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Why flexible transportation is key to getting high-risk individuals vaccinated against COVID-19

Getting people like seniors, low-income earners and those without vehicles to COVID-19 vaccination centers safely and efficiently is a major challenge in many places. Here’s how on-demand transit can help.

Kristen Lau

Lack of adequate transportation is one of the major logistical challenges facing cities in their COVID-19 vaccination efforts. Without it, society’s most vulnerable — low-income groups, seniors and those with limited mobility — could miss their shot at getting their shot, says Kelley Coyner, a mobility consultant and senior fellow at the Center for Regional Analysis Schar School of Policy and Government at George Mason University.

“Across the country, many of the very people who need the vaccine most - essential workers, seniors who live at home and people with disabilities - don’t have access to a car or can’t drive. Getting the vaccine to centers is meaningless to them, if they cannot get to centers.”

Not just a vaccine problem

The transportation gap between people and healthcare isn’t new. In 2017, almost 6 million Americans delayed medical care because they lacked a ride. COVID-19, which has forced many transit agencies to slash fixed-route service due to declining ridership caused by the virus, has only exacerbated the problem.

That’s why, Coyner says, transit agencies need to think outside this paradigm. On top of service cuts, fixed-route might not always be accessible, in particular for people with mobility issues or those living in transit deserts.

“Pop-up (or ad hoc) options that are flexible and accessible like on-demand microtransit and non-emergency medical transit are needed to meet [vaccine and other healthcare] demand,”  she adds.

How transit agencies can create a dedicated vaccine service

Redirect resources

By its very nature, on-demand transit is flexible. That means the number of resources allocated to it aren’t set in stone; they scale up or down based on demand. It also doesn’t require completely new ones either.

Transit agencies looking to start dedicated vaccine transportation can take advantage of diminished fixed-route timetables and redirect underutilized fleets and drivers towards demand-responsive vaccine transit. They don’t necessarily need to have an existing microtransit or paratransit service to make this happen. This also allows transit agencies to pilot the on-demand concept without having to invest in new infrastructure.

A microtransit software platform however can help to properly reallocate resources the right way. Rhine-Neckar Transport (rnv) in Mannheim, Germany is borrowing two vehicles from its upcoming microtransit fleet to provide a standalone service to the elderly who want to get vaccinated through Spare. The vehicles are still part of the microtransit system but are blocked off for the vaccine-specific service. Rnv’s vaccination program was launched ahead of its microtransit service, giving the agency and certain residents time to get familiar with the concept.

Create pop-up zones

With on-demand microtransit, transportation providers can work with cities and regions to create microtransit zones based on their vaccine response strategy. The number of stops within a zone can increase or decrease with demand and also move throughout the zone. New zones in areas that previously did not have transit access can also quickly be created, which could be particularly useful in rural communities, which often lack public transportation.

In Texas, Star Transit extended on-demand microtransit coverage outside its regular service zone to those with confirmed vaccination appointments by offering free rides. It also added a Saturday service to meet demand and is allowing riders to travel to any vaccination site in the coverage area. Riders within the agency's regular microtransit zone, can also book the specialized transit through the agency’s STARNow app using a promo code to get their no-fare ride.

Deliver the right service to the right people

Not all people can walk or easily get to a transportation hub. For those riders, a door-to-door service is necessary. Within the same service zone however, transit agencies may wish to have a stop set-up. Microtransit software makes this hybrid system possible. The same fleet is used throughout the zone but only those eligible for door-to-door pick-up and drop-off can book that option. Transit agencies can enable round-trip bookings only or provide flexibility by allowing riders to choose where they’d like to be dropped off once they’ve received their vaccine.

Bring the vaccine to the home

In the United States, almost 2 million people aged 65 and older are mostly or completely homebound and another 5 million have health conditions that make it hard to get out. In those cases, it might be necessary to bring the vaccine to them. But nurses don’t always have their own individual vehicle to get around, and vaccine storage requirements would make it impossible for them to take fixed-route buses. Dedicated or Non-Dedicated vehicles can be used to transport the vaccine and the personnel needed to administer it to neighborhoods where there is demand, ensuring that even the most vulnerable of vulnerable receive it.

What transit agencies can consider for their service configuration

Make scheduled bookings mandatory

Modern on-demand transit is all about getting transportation to people in real-time. However, for vaccination and other non-emergency medical transit, it makes sense to run service as pre-scheduled only. Agencies can require that all vaccination transportation be booked a set number of days in advance through a call-in booking system or by setting up booking windows in their microtransit smartphone app if they have one. This provides transit agencies with time to properly inform riders about their specialized ride, including any hygiene protocols they must follow, and screen them if desired.

In Lubbock, Texas, where Citibus recently debuted its vaccination transportation campaign, riders with confirmed appointments must book their travel at least 24 hours ahead of time either through its on-demand app or by calling in. All fleets in the agency’s microtransit service however can be booked for the service, which is offered at no-cost for the rider.

Restrict pooling/ridership

At-risk populations in particular might be hesitant to take regular public transit to a vaccination site because they are worried about contracting the virus on route. With demand-responsive or on-demand software, transit providers can set limits on the number of riders per vehicle at any time, ensuring proper physical distancing.

Rnv in Germany is limiting pooling to two riders per vehicle at a time. Together with extensive hygiene protocols, like mandatory masks and ensuring passengers are seated diagonally at a distance of over 5 feet, this will help mitigate the risk of transmission and put passengers’ minds at ease.

Segment services by risk

Software that allows transit providers to slot riders into groups can be used during vaccination transportation to ensure that groups that shouldn’t mix, don’t. For instance, a transit agency might not want to schedule a senior on the same shuttle as a frontline worker, who is more likely to be exposed to the virus on a daily basis.

Create an eligibility protocol

While vaccines are still limited to certain populations, transit agencies can use a customer relationship management (CRM) database together with scheduling and dispatching software to ensure that only eligible people gain access to the pop-up medical service. For instance, transit agencies could require riders to upload a copy of their vaccination appointment form in order for them to qualify. Booking agents can also verify these details over the phone and enter them in the customer database on their behalf.

Waive fares for certain riders

Low-income earners might not have the ability to pay for transit to a vaccination center but this shouldn’t keep them from receiving the vaccine. By qualifying certain individuals under a low-income program through an eligibility protocol, transit agencies can waive fares for these specific individuals and ensure more equity when it comes to vaccine rollout.

Many cities and regions are at the beginning of their COVID-19 immunization campaigns. But as the vaccine becomes more readily available and vaccines move closer to where people live as opposed to centralized locations, maintaining adequate community transportation will continue to remain important. That’s why rolling out a vaccination transportation program can be a first-step in improving an area’s overall transit system through on-demand microtransit.

Learn more about how Spare can help your transit agency create a new specialized microtransit service by checking out our vaccine transit solution or drop us a note at, and we’ll get back to you within a day.