Shelters struggle to vaccinate homeless people

PITTSBURGH — Light of Life Rescue Mission had a vaccine clinic planned to help vaccinate homeless people earlier this month. The shelter, which operates short- and long-term programs for the homeless, as well as addiction recovery and employment assistance, planned to administer the single-shot Johnson & Johnson vaccine. Then, about three hours before the April 13 event was supposed to start, news broke that use of the vaccine had been paused.

The shelter quickly shifted gears and administered the Moderna vaccine instead, said Jerrel Gilliam, executive director. But the development altered Light of Life’s vaccine strategy, as clinicians had to inform patients, many of whom were had no housing, that they needed to return for a second dose.

“It is very frustrating,” Gilliam said. “For homeless shelters across the nation, this was part of our strategy to use in the camps, because of the one shot. It has yet to be seen how long this will go on and how this is going to impact that, but it definitely is a blow to those of us working in this community.”

U.S. health officials later lifted the 11-day Johnson & Johnson vaccine pause, but many of the challenges facing shelters and the homeless during the pandemic will remain. From the beginning of the pandemic, homeless individuals have been especially vulnerable to COVID-19 transmission. Congregate living in shelters poses many of the same risks of transmission as in nursing homes and correctional facilities. Studies show homeless people are more likely to contract severe cases that require hospitalization and death, due to the prevalence of several health issues and difficulty following public health guidelines.

The virus’ spread in homeless communities creates an added danger of overcrowding of hospitals and emergency rooms, Gilliam said, because homeless individuals aren’t as likely to have health insurance or a primary care physician.

Shelters have had to significantly alter their processes to keep people safe. And as vaccine availability improves, those workers are still grappling with hesitancy and difficulty reaching a transient population.

“These mass events that are happening are wonderful, but when you’re dealing with the population that we are dealing with, they have multiple barriers they have to overcome,” Gilliam said.

Early on, shelters and health providers in Pittsburgh collaborated to take a proactive approach, many reimagining how meals were served, capacity limits and strategies for outreach in homeless camps. Several partnered with the Allegheny County Health Department, the region’s hospital systems and federally-qualified health centers to provide testing and, later, the vaccine.

But shelter operators said vaccine distribution has been frustrating at times, dealing with a bureaucratic system and shifting eligibility definitions.

Even now, when all Pennsylvanians older than 16 are eligible, there are still challenges to getting the homeless population inoculated. Many homeless individuals don’t have adequate access to transportation, childcare or the internet — making it difficult for advocates to spread the word about clinics and get people registered.

Outreach teams must make regular rounds to homeless camps and communicate with community leaders to find neighborhoods with populations that need vaccine.

There is also prominent vaccine hesitancy in the population, said Annette Fetchko, executive director of Bethlehem Haven, a shelter offering services mostly to women.

“It’s been very challenging to get the word out, but we’re doing our best,” Gilliam said.


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