Transportation is essential to ensure the most vulnerable residents of King County receive vaccinations.
Those without secure transportation experience insecurity, confusion, and complexity when arranging transportation to vaccination sites, especially when they must travel outside of their local areas. This challenge is particularly poignant for older adults and people with disabilities who lack support systems. These vulnerable populations deserve the highest priority.
Transportation can be a barrier to securing vaccinations for many reasons.
- Travel Distances: Individuals may need to travel longer distances, sometimes beyond their familiar neighborhoods and across county lines, to receive their vaccine. This requires them to have a transportation option that can take them long distances.
- Inflexible Appointment Times: Complex schedules and inflexible vaccination appointments require individuals to arrange transportation multiple times. When considering carpooling or shared rides, there is no existing mechanism to help find other riders getting vaccinated within the same timeframe.
- Complex Transportation Options: Individuals are forced to wade through a complex set of transportation options. Without a working knowledge of these options, finding one that works for them can be insurmountable. Outreach, education, and up-to-date information on transportation options is essential to assist individuals with anxiety and confusion about how to navigate transportation choices for their vaccinations. Connecting those who seek vaccinations to those who know transportation resources is crucial in getting people vaccinated. The intricacy of understanding what transportation options are available is even more difficult when resources are not communicated in culturally inclusive ways, like by being translated and shared in community information networks. Similarly, without coordination and outreach to educate people on their options, riders may end up incurring or being inhibited to seek vaccinations if the only transportation option they know of is one where they must travel farther and cover the full cost of the trip.
- Public Transit Availability: Vaccine sites are not always nearby or accessible for individuals using public transit. When some transportation services are closed or on reduced schedules during the weekend and evenings, getting to appointments is even harder. Even when sites are near public transit, their location and availability may not be well advertised and understood by the public.
- Perceived Risk and Safety: People seeking transportation to vaccine sites may be afraid for their health and safety due to COVID-19. They must be assured that protocols for social distancing, sanitation, and cleansing are rigorously observed before they are willing to book a ride and travel.
Furthermore, transportation providers also experience obstacles when providing services.
- Cannot Accommodate Drive-Through: Drive-through only vaccine sites do not allow for drop-offs or walk-ups. This severely limits available transportation options such as public transit, paratransit, and transportation network companies like Uber and Lyft. When transportation providers are unable to remain on-site for the duration of a rider’s vaccination and after-care, drive-through only sites restrict access for many people seeking vaccines.
- Vehicle Capacity Constraints: Social distancing requirements limit the number of passengers providers are able to transport at the same time.
- System-Wide Capacity Constraints: Transportation providers are stretched thin. They may lack funding when trying to accommodate additional people needing rides to vaccine sites. Many providers in our region are constrained by a lack of resources to get people to vaccination sites. Without additional funding, expanding services is difficult or impossible. Providers struggle to balance the call to increase capacity while maintaining regular service.
With all these transportation barriers, marginalized groups are excluded from receiving their vaccines. Strengthening transportation accessibility and resources is essential as King County plans for the imminent arrival of a greater supply of vaccines and the opening of more large-scale vaccination sites. Those seeking vaccinations and transportation providers seeking to assist them require special consideration from Seattle, King County, and Washington State Department of Public Health to meet the needs of the most vulnerable.
In response to these challenges, below are recommendations for filling gaps related to transportation to vaccination sites. The King County Mobility Coalition’s Access to Healthcare Committee makes these recommendations to both the Washington State Department of Public Health and local public health departments. We believe that, when implemented, these recommendations will reduce and remove transportation barriers to better serve people most in need of vaccines.
- Improve Transportation Planning for Large Scale Vaccination Sites: All vaccine sites should accommodate walk-ups. Drive-through-only sites significantly limit access. For sites without walk-up options, barriers can be reduced by offering shuttles to house walk-up clients while waiting for their vaccinations and being monitored during post-vaccination. Express lanes and/or private entrances for transportation providers would enable efficient rider delivery, drop-off, and return trips without vehicles delayed in long wait lines. Large scale sites should be located close to public transit options. Walk-up sites should designate pick-up spots for riders waiting for their rides after receiving their vaccines. Transportation providers need short turn-around times to serve the largest number of riders.
- Acknowledge Transportation Insecurity into Vaccine Appointment Process: In the current system, individuals with transportation barriers either do not seek vaccination or are tasked with figuring out their transportation issues on their own in an already fragmented process. This procedure means it is difficult to gauge just how prevalent transportation barriers are to vaccine access. More importantly, the burden of securing transportation is placed on individuals themselves without assistance. With more opportunity to field transportation needs when booking vaccine appointments, individuals could be referred to a single source to coordinate a transportation solution specific to each client. During intake, Public Health staff and medical providers should work with those seeking vaccinations to find transportation through this referral process.
- Vaccination for Drivers: Paid and volunteer drivers perform essential services by transporting eligible riders to their vaccine appointments. As they provide this service, they must protect their health and safety. We recommend the inclusion of paid and volunteer drivers in the early phases of vaccine access alongside other essential worker groups.
- Keep Transportation Providers Informed: Transportation providers must be informed about planned vaccination sites, projected openings, and infrastructure, including pop-up sites, new clinics, and large scale vaccination locations. Public Health should notify transportation providers as soon as details are known and contracts signed. Lead time is essential for providers to integrate their services with outreach, publicity, and preparing their staff to serve people seeking transportation to these new sites.
Mobile clinics have been a successful mode of vaccine distribution that mitigates transportation barriers for vulnerable communities. Increased mobile clinics represent a valuable opportunity to meet people where they’re at and best serve needs.
Hopelink Mobility, the King County COVID-19 Vaccine Mobility Task Force, and the Access to Healthcare Committee are committed to working with relevant partners to ensure transportation is not a barrier. We will continue to collect information on needs, coordinate solutions, and advocate for equitable vaccine access. We find solutions and pilot initiatives in collaboration with public health officials, medical providers, and mobility stakeholders to build the most efficient and caring system for people with special needs. We are grateful for the collaboration of stakeholders in our region and believe we can address unmet needs through these coordination efforts.
The King County COVID-19 Vaccine Mobility Task Force includes representation from the following agencies:
- Catholic Community Services
- City of Kirkland
- Hopelink Mobility Management
- Hopelink Non-Emergency Medical Transportation
- King County Metro
- MV Transit
- Seattle and King County Aging and Disability Services
- Seattle and King County Public Health
- Sound Generations