ALBANY COUNTY — With nearly 65 percent of Albany County residents over the age 65 having received a full COVID-19 vaccination as of April 6, the county is outpacing both the state and the nation to inoculate its at-risk populations.

Only six counties, the largest of which have only one-third the population of  Albany County, in New York have immunized a higher rate of their senior citizens than Albany County, whose strong numbers appear to be due in part to several county-led initiatives. 

Across the state and nation, vaccination of elderly people got a boost because federal guidance dictated vaccinating nursing-home residents first. In New York State, the guidance, for 1a, also dictated front-line hospital workers be vaccinated, which is a group typically younger than 65 — all forces beyond the control of county government. 

However, it appears that decisions Albany County was able to make made a difference in having more elderly residents vaccinated than in most New York counties.

Early on, when the federal government started distributing vaccine doses to states, Albany County enlisted United Way to talk seniors through their questions and insecurities by dialing 2-1-1.

In addition to its mass-vaccination site, the county also set up pop-up clinics in rural and inner-city communities where residents, particularly the elderly, may not drive or have the confidence to venture further.

Albany County also set up an online pre-registration system to end what the county executive called “the Hunger Games” as residents — some of them seniors without computer skills — had trouble securing vaccination slots on state sites.

Finally, the county formed a partnership with Mohawk Ambulance where medics travel to public-housing sites to vaccinate homebound seniors and have also staffed pop-up clinics.

 

 

 

 

Pre-registration in Albany County

In the early days of the state’s fractured rollout effort, it was a challenge to connect senior citizens with vaccination locations, said Mike McLaughlin, Director of Policy and Research for Albany County Executive Daniel McCoy. 

As the county fielded calls from residents and advocacy groups looking for some guidance with the process, its Department of Aging began to compile contact lists of eligible individuals as well as of the groups that could “get the word out to seniors about available vaccines,” McLaughlin said. 

In addition, the county began reaching out to senior-housing organizations to determine the best locations to set up immunization sites. And when the vaccine supply did arrive, the county partnered with Mohawk Ambulance on a senior-housing vaccination effort.

There’s a pretty small window of time in which a vaccination can be administered, McLaughlin said, so when a local provider, for example, Rite Aid, would find itself in possession of 100 additional shots on day five of the vaccine’s seven-day lifespan, it would reach out to the county for help. And the Department of Aging, which, working from its contact list, would be able to find concentrations of individuals eligible and in need of a vaccination, he said.

Things were a little haphazard and slapdash during the early stages of the vaccine rollout, McLaughlin said, but the county was consistently able to provide residents to providers with excess supply. 

But it was the deployment of the county’s online pre-registration system that would both streamline and speed up the vaccination process.

Pre-registration has been a “huge success,” McCoy said.

The county launched its pre-registration option in January, and the online site allowed people to select from a list of chronic health conditions so then, when the state made those conditions eligible, the pre-registrant would be notified with an appointment date. 

About 38,000 people have used pre-registration, McCoy said. 

“As we’re pulling off the list, it’s a home run,” he said. Yes, there were complaints, he conceded, but often the reason was that the complainant’s cohort had yet to be approved for vaccination.

Albany County recently extended the option to residents of Schenectady and Rensselaer counties. 

“I wish the state of New York did this on a statewide level,” McCoy said. “What we did here in the county,” with pre-registration, “but again, it’s making it personal and bringing it to the people.”

Approximately 41 percent of Albany County’s 307,117 residents, or 126,257 residents, have received at least one vaccine dose, according to April 6 state data, while over 27 percent are fully vaccinated; statewide, about 33.8 percent of all residents have received one dose and approximately 21.2 percent are fully vaccinated; and nationwide, those numbers are 32.6 percent and 19 percent, respectively.

The county has been responsible for administering or reallocating close to 40,900 first- and second-shot doses as of April 6 — while its administered nearly 26,000 first and second doses at its Times-Union Center and Albany Capital Center vaccination clinics.

 

Partnerships 

McCoy said Albany County partnered with emergency-medical-service providers from the towns of Guilderland and Colonie to administer immunizations to homebound residents, and with Mohawk Ambulance on vaccinations in Watervliet.

In mid-March, Guilderland Emergency Medical Services received 95 of the county’s 500 single-shot COVID-19 doses from Johnson & Johnson; this week, it was 200 first doses of the Moderna vaccine.

McLaughlin said the pre-registration system’s mapping and analytics capabilities allowed the county to identify high-density areas where residents wanted, but had yet to be vaccinated.

The county was able to use the pre-registration system to set up several of its point of dispensing, or PODs, McLaughlin said, from the Hilltowns to Watervliet to municipalities in between. 

Just this past weekend in the city of Albany’s Pine Hills neighborhood, the county set up a POD “because that ZIP code area had a very high level of pre-registered individuals who still hadn’t gotten a vaccine,” he said.

McCoy said, “We went to pockets of the county that it was easier for local people to come there, and they were with people in their community and they were dealing with people in their community that made it feel more safe and secure for them.”

In January, Albany County partnered with the United Way of the Greater Capital Region to alleviate its health department from having to take calls from residents who had questions about vaccines.

There are a lot of senior citizens who have problems with navigating the internet — that’s where 2-1-1 came in, McCoy said; the United Way was able to talk seniors through pre-registration and answer any questions or concerns they had about the process. 

 

Helping people

where they live

Before Albany County even began vaccinating residents, one of the biggest problems it faced, McCoy said, was: Where did the people most affected by the virus live.

It was the county’s Black, brown, and senior citizens’ communities, he said.

The county’s first-in-the-state walk-up COVID-19 testing sites were located in the city of Albany’s South End, Arbor Hill, and West Hill neighborhoods. “We knew it was effective,” McCoy said. “Now, luckily it wasn’t as bad as it was downstate … But why wasn’t the state doing walk-up testing in these communities where it was the biggest problem?”

And people by and large are parochial, he said; they don’t want to have to venture to mass-vaccination sites like the Times-Union Center, Washington Avenue Armory, or the University at Albany.

When the federal government was setting up its mass-vaccination site at the Washington Avenue Armory, McCoy said, the county set up a POD two blocks away at a church. “We’re lining up” a significant “number of people,” McCoy said, “they like that, they like the smaller PODs, they like to get in and out, they don’t want to be around a lot of people.” 

But the vaccine rates in the county’s minority communities are extremely low.

Just 7.7 percent of Black residents, 6.3 percent of Asians, and 4.1 percent of Hispanic or Latino residents have received at least one vaccine dose, according to state data; for the county’s white residents, that number is over 85 percent.

Communities of color have a general and not unfounded lack of trust in government, McCoy said, so it’s on government to bring the trust to them, which means setting up vaccination sites in their neighborhoods. And it also means buy-in from local elected officials, McCoy said, which has been happening.

Because local politicians have personal relationships with community leaders, McCoy said, who in turn are able to push residents to get vaccinated.

In addition, the county has aired public-service announcements aimed at its minority communities, McCoy said, adding, “Another one is coming.”

The vaccination rates coming out of minority neighborhoods may also be under-reported. 

Some residents in those communities are simply skipping over the box marked, “race,” on their registration forms, according to McCoy spokesman Cameron Sagan. He said that they are “filling out some of the information that’s required, like contact information and name. But we’re finding that they’re not self-identifying race and ethnicity. And that’s actually been buried out in some of the data.” 

Approximately 20 percent of registrants aren’t self-identifying, Sagan said.

 

Empire Center analysis

The Empire Center reported last week that, “in the race to vaccinate its oldest and most vulnerable,” 43 states had a higher percentage than New York of residents over 65 years old who had received at least one vaccination shot.

In contrast, the state was better at administering a first shot to all residents over 18 years old — it ranked 24th — and to those between the ages of 18 and 65, where it ranked ninth.

“The disparity suggests that New York’s vaccination policies and procedures are giving younger people an advantage relative to other states,” the Empire Center posited, and noted that the “ratio of younger to older New Yorkers who have received a first shot is 1.75-to-1, the seventh highest in the country.”

One reason for the state’s high first-shot ratio among its young, the Empire Center suggested, was “the process for finding and scheduling an appointment, which gives an edge to the computer-savvy.”

April 6 data from the Centers for Disease Control show New York State has already improved its vaccination rates since the April 2 Empire report, moving from 44th to 42nd with its first-shot immunizations of residents over the age of 65, and with the percentage of population over the age of 18 who have received at least one vaccination dose, moving from 24th to 22nd.