About 25 percent of people age 65 and older have not been vaccinated against COVID-19, either because they are isolated, live alone, lack mobility, are not fluent in English, cannot access the Internet, have a disability, or belong to communities of color. 

The situation has become a major challenge at the local, state and federal levels in making sure that all those who want to be immunized have access to the necessary doses. 

Kim McCoy Wade, director of the California Department of Aging, said during a press conference held by Ethnic Media Services that "we're still in the middle of the pandemic," so there are challenges in immunizing the older adult population. 

She noted that, according to data from a month ago, in California, overall 3 out of 4 adults 65 and older have been vaccinated, however, rates vary by race, ethnicity and community. 

In that regard, he emphasized that the vaccination rate among those seniors over 65 in the Latino community is only 40 percent, while those in the 70-80 age group is even lower.

This, he said, despite the fact that they are the age groups in the community that have been most affected by COVID-19. The situation is the same for African Americans.

He noted that while it is true that the other communities do not reach 100 percent, they show better numbers, as 80 percent of Asian-Americans over 65 are immunized, similar to Caucasians, while that of Native Americans reaches 60 percent.

These gaps, he explained, have been addressed through state actions such as community vaccination sites, free transportation, language support phone lines, a website, and walk-in access to the vaccine. 

"We are trying to make it easier to find a vaccine," he reiterated, while explaining that such actions have been joined by various health officials who have gone to various communities to resolve doubts regarding immunization, cash drawings have been made for those who are vaccinated, in addition to gift cards. 

Sick older adults and people with disabilities have less access to the vaccine. 

For Dr. Louise Aronson, a geriatrician and founder of the aging optimization practice at the Osher Center for Integrative Medicine at the University of California, San Francisco (UCSF), healthier older people are more likely to get vaccinated than those who are not as healthy.

This, he said, despite the fact that "the least healthy people are the most likely to get a serious illness that requires hospitalization and die. 

He noted that in this pandemic, about 4 percent of U.S. seniors live in nursing homes and assisted-living facilities, yet they accounted for 34 percent of deaths nationwide.

And, he said, those older adults who lived in the communities and became ill with the coronavirus were taken to nursing homes, and because they did not have adequate protective equipment, they served as ideal places for workers to take the virus home, usually in low-income communities of color.

 "So yes, there is an increased biological risk with age and disability," he said. 

Aronson explained that older adults become invisible at a certain point because as they age, disability prevents them from leaving their homes, making it more complicated for the state to care for them, a situation that is exacerbated in the community of color. 

In addition, he noted that most of these strategies are Internet-based and "we know that the three communities with the least access to the Internet are the elderly, those in rural areas and those with English as a second language, immigrants and low-income people. 

He said the official publicity is designed to get parents to vaccinate their children, but it should also focus on children taking their parents, grandparents and family members with disabilities to be vaccinated.

Inclusion, the key to progress

Anni Chung, president and CEO of Self Help for the Elderly, which strives to promote independence, dignity and self-esteem for the elderly, said there is a lot of misinformation about the COVID-19 vaccine in limited-English-speaking communities.

At the beginning of the distribution of vaccines, all appointments were made via the Internet and the sites were only available in English, which made it difficult for immigrants, low-income people and seniors to access the information.

Faced with the situation, the organization she leads contacted the Department of Health to let them know that it was urgent and necessary to find other ways and alternatives to get the vaccines to the elderly where they were needed.

"Most people have been vaccinated, except for a last 20 percent who are very stubborn and somewhat stubborn about it, but we don't give up," he stressed. 

Hard blow to the African-American community

According to Cindy Cox Roman, executive director of HelpAge USA, a global nonprofit organization that promotes the well-being and inclusion of older people in the world's poorest communities, the voice of low-income African American seniors is not represented on the various panels on COVID-19 vaccination, yet they are among the most affected.

He noted that qualitative research conducted in recent months, which involved 32 African-American seniors with an average age of 70 across the country, but concentrated in Washington, D.C., Atlanta, the Contra Costa County area and Mississippi, revealed that a small group is against the vaccine, and another group is made up of those who would rather wait and see what happens before accepting immunization.

This, he said, due to inaccurate information, as these groups are dominated by television news or small social networks, and are part of a "lost generation" in the age of technological information, in addition to the fact that there are "gaps" in information sources in senior centers, libraries, or by elected officials.

"Families are not sharing accurate information across generations, few of the people we interviewed had talked to their adult children or grandchildren about the vaccine." 

In addition, there is a lack of trust in the health care system, as they consider that care is not equitable for black older adults. 

In that regard, she said the way forward for advancing the vaccine response is to ensure that vaccination sites are accessible to all, empower medical personnel to do greater outreach, improve the dissemination and quality of information as well as the channels through which it is disseminated, and publicize the increasing vaccination rates among African-American adults to reassure the community.

Finally, she said, the voice of older adults in the African American community must be heard to participate in the development of strategies to address health disparities within communities. 

Removing barriers to disability

Jessica Lehman, executive director of Senior and Disability Action, said people with disabilities have also been largely overlooked in accessing COVID-19 vaccination.

In the U.S., he said, there is not even information on how many people with disabilities have died from the virus, "which is a troubling sign of the lack of data and visibility of disability.

"The COVID pandemic is the most horrific manifestation of ableism - a form of societal discrimination or prejudice against people with disabilities - and ageism - stereotyping or prejudice against people because of their age - that I think most of us have seen in our lives," he said. 

He noted that during the most difficult stages of the pandemic it was assumed that older people and people with disabilities would be at the bottom of the priority list because of survival rates.

In light of this, Lehman questioned: do we value the elderly and the disabled being seen as less important and more expendable? 

However, he felt that there is a huge opportunity to put things right, "to change the way we look at disability and age".