How ‘Pharmacy Deserts’ Hinder Widespread COVID-19 Vaccination

More than 390,000 people have died in the United States as a result of the COVID-19 pandemic, and the number of new cases is currently surging in many parts of the country. After nearly a year of fighting this battle, many of us are emotionally exhausted, desperately dreaming of a return to some sense of safety and normalcy. And hope appeared on the horizon, thanks to the Pfizer and Moderna vaccines. President-elect Joe Biden has promised to deliver 100 million (2-shot) doses in his first 100 days in office, though reports released on Friday reveal that upcoming vaccination plans will be delayed by the surprising absence of a promised federal vaccine stockpile.

According to new research from GoodRx, whenever these vaccines do become available, they are likely to be unevenly distributed due to "pharmacy deserts," or areas where populations have reduced access to the pharmacies tasked with the vaccine's administration.

Pharmacy deserts are defined as areas in which residents have to drive a considerable distance to reach a pharmacy and/or where a large number of people share one pharmacy. The former typically occurs in rural or low-income areas while the latter typically occurs in densely populated regions.

Los Angeles, for example, is considered a pharmacy desert, despite its many pharmacies, simply because its population density requires a large number of people to share each future vaccine site. And the city's pharmacies aren't evenly distributed, either; additional research from the University of California adds that there are areas without nearby pharmacies in Los Angeles, and that they tend to have large numbers of low-income Black and Latino residents. This problem is not unique among big cities, and as a result, racial injustices are expected to contribute to disparities in vaccination access, just as they've contributed to greater vulnerability to the virus among certain populations. In other words, those most likely to get sick and die from COVID-19 may face the greatest barriers to vaccination.

According to GoodRx's research, the distribution of 100 million vaccines would result in the vaccination of 15.7 percent of the American population. But this does not mean that 15.7 percent of every county will be vaccinated. On the contrary, percentages are projected to vary wildly based on a region's pharmacy access, and approximately half of the country will experience vaccination rates of less than that 15.7 percent after the first 100 million vaccines are distributed. More alarmingly, nearly 200 counties in the country actually have zero pharmacies, which means they will not be able to vaccinate any of their residents if pharmacy sites alone are relied upon to deliver the shots.

When these lowered vaccination rates occur, the risk of virus transmission will remain high. This is why cities like Los Angeles are opening additional vaccination sites in order to lower dependency on pharmacies. But lower density areas are unlikely to see sites such as those cropping up in high-density areas, which means other solutions must be identified. Not everyone, after all, can drive a distance to get vaccinated; they may not own a car, be too unwell to make the trip, have trouble obtaining time off from work, etc.

The most recent COVID-19 relief package approved by Congress does specifically includes funds earmarked for aiding in the distribution of vaccines in underserved areas. President-elect Joe Biden has proposed an ambitious $1.9 trillion relief package that would to increase such spending if passed, too. And in some areas, local nonprofits and other organizations are assuming a role in vaccination distribution to fill in the gaps. In New York, for example, a task force composed of Black civil rights leaders has formed with the specific intention of increasing vaccination access in Black communities.

Not every community will be remembered in this way, however, and vaccination equality will presumably be as challenging to achieve as other forms of health care equality in the U.S. Vaccination deserts are, after all, emblematic of a larger disparity in care, as pharmacy access is essential to the health of a population generally, and not just as it pertains to COVID-19 vaccine access. In this specific case, however, inequality in access means that the hope for safety from COVD-19 may be, at least for some time, a privilege elusive to many.