Grab a vaccine appointment, then face the next hurdle: how do you get there?

The airport says a lot about Cortez, Colorado: The single-engine planes that fly into its single-room airport can accommodate a maximum of nine passengers. The city of around 9,000 people is best known as the gateway to beautiful places like Mesa Verde National Park and the Four Corners Monument. But covid vaccines made Cortez a destination in its own right.

“We flown a couple in to get their vaccine from Denver, which wasn’t available in the greater Denver area,” said Marc Meyer, director of pharmacy services and infection control for the Southwest Health System, which owns Denver clinics and community hospital, Cortez. Others come from neighboring states and even California, Florida, and the Carolinas. “They’re all coming back for their second dose,” he said. “Because it’s so hard to get into the cities.”

As vaccines are now available to the general public in large parts of the country, the privilege of easy access is becoming increasingly important. In extreme cases, vaccine tourists can use funds to intercept vaccinations, as Forbes has reported, for example in Israel, the United Arab Emirates and even in Cuba, where advertisements are offered. “Mojitos and vaccine. “On the other hand, some people have a hard time getting a vaccine appointment a few miles away.

Around the same time people were flying to Cortez to get their pictures, some locals couldn’t get to the vaccination sites, Meyer said. This was especially true for people who are at home or homeless.

That’s why Meyer and his colleagues developed a kind of SWAT vaccine team made up of paramedics and a handful of ambulances with vaccine bottles. The team visited about 40 homebound. For about 30 people homeless in the area, Meyer grabbed leftover doses of the single-dose vaccine from Johnson & Johnson from a nearby county.

But he said he didn’t know if his team reached everyone who wanted vaccines. “The problem with health inequalities in rural areas is that there is no data,” he said. “It would be really helpful to know how many people have transportation problems.”

A KHN analysis of the Colorado Department of Health data shows that by the end of March, approximately 43% of Coloradans who received their first doses and had addresses on file received those recordings outside of their home country. At least 60,000 Coloradans – about the same number as in Grand Junction, the largest city in western Colorado – received their first dose of vaccine 50 miles or more as the crow flies from their zip codes.

And the state has vaccinated more than 20,000 people from overseas – tourists, traveling nurses, cross-border commuters, and others whose primary residence is elsewhere – about 1% of the total number of people who received their first doses in Colorado as of April 1.

Other states have noted similar migrations. In Missouri, for example, there was an exodus of urban residents into rural areas in search of vaccines, leading critics to say that the doses had been misallocated in ways that neglected cities like St. Louis.

However, traveling for a vaccine requires money, flexibility in terms of time, and a vehicle. Transportation was a health concern even before the pandemic, said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials. Researchers writing in the American Journal of Public Health found that in 2017 alone, 5.8 million people in the United States delayed medical care because they lacked transportation. This group was disproportionately poor and had chronic illnesses.

According to Freeman, access issues are likely misrepresented as vaccine hesitation. Even some who live in cities with sturdy public transportation and hail services have jumped through tires to get to a vaccine appointment.

Bob McIntyre, 81, lives in Denver in an apartment near a major freeway, so the traffic “sounds like ocean waves in the distance.” But he doesn’t have a car. “It’s just too expensive,” he said. Before the pandemic, McIntyre could walk or use public transport. With the coronavirus floating around, he’d rather not be locked in a box with a few strangers. “So I’ve become reclusive.”

Hail fighting companies Uber and Lyft have offered free rides to vaccine appointments, but McIntyre doesn’t feel safe using these services. He eventually found out about A Little Help, a nonprofit that offers everything from free gardening to rides for covid vaccine appointments. Volunteer drivers took him to his two vaccination stations, which were about 15 minutes from his home but would otherwise have been inaccessible.

Maggie Lea, program director at Mile High Connects, fears that others may not be as lucky. Your organization believes that more affordable and accessible transportation is key to a racially and economically just Denver – right now.

“There are people who may or may not already be motivated to get the vaccine,” she said. “If they don’t have access to transportation, or if it is particularly expensive for them to get there, or if it is a hassle for them to get to a vaccination site, we find they just won’t go.”

Transit systems can use federal Covid Relief funding to help people get their vaccines, said Amy Conrick, director of the National Center for Mobility Management.

In West Texas, the SPARTAN public transportation agency offers free rides to secret vaccine appointments, including many at headquarters.

An Oxford, Ohio public health worker gets on a public bus to give the vaccine to seated residents. (William Snavely)

In Oxford, Ohio, older adults can be vaccinated by nurses on buses that hold oxygen tanks and wheelchairs. The city has set up a hotline that residents can use to plan their vaccine and transportation in one phone call.

“We live in a rural community where some people just don’t have internet,” said Jessica Greene, assistant city manager.

Transit systems need to speak to public health officials, Conrick said. “Now is the time,” she said. “Well, actually yesterday was the time.”

But many places lack decent public transport. For them, Freeman from NACCHO Covid Shots introduces himself, waiting wherever people gather, even at NASCAR races, as soon as the offer rises. “You should be able to turn in any direction and get a vaccine,” she said.

Currently, the demand is so high that vaccines will take up arms as soon as they become available, Freeman said, but soon public health officials will have plenty of vaccines but a shrinking group of people who want to make the effort to get them to get. “We’re going to make a tough stop where we look full-faced at the universe of people who don’t want to get the vaccine.”

Then, she said, it is even more important that vaccination is not only possible but also easy.

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