I Worked A Vaccine Hotline. Here’s The Big Problem With The System.

by Joseph K. Clark

For the past three months, I worked the vaccine registration hotline for a county in suburban Pennsylvania. From the first day, I worked for the hotline, I was struck by the magnitude of a systemic inequity among vaccine recipients and hopefuls: computer access and literacy. I was happy to get the job: I was unemployed at the time, applying for any available position, but in the throes of the winter COVID-19 upswells, nobody was hiring. The call center was a lucky find: It didn’t pay grand, but it was well within my skill range, not dull, allowed me to work from home, and allowed me to help people. I bought a $30 headset from Target, underwent one day of training, and then was ready to work. The title “vaccine registration hotline” ended up being a misnomer ― I couldn’t register people over the phone, only coach them through the online registration process.

I could transfer people to the Health Department’s mainline (whose unnavigable menu generally kicked people back to us). I could answer questions about vaccine locations, timetables, and schedules. Or I could transfer people to the phone registration line. If a caller had a problem, we could write a report and submit it into the ether (well, to our boss, who turned it over to the county health department ― we worked for a contracted third party and had no way to contact the county or anyone at it directly).


In theory, accommodation was available for those without internet access. The county’s senior services program had set up a phone registration line to register people over the phone if they had no computer. However, we were explicitly told (and sometimes reprimanded) to only transfer people to it if they had no computer or internet, not if they had a computer and didn’t know how to use it. We couldn’t break protocol because our calls were listened to by administrators.

So when someone started their call by saying, “I’m on my computer, but I can’t figure out how to get to the website and register,” my shoulders would sag because I knew it was likely I couldn’t help them. I tried my best to talk people through the web registration process, and I was pretty good at spelling out the web address, talking through the steps, and explaining what they could expect next. I probably guided about 80% of callers to register successfully.

But some people lacked even the computer skills to follow directions. Some people couldn’t figure out where the taskbar was or how to open a tab. MANY CALLERS HAD NO IDEA when I asked questions like, “What browser are you using?” many callers had no idea. My only hope was that these callers would call back again, claim they had no computer, and be transferred to the phone registration line.

But that was not a solution for many callers ― the two registration processes were separate. So if a person wasn’t registered, they could be written either way, but if they had been reported over the computer but, for instance, lost computer access or weren’t sure their registration had gone through correctly, then neither the phone registration people nor we had any way of checking their status for them. I worked the hotline for the first two months; the county was vaccinating people in category 1A, anybody over 65, people with qualifying medical conditions, and healthcare workers. The county had drastic vaccine shortages, meaning it was vaccinating people who had registered on Jan. 13, the first day that registrations were open. For over a month of that time

That would have been exasperating enough on its own. Still, communications from the county were spotty and inconsistent. The list frequently got shuffled out of order. People who registered on subsequent days were sometimes called before the county was through, with those who wrote on the 13th. Oh, and the entire web system shut down the day, and the clinics went walk-in.

All of this chaos is bad enough if you are an internet-savvy person who can figure out how to register with multiple providers and constantly check their websites for updates. But for seniors who were already overwhelmed by the county’s registration system and lacked the web skills to figure out alternatives, it was dread-inducing. I had callers cry on the phone. I remember one voice in particular, a hoarse voice repeating, “I think I’m going to die. If I don’t get this vaccine, I’m going to die.” There was nothing I could do but stay on the phone and try to be empathetic.

People middle-aged and younger vastly overestimate the ubiquity of computer literacy. While I would go to the internet to look up how to get vaccinated, many callers had found the hotline number on TV segments or in physical newspapers or paper county newsletters. Furthermore, we also overestimate the access to support. Many seniors who called lived alone or with their spouses, without family members or neighbors nearby to help them. Public libraries were not all open, and many people did not have access to transportation.

Of course, not all seniors lack computer literacy ― probably not even the majority anymore ― and not everyone who lacks computer literacy is a senior, but that’s the general trend. When public health infrastructure seeks to prioritize seniors, it is particularly irresponsible to make the only means of access to the Internet. It’s also worth mentioning that computer literacy wasn’t the only access problem people encountered. Due to the pandemic, many local public libraries have been closed, cutting off reliable computer access for the homeless, transient, or those who can’t afford a computer or reliable internet.

The county’s website is written in English, so if people didn’t know English, they needed someone to translate it. On the hotline, I connected to an interpretation relay service. The interpreters were usually excellent so that we could talk people through the website registration process, but they would still need someone to translate the email they got giving them the time and day of their appointment. Things are better now. The county got through its high-priority list and is now vaccinating people in all categories. Some walk-in appointments are available, which significantly expands access to those without internet access or literacy. It has a vastly improved web registration system, updated about halfway through my time there, and is much easier to navigate than the old one.

I was effectively laid off the same week I’d given my notice (I am happy to report that I have found a new job related to my college degree!) because the hotline received far fewer calls. So while things are better, they should have been better initially. If statewide vaccination registrations were more centralized, if we hotline personnel could create, access, and edit registrations ― if, generally, the whole system wasn’t set up exclusively to be accessed via the internet, with the phone an afterthought, more people would have had access to vaccines far sooner.

Many things have shifted online during the pandemic, I frequently hear this touted as a win for accessibility, and the internet is described as an equalizer. That can be the case. But systems set up to be exclusively accessed via ithe internet are not accessible to all people, particularly tenors. Other options must be equally viable and usable, not an inaccessible afterthought.

I hope this will be a lasting lesson of the pandemic and inform future public programming. I don’t think it will be, though. Internet access is becoming increasingly necessary to participate in society, and those who can’t keep up will continue to be left behind. Do you have a compelling personal story you’d like to see published on HuffPost? Find out what we’re looking for here, and send us a pitch!  Calling all HuffPost superfans! Sign up for membership to become a founding member and help shape HuffPost’s next chapter.

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