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For months, California planned how to get the COVID-19 vaccine to those hardest hit by the virus -- like communities of color where high numbers of people with service or manufacturing jobs living in crowded housing led to some of the city's highest infection rates.
Despite promises of an equitable rollout from Gov. Gavin Newsom on down, the effort is falling short.
Just look at the recent vaccine data from the L.A. County Public Health Department: Black Angelenos over 65 have the lowest vaccination rate of any racial group.
"It's unfortunate to say, but I wasn't totally surprised," said Rhonda Smith, executive director of the California Black Health Network.
One issue for many Black Americans is that structural racism has bred mistrust of the medical system, and that has not been alleviated by the messaging surrounding the coronavirus vaccines, she said.
Smith believes the phrase "Operation Warp Speed," the Trump administration's moniker for the vaccine effort, was a mistake.
"It created the perception that boom, let's just get the drug to market no matter what," she said. "The process was accelerated, but not rushed. And I think the perception is that corners were cut, the process was circumvented."
The science underlying the Moderna and Pfizer vaccines is not new; they rely on messenger RNA technology, which has been studied for over a decade, according to the Centers for Disease Control and Prevention.
The lack of transparent, accurate information about how the vaccines were developed has contributed to hesitancy in communities of color, Smith said.
"They didn't talk about the fact that never before in the history of clinical trials, has there been this much diverse participation, especially with the Pfizer vaccine," she said. "It had the highest level of participation for the African American community ever, for any clinical trial, at least to my knowledge."
People have a lot of questions about the vaccine, but few places to get accurate information, Smith said, noting that "a lot of communities ... are medical deserts [and] some are Wi-Fi deserts."
'A LOT OF MY FRIENDS ARE SKEPTICAL'
Gregory Williams lives in West Athens, an area in south L.A. that has one of the lowest vaccination rates inthe county. Just 7% of people there have gotten the first shot. In a number of the county's affluent areas, it's over 20%.
A semi-retired finish carpenter, Williams has lived in L.A. his entire life. He's 64, with health issues including damaged lungs from years of smoking.
Williams knows a number of people who have gotten the coronavirus, and he thinks he had it in December. He never got tested to confirm it, but he lost his sense of smell, a telltale sign of the virus.
"To this day, I can't smell anything," Williams said. "Put a bottle of perfume under my nose, I can't smell it. I'm hoping it comes back."
The CDC says reinfection is a possibility over time, especially with the new COVID-19 variants in circulation.
But despite his age and health condition, Williams still doesn't yet qualify for the vaccine.
At the same time, he's been hesitant about getting it. And he says he's not alone.
"A lot of my friends I've talked to, they are skeptical, really skeptical," Williams said. "You don't know if this is good or bad, you don't know what to trust."
He has questions about getting the vaccine if he's already gotten the virus, but he's waiting a few weeks until his next doctor's appointment to ask.
Williams knows of other people who have been vaccinated, including his elderly mother. But even if he decides to get immunized once he's eligible, he's not sure how to make an appointment -- a problem that's further complicated by the fact that he doesn't have a smartphone or internet.
"I'm like a lot of people, you know, I don't use a computer, we don't even have a computer in my home," Williams said.
'WE'RE SEEING SOME HESITANCY, NOT RESISTANCE'
To reach people like Williams, St. John's Well Child and Family Center, which operates a network of South L.A. clinics, set up a phone line for patients who don't have internet so they can make vaccine appointments.
It has 15 operators to explain that the vaccines are safe and effective, said CEO Jim Mangia.
"That's one of the reasons we set up the vaccine command center. Most of the calls are questions," he said, adding, "we're seeing some hesitancy, but we're not seeing resistance."
To help spread the word about the vaccines, St. John's is buying TV ads and sending people out into the community to talk, Mangia said.
"The more education we do, the more we engage with people, the more willing they become to getting vaccinated," he said, noting that "the more people we vaccinate, the more people will be open to it."
But snagging appointments remains difficult. The state's problematic online booking system, MyTurn, won't allow vaccine providers like St. John's to target specific populations. That's led to some Black and Latino seniors getting shut out, even if they have internet access.
Mangia expressed frustration at seeing appointments get snapped up by "vaccine chasers" -- healthy people from wealthy, mainly white areas who have the time to wait for appointments to open up.
"There was a line of vaccine chasers down the street," he said. "They took appointments before our receptionist could enter ... seniors [from the neighborhood]. They literally walked up with their iPhone or their laptop [and said], 'I have an appointment.' They literally took it in real time right in front of my face."
SEARCHING FOR SOLUTIONS
Mangia's frustration with MyTurn is shared by L.A. County Public Health Director Barbara Ferrer.
"Ideally you have an appointment system that allows you to just be able to have the people you want to make appointments at that clinic.," she said. "Right now MyTurn doesn't allow anybody to do that."
To try to fix the problem, the state has hired Blue Shield to take over California's vaccine distribution.The company says it will divvy up supply using an equity algorithm. How that will be calculated has not been shared with the public.
Allowing walk-ins at vaccination clinics and even going door to door in some neighborhoods may be the solution to vaccinating more people in L.A. 's hardest hit areas, Ferrer said. But that depends on the county getting more vaccine doses.
"We've been limited in going door to door because we can't vaccinate everybody in the household yet," she said.
The newly-authorized Johnson & Johnson vaccine may help. It's just a single dose, and can be stored in a refrigerator, making it an attractive option in hard-to-reach areas.
Gregory Williams feels more comfortable with it than the other vaccine options.
"If Johnson & Johnson came out with the medicine, I believe I would take it," he said.
Williams is more familiar with the company, and he likes the idea of just one shot. Of course once he does qualify for the vaccine, he'll still need someone to help him set up an appointment.
