Getting vaccinated in Pennsylvania

Approximate Reading Time: 6 minutes

The gymnasium at Montgomery County Community College set up as a vaccination center, winter 2021.

“[Yesterday, President] Biden announced that by April 19, more than 90% of Americans over the age of 16 will be eligible for a vaccine and will live within five miles of a vaccination site, including 40,000 pharmacies.” —Heather Cox Richardson, Letters from an American, 30 March 2021

This is great, but goes no distance at all in explaining or justifying why, as of yesterday, the only sure way to get an appointment for a vaccination shot (no choice as to location of the vaccination site, one of three major ones, and no choice as to date, never mind the type of vaccine that would be administered) was to be sure you were registered some time in January or February—and, as I write, in two days it will be, indeed, April. I am talking about those of us, and there are two of us in our household, who qualify by age or other ineluctable factors for being in the first wave of vaccination registration in our county. Pennsylvania, where that county is located, has elected, regardless of the county administration’s ability to handle the logistics, and regardless of the population size and distribution, chose to do it this way. It took the state two full months after vaccinations began in earnest to allow distribution from third-party providers equipped and qualified to administer vaccines in a safe and medically approved manner (like pharmacies and hospitals and medical centers). Distribution was slow and unreliable regardless, and it took the state a full six to eight weeks to ramp up.

I signed up, that is, I registered to be on a list for an appointment in a county-sanctioned vaccination center, on the last day of the deadline period for the initial round of vaccinations to be given. I received an acknowledgment of my registration immediately, and this message also was the opening salvo of weekly “updates” from the county of how the process was going. The messages were lengthy and detailed, but the bottom line report was, “slow and steady.” I received the information and identification materials I would need to appear for my first shot on a specified date, which turned out to be some seven weeks after the registration date deadline I had met. They did tell us it would take as many as ten weeks for this process, so I guess I am not supposed to complain about efficiency, never mind other indices of governmental administrative competence and performance.

I was told where to appear on that particular date, and I was given a choice of a time of day, with remaining slots for five minute intervals of each hour indicated.

The original two sites selected by the county, since expanded to three, are located in county owned or country-run venues (the original two are located in a county administrative buidling in the county seat, a town located about 15 miles from my home, and in the county community college campus, about the same distance away). Albeit true I live on the fringe of the county boundaries, located immediately adjacent (our house is located some 1200 feet or so from the county line) to the most densely populated county in the state, that of Philadelphia, the largest city in the state, and the fifth largest metropolitan area in the country, we are clearly not in the heart of things county.

I’ll interject here that Philadelphia has a minority population, out of two-and-a-half million of just shy of 40%, most of these residents being African-American or somewhat smaller minorities of people of color. You couldn’t tell that by walking the streets of our small town, literally yards away from West Philadelphia, a neighborhood which is even more densely populated by minority residents. We appear to be, because we are, a predominantly white middle-class suburb, which just happens to be in one of the small set of zip codes in this county, and which themselves happen to be in the top decile of the wealthiest zip codes in the entire nation.

We see a lot of black faces, but that’s because most of the jobs that predominate in public service markets: retail, fast food, groceries and beverages, etc. are filled by people of color. As we are so close to the division between city and suburb, and as we are more easily accessible to most of the kinds of businesses, including eating establishments, that the public frequents than one would find to be the case in the city (a condition counterintuitive to what you’d expect given the differences in density per square mile of private homes, especially in our suburb and those immediately adjacent, which are, except for political demarcations by precinct and ward and other jurisdictional determinants, identical). The ease of access and density of choices for where to get a prescription filled, or an order of hamburger and fries, or fried chicken, or a cheesesteak (the staple of the local culinary vernacular) is a function of the predominant mode of transportation for accomplishing any task more complicated than attending your immediate neighbor’s backyard cocktail party, the automobile.

So, day and night, our shops and restaurants are patronized in far greater numbers than by actual residents of our neighborhoods, by the residents of the city’s nighborhoods. The African-American, LatinX, and other minority populations of color are served in the common amenities and categories of purveyors of merchandise and refreshment nowhere closer by than within the borders of this county – Montgomery County – and that immediately adjacent, Delaware County. Though Delaware County is more middle class and lower and extends to the south to the state border with (as you might guess) the President’s home state.

What all this has to do with vaccinations is this. The sites chosen for vaccination administration centers are deep in the interior of Montgomery County, indeed are actually closer to the opposite boundaries of the county to the northeast and northwest than we are (given our proximity to the City of Philadelphia). Yet the members of our household given leave and registered to be vaccinated had to travel, because of the convoluted geographic routes to those venues, the better part of an hour to get to a point only 15 miles away by car. We are actually closer to sites, including medical care annex sites of the major medical center in downtown Philadelphia where we are both treated (these annexes and the medical center itself are between four and six miles away, on local streets and thoroughfares), where the vaccines are administered. However, because we are neither residents nor do we work in either Delaware or Philadelphia Counties, we are constrained by the regulations stipulated by the state government from having the vaccine administered to us in these nearby locations.

Such constraints are irrespective of supply and efficiency of administration in any one of these counties. It just happens Montgomery County, which has perpetually been rated by the monitoring done of all counties in the country by the New York Times as having a “very high risk” of Covid infection, apparently also has one of the worst records for rate of vaccination of county residents.

In turn, I’ll ask rhetorically, what does this have to do with the minority population density of Philadelphia and adjacent counties? I’ll answer simply by observing – and admittedly these are purely personal and anecdotal observations – that both I and the other member of the household who qualified for vaccination, and finally were able to have done so, at least, so far, for the first shot of two of the Pfizer/BioNTech vaccine assessed the unrelenting crowd of fellow citizens being processed and vaccinated in two different vaccination centers as being far and away predominantly white and (somehow a salient if merely collateral observation) as a whole, individually significantly overweight.

I’ll only observe further that I have long since noted that the whole American system of political division within an individual state by county is innately an ancient legacy of the effective modes of government that originate in the colonization of this continent by the imperial European regimes that bankrolled the exploration and development of these originally pristine and wild frontiers of virgin geography. And further, of course, the word “county” itself is feudal in origin, being the fiefdom of that noble taxonomy of lord called a “Count” (or, in the original French, “comte”), as in the Count of Savoy. With, obviously, no regard for how these divisions serve our needs as a nation – in all dimensions: political, social, cultural, financial and economic – we preserve the feudal order, and live with what seem otherwise to be the arbitrary dictates such order imposes on the daily lives of our citizens. And as various and unpredictable as the whimsey of the particular Count who was your lord in those olden days. I’ll leave it to you to figure out the rest insofar as to the implications that may be drawn.

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