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The rumors hit local social media like a tornado on the morning of Wednesday, March 10.
Any adult living in a select number of Minneapolis zip codes could get their COVID-19 vaccine—right now!—the local tweets claimed. All people had to do was call one number, schedule an appointment over the weekend, and show up at the Allina Health headquarters in the Midtown Exchange building, on Lake Street, to get the Johnson and Johnson vaccine.
At first, social media posters shared information that claimed anyone 18 and older living in two zip codes—55404 and 55407—could sign up for a vaccine during Allina’s weekend drive. Then, two zip codes multiplied to 11 zip codes.
Many people, including myself, were surprised. Just one day earlier, Minnesota health officials and Governor Tim Walz announced the state would be opening up guidelines to allow vaccination for roughly 2 million more Minnesota residents. But they hadn’t yet opened eligibility to all adults—at least that’s what I thought.
After a few phone calls with state leaders and health providers, I learned Minnesota officials were indeed allowing health care providers, retailers, and drug stores to distribute vaccines to people outside of current eligibility guidelines who live in areas that rank high on the federal Social Vulnerability Index. This metric uses US Census data to measure the demographics, socioeconomic status, and transportation resources of different communities.
The point of the state allowing vaccines to be broadly distributed in these communities is to encourage more equitable distribution of the vaccine. So far, Minnesota’s own statistics show that people of color are getting vaccinated at lower rates than their share of the state population. That fact has led to calls from doctors, policy makers, and community members for greater equity in how the vaccine is distributed.
The confusion and tension over Allina’s event also revealed how another area—access to quick and easy information about available vaccines—can compound the problem of inequity.
So how did this all happen? Here’s what I found. In a news conference on Monday, Minnesota Health Commissioner Jan Malcolm said a handful of federally qualified health providers and community pharmacies working in high risk areas were distributing the vaccine with expanded guidelines. She did not give more specifics, however, when asked.
Indeed, the Phillips neighborhood where Allina is based represents a high risk area. It ranks .96 on the Social Vulnerability Index out of a possible 1. (By comparison, the well-to-do Minneapolis neighborhood of Kenwood ranks between .29 and .51 on the same scale, depending on Census tract.)
Using more familiar social measures, the percentage of people in Phillips living below the poverty line is nearly double the state average. Phillips is also diverse: More than one-third the population are immigrants and 70 percent are people of color.
In all, this profile would seem to fit the state’s guidelines to allow broad distribution of vaccines in neighborhoods high on the Social Vulnerability scale. Could this be what the Allina vaccine drive was doing by targeting people living in Phillips and nearby zip codes?
To confuse the matter even more, word of this special eligibility during the vaccine drive never officially came from Allina. Instead, the news spread through random people on social media. Were they right, or did they misunderstand the situation? And how did they find out in the first place?
‘Who is running the show?’
Just before noon on Wednesday, March 10, I called the Allina appointment number to check the availability for myself. An automated voice told me all phone lines were busy and to call back later. By now, I started to hear anecdotally that appointments for the event were already booked.
I rang up two people on Allina’s media relations team to figure out what was going on. Of course, I didn’t get through to them. (Their call traffic must have been crazy.)
Next, I made my way to Allina’s headquarters in Midtown Exchange. I got only as far as the front desk security guard, who seemed just as perplexed about the whole thing as I was, and politely told me I could not meet with anyone inside the building.
The next day, Allina spokesperson Tim Burke emailed me and attempted to explain what was happening. Allina’s weekend vaccine drive was, as I’d begun to suspect, targeting individuals living in Phillips.
Allina initially sought out people aged 65 and older for the drive, Burke wrote. Then, Allina started more broadly targeting the “communities of color and the limited English proficient population” that live in the area.
Burke added that people registering for a vaccine still needed to meet the state’s current eligibility requirements—for instance, individuals under age 45 and with diabetes and obesity—in order to receive an appointment. In other words, this event was not open to anyone 18 and older living in the selected zip codes.
Last Thursday and Friday, the whole incident took yet another turn. I started hearing new anecdotal accounts on social media, and from Sahan Journal multimedia reporter Ben Hovland, who lives in the area: Allina staffers now were calling people who’d registered for the event and cancelling appointments if they weren’t eligible under the established state guidelines.
One day, community members thought they were scheduled to get a life-saving vaccine. The next day they were left waiting again. Some people who got those cancellation calls grew furious.
“I am disappointed,” wrote one person on Facebook. “But in honesty, this was a bulls— way to allocate vaccine. If someone you know passed along a text and you call fast you might have gotten through? There was nothing equitable or scientific about it. Who the f___ is running the show?”
These comments, to repeat the obvious, appeared on social media—the same platform that had spread early word about appointment availability by zip code. They also appear to have come from a tech savvy population—adding more questions about how viable this method of information distribution is for achieving vaccine equity.
An Allina spokesperson told me that messaging about the event “got ahead of us” and acknowledged, “we probably could have done a better job.”
‘No roadmap or toolkit’ to ensure equitable vaccine distribution
So how did this all happen? Vivian Anugwom, Allina’s health equity program manager, told me that after the state announced it was opening up vaccine eligibility rules, “there was a little bit of miscommunication on how that was interpreted.”
Did Allina interpret the guidelines incorrectly? Not necessarily, Anugwom said. To get the word out to the community about this vaccine drive, Allina worked with multiple “trusted community messengers” such as the Cultural Wellness Center, a nonprofit in the Phillips neighborhood. But Anugwom didn’t fault the “community messengers” for the confusion either.
(A voicemail to the Cultural Wellness Center wasn’t returned before press time. When I visited the location last week to ask a few questions, no one was present in the office.)
“We’re still trying to figure out what happened,” Anugwom said.
It’s not clear how many appointments Allina ended up cancelling; the company didn’t provide that number before press time.
‘As we’re trying to get the word out, we’re learning’
In the end, nearly 800 people got vaccinated during the drive, according to Allina’s data. Eighty percent of them came from the Phillips neighborhood, according to Anugwom.
Allina did not disclose the racial or ethnic breakdown of people vaccinated during the event. As a result, it’s hard to gauge how far this drive went toward achieving vaccine equity. Allina did note to me that patients who got the shot listed numerous countries of origin, such as Ecuador, Mexico, Nicaragua, and Somalia.
Allina is planning to offer more drives like this in the future. Will they be just as confusing for the community? Allina officials hope not. Anugwom said Allina staffers will be agile and “pivot when needed” to make sure people in need of the vaccine have access to it.
“There’s a lot of talk about equity and ensuring equitable access, and to be honest there’s no roadmap or toolkit for this work,” Anugwom said. “So as we’re popping up these events and as we’re trying to get the word out, we’re learning.”
At least one other health provider in Minneapolis recently opened up the vaccine to additional patients in the name of equity. Starting last weekend, the People’s Center Clinic & Services, a community health clinic in the Cedar–Riverside neighborhood of Minneapolis, started allowing existing patients to get vaccinated if they’re 50 years old and over and experience a “social determinant of health.”
People’s Center spokesperson Paula Guinn described an example of a “social determinant of health” as someone without secure housing or someone without reliable transportation. She said many People’s Center patients fit under this category.
Expect more vaccine equity drives to happen as shots become available in the coming days and weeks. Officials promise they are learning as they go along, but that’s no guarantee that everything from here on will go more smoothly.