.

In conclusion, this blog post represents just a sample of some of the issues that have been raised with the vaccination program and the efforts I've been making to respond since I last wrote. While the Baker Administration appears to be making some progress in terms of the efficiency of the overall program, the Governor also appears willing to sacrifice equity for the sake of efficiency, and this is not acceptable or fair to our most vulnerable residents or to the communities most impacted by the pandemic.

As always, please do not hesitate to reach out with any questions or concerns. I plan to participate in a call with Secretary Sudders on Thursday where I will continue advocating for our state to strive for equity and efficiency in the vaccine program.
Yours in service,
Rep. Mike Connolly