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Covid vaccine ‘deserts’ and tech woes: Publix’s Florida rollout highlights risks as retailers play a larger role

  • Grocery story chain Publix is a key part of Florida's Covid-19 vaccine strategy.
  • It has unique advantages, such as its pharmacy staff's experience giving vaccinations, convenient locations and a business that's designed for efficiency and profitability.
  • As retailers become a bigger part of the vaccine's rollout, however, states could reinforce inequities by expanding access for people who live near the stores and make it harder for lower-income, minority and rural residents who live in pharmacy or food deserts.

A Publix supermarket and Pharmacy in Fort Myers, Fla.Jeff Greenberg | Universal Images Group | Getty Images

In Florida, hundreds of neighborhood grocery stores have become cornerstones of the state's Covid-19 vaccination program.

Publix was tapped by the governor's office in early January to administer shots to senior citizens and other priority groups as part of a pilot program. In about a month, hundreds of thousands of people have flocked to the Florida-based grocer's website, hoping to snag an appointment. Starting next week, Walmart and Winn-Dixie stores in Florida are poised to receive vaccine shipments as part of the federal expansion.

By teaming with Publix, the state sought to capitalize on the natural advantages of the private sector: The grocery chain already has pharmacists trained and ready to give the shots. It's designed for efficiency as a company that relies on large shipments of groceries and medications. It administers other vaccines, such as for the seasonal flu and shingles. Its locations are familiar to many Floridians who live near a store or already fill prescriptions or pick up milk there.

Yet, the partnership has become a lightning rod for the many criticisms about the broader vaccine rollout. It has sparked a debate about how to fairly and efficiently administer a vaccine that's in short supply, and it illustrates a challenge that could play out across the country.

'A vaccine desert'

As retailers play a larger roll in the vaccine's rollout, they could exacerbate the divide between wealthier, White communities that have stores nearby and lower-income, minority and rural residents who do not. The technology used for signups also has created a hurdle for some groups.

All the while, the emotionally charged messages on social media, where families searching for appointments share feelings of deep relief and disappointment, will continue to stoke the conversation.

"One of the positives of using private companies is more locations, but one of the disadvantages is they're profit maximizing," said Emma Boswell Dean, an assistant professor of health management and policy at University of Miami's Herbert Business School. "They're going to be in the neighborhoods where they can make money. So you have communities hit twice. You're a food desert. Now you're a vaccine desert."

The supermarket chain's locations are a long drive from many low-income and Black neighborhoods across the state, according to an analysis by the South Florida Sun-Sentinel. That creates another barrier for those who don't have a car or time off from work.

"It's almost like we're missing the populations who are also most affected by Covid throughout the crisis, and that's something that is a lightning rod to a lot of people," Dean said.

The vaccine rollout has already been uneven. Most of the nearly 13 million people given at least one shot of a Covid vaccine within the first month of distribution were older, White and female, according to a study by Centers for Disease Control and Prevention.

Yet Covid has had a disproportionate toll on Black Americans. Black Americans have died from Covid at 1.5 times the rate of White people, according to data compiled by the COVID Tracking Project, which is run by journalists at The Atlantic.

Answering the call

Other retailers, including Kroger and Texas grocer H-E-B, have started to administer the vaccines at some of their locations as they get doses. This week, the Biden administration said it will increase shipments to states and start sending some doses directly to retail pharmacies, including the country's largest drugstores CVS and Walgreens, which will give shots at some of their stores.

For the retailers, the vaccines are a money-making opportunity as well as a way to be good corporate citizens. They get reimbursed for each dose by the government or health insurers and can drive sales by drawing more foot traffic.

Meredith Beatrice, a spokeswoman for Florida Gov. Ron DeSantis, told CNBC the governor's office was in touch with several retailers but Publix was first to answer the call and could quickly mobilize vaccination sites. She said Florida's ability to launch new partnerships depends on its vaccine supply from the federal government.

Along with working with Publix, Beatrice said Florida has helped county health departments open nearly 80 vaccination sites, turned Miami's Hard Rock Stadium into a vaccination site, and launched new partnerships to offer the shots at places of worship in underserved areas.

Publix spokeswoman Maria Brous said in a statement that its stores are just "one facet to the Governor's overall strategy."

Finding arms to jab

Florida has administered the vaccine more rapidly than most other populous states. It also has been quicker to add its many seniors to the priority list, even if they have to wait for an appointment.

Nearly 3.7 million vaccines were shipped to Florida as of early Thursday. Only California and Texas have received more, according to the CDC.

Florida has distributed 10,354 doses per 100,000 people as of Thursday. That puts it behind more than a dozen smaller states and territories like Connecticut and West Virginia, as well as New York, but ahead of California and Texas.

Dean, the University of Miami health management professor, said the Publix partnership is a part of the reason for Florida's success. She said Florida's decision to expand eligibility increased demand and wait times but made it easier for vaccine administrators to find arms to jab.

Since Publix administered its first vaccines in Florida on Jan. 7, it has given more than 100,000 doses. The demand is overwhelming. Each store averages about 120 doses per day of the Moderna shot.

It's now offering the shots at 325 stores across 23 counties — more than 40% of its nearly 750 stores in the state with pharmacies. And it also provides vaccinations in Georgia and South Carolina.

The government, not Publix, determines who can administer the shots and the number of doses it gets, Brous said.

"It's supply and demand," she said. "It goes back to there's more demand than supply and that is frustrating, I'm sure."

That can best be captured by how quickly the appointments fill up. When Publix opened up reservations for 48,900 appointments two weeks ago, the spots filled up in 2½ hours, Brous said. At any given time that morning, more than 300,000 people were in the website's virtual waiting room.

Waiting and hoping

Landing an appointment can feel like winning a lottery ticket. Vaccination sites have posted signs and taped recordings for phone lines, warning customers that there's no vaccine surplus and appointments are needed.

At Publix, Florida residents must sign up online. This means, staring at a computer screen for hours, hitting refresh, to fill out forms. Appointments typically open up at 6 a.m., after the company confirms the number of doses it has and frees up slots based on that total. People wait in a virtual waiting room, which helps manage the heavy web traffic. If they get past that, they must move quickly to sign up for a spot before they fill up.

The system has prompted frustration and concerns about access, especially for seniors who aren't tech savvy and don't have a neighbor or family member who can assist.

Jeff Groob and his wife, Kathy, were among the hundreds of thousands who recently logged on shortly before 6 a.m. to get a spot his mother in West Palm Beach, Florida. Sitting in bed in their pajamas in Kentucky, they each pulled up Publix's website and stared at their laptops. Four other family members in other parts of the country did the same.

They got lucky. A few days later, Lee Groob drove half a mile to her nearby Publix and got her first shot.

"It was a huge weight lifted, a huge relief," Kathy Groob said.

For Lee Groob, 87, the pandemic has been an isolating experience broken up only by Zoom calls with family, occasional socially distanced games of bridge on an outdoor patio and swimming laps in an outdoor pool.

"I never realized how difficult it would be," she said. "You deal with it, but instead of getting better, it gets harder."

With the first vaccination, she said she feels closer to being able to resume the activities she enjoyed before the pandemic like flying to visit her family, whom she hasn't seen in a year. But it also stirred up some jealousy among friends who are still waiting their turn, and felt the assistance she received gave her an advantage.

 "I think it's just because she didn't get it," Lee said, about the reaction a friend had. "She was online, too, and she was so desperate for it."

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