Dee Wynne of Liberty, Missouri, started registering her 87-year-old mother, Barb, for a COVID-19 vaccination on multiple websites as soon as she could. Filling out the online forms would have been impossible for her mother, who doesn’t own a computer. 

“I couldn’t have done it on my own,” said Barb, who asked not to use her last name for privacy. “I’m surely not the only one that doesn’t have a computer. It does make it difficult for some people, the older people especially.”

Despite filling out multiple vaccination sign-up forms, Wynne finally scheduled an appointment for Barb by visiting Truman Medical Center in Hospital Hill. Two days later, Barb received the first shot of the COVID-19 vaccine — her second appointment is scheduled for this week.

As family members help older parents and relatives with the vaccine registration process — from signing up for the vaccinations to driving to appointments — they’re finding the path to vaccination can often become a tangled web of online forms hosted by state and local health departments and medical providers. 

But what might be an easier task for people with Wi-Fi and a computer is an obstacle for those without, particularly older adults. In the middle of a pandemic that has been deadlier for older adults, and without assistance from loved ones or a social services organization, conducting the vaccination sign-up online is a process that could shut out the very people who need the vaccine the most, experts say.

According to the American Community Survey, an estimated 23,144 adults ages 65 and over in the Kansas City metropolitan region do not have an internet subscription. Even more adults in that age range — about 37,665 — don’t have a computer at home. 

James Stowe, director of aging and adult services at the Mid-America Regional Council, the planning organization for the Kansas City region, said folks 85 and older particularly struggle with digital access. 

“We really observe that those with the lowest resources, those who would be most impacted by COVID, and are most likely to have poor outcomes are the least likely to be able to access digital registration tools, digital appointment tools, etc.,” Stowe said. “They’re kind of being left behind.”

Adults ages 65 and over are currently eligible for the COVID-19 vaccine as part of Kansas and Missouri’s vaccination rollout plan. According to Missouri’s COVID-19 vaccine dashboard, adults over 65 years old make up 82.9% of residents who have received at least one dose of the vaccine as of Feb. 15. In Kansas, residents 65 years old and over make up 46.2% of residents who have received at least one dose as of Feb. 15. 

Local health departments are already seeing how hosting the vaccine sign-up form online creates obstacles for those without internet access. The Kansas City, Missouri, Health Department recently stated that the agency had received more than 1,200 voicemails from people who needed help with the city’s COVID-19 Vaccine Contact Form. 

Digital obstacles

Delma Morgan, 82, is eligible for the COVID-19 vaccine, but she doesn’t have a computer or an email address. That’s where her daughter, Amy Morgan-Rodgers of Kansas City, Missouri, came to help.

After signing up her mother and her family for COVID-19 vaccinations through the Platte County Health Department website, she later received a robocall from Liberty Hospital saying Delma was eligible for the vaccine. But the robocall provided the link to a website for scheduling the appointment so quickly that Rodgers couldn’t write it down all the way.

After calling Liberty Hospital’s COVID-19 information line, Morgan-Rodgers successfully scheduled her mother’s first COVID-19 vaccination appointment.  

“My mother never would have been able to do that — she’s very hard of hearing,” she said. 

For people who want to sign up for a COVID-19 vaccination appointment but cannot do so online, calling their local or state health department is a second option. But registering for the vaccine over the phone is not a perfect workaround. Even local health departments have been getting bogged down by an increase in phone calls. 

The Kansas City, Missouri, COVID-19 Vaccine Contact Form is online. The form requires a phone number, and an email address is optional. 

Missouri residents can sign up for the vaccine through the state’s COVID-19 vaccine navigator website. The sign-up form requires an email address. Kansas does not have a statewide vaccination sign-up form like Missouri. Instead, vaccine forms are hosted through local county websites, and scheduling is conducted through local health providers. 

Cost can also be an obstacle for older adults, particularly those who live on a fixed income from Social Security or Supplemental Security Income. In Kansas City, Missouri, about 9% of adults 65 years old and over live below the poverty line, according to census data. 

As director of the Don Bosco Senior Center, Anne Miller knows that many of the center’s older adults struggle with cell phone and internet costs, and many have scarce resources. She said even retrieving a voicemail message can be difficult for them.

“The people that we serve are very limited, and many do not have family who can help them get registered,” Miller said. 

Laura Gilman, director of older adult services at Jewish Family Services of Greater Kansas City, faced difficulties of her own when trying to schedule COVID-19 vaccination appointments for older clients who couldn’t do it themselves — she couldn’t use her email address to schedule more than one appointment. 

“There were so many barriers in this system that, first of all, assumed that people had digital access,” she said. “And secondly, assumed that people had an email address.”

As local leaders and health departments also work to address concerns about the vaccine, Stowe said the digital obstacles facing older adults can exacerbate that hesitancy. 

“It makes them feel that the systems in place have not considered them and it doesn’t provide them the choice of access that they need to get the vaccines effectively,” he said. 

In Prairie Village, Kansas, Polly Revare and her sister teamed up to ensure their 87-year-old mother would receive the COVID-19 vaccine. Though their mother owns a computer and uses email and Facebook, Revare said she doesn’t think her mom would have been able to navigate the COVID-19 vaccine rollout. 

She said older adults without any assistance are more likely to be out of luck, particularly with difficult-to-navigate vaccine websites.

“If you have someone to help you, then you’ve got some backup, and you can get what you need,” Revare said. “But otherwise, you may not.”

Non-digital solutions

Thinking about the older adults living independently who may not know how to register for a vaccination appointment online, local and regional organizations are working to ensure that those facing obstacles to the vaccine are still able to receive it. 

This week, the Mid-America Regional Council launched a COVID-19 vaccine hotline to serve adults over 60 in the Kansas City region. Stowe said the governor’s office provided the resources to establish the call center, which will be staffed by community organizations, city government and local nonprofits. 

“We’ll take their request by phone, answer their questions and get their info to put them in the registry,” Stowe said. “For anyone who can’t be notified of their appointment, we’ll notify them when their appointment is scheduled and make sure they can get there in time.”

Social services organizations like Jewish Family Services have also been dedicating resources to helping older adults, from the first step of registering for an appointment to the final steps of traveling to and from the vaccination site. 

Morgan-Rodgers was notified about her mother’s second vaccination appointment via email. When her appointment comes this Saturday, Morgan-Rodgers and her husband will accompany her to the facility and back. 

Morgan-Rodgers said for older adults with a support network, getting the COVID-19 vaccine will be a success. But not everyone will have that same access. 

“I think that seniors who are isolated,” she said, “who don’t have family members that check in on them frequently, or who are more isolated in the community, are not going to be able to get access to the shot.”

This story has been supported by the Solutions Journalism Network, a nonprofit organization dedicated to rigorous and compelling reporting about responses to social problems.